Biomedical subjects
Publications and source records attributed to F Limacher.
The authors report on an extremely rare complication observed by them in association with uterus myomatosus, namely, rupture of a pedunculated myoma node during an examination under anaesthesia with subsequent haemoperitoneum. Basing on this case report, rare but dramatic complications in uterus myomatosus are recalled.
Changes of diagnosing foetal malformations via sonography are greatest with regard to the skull. Anencephalus or hydrocephalus are most frequent, whereas cysts are comparatively rare. In the case under report a large intracranial cyst was diagnosed during the 33rd week of pregnancy. After moderate size increase spontaneous birth of a normal boy occurred during the 38th week. Prenatal findings were confirmed post partum via diaphanoscopy, sonography, ventriculography and computed tomography. The definite diagnosis of the suspected arachnoidal cyst, however, could be established only at the age of 8 months on the occasion of craniotomy with fenestration of the cyst. The problems connected with prepartal and postpartal diagnosis of foetal intracranial cystic space-occupying growths and their management are shown on the basis of the case report and the references. Prenatally it is recommended to proceed along conservative and cautious lines. A warning is issued against exaggerated enthusiasm in trying to manage foetal malformations by means of interventions monitored by ultrasound.
Despite improved ultrasound methodology it is probably not possible to determine the fetal sex accurately prior to the twentieth week of gestation by ultrasound. The clinical significance of this non-invasive method of fetal sex determination is therefore still low. The technique and accuracy is discussed from studies of the literature and a personal investigation of one hundred and four cases.
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The first known case of a 20-year-old cystic fibrosis patient in Switzerland, ending at 40 weeks' gestation in delivery by cesarean section performed under peridural anesthesia is presented. Obstetric care of the patient was complicated by pneumonia during the 31st week of pregnancy. The epidemiology, pathogenesis and clinical symptoms of cystic fibrosis, the problems anticipated during pregnancy, delivery and childbed in patients with cystic fibrosis, and the questions surrounding therapeutic abortion and contraceptive counseling are discussed.
It is a well-known fact that pregnancy and parturition, as well as the post-partum period and puerperium, present special problems in multiparae. Hence, we compared 203 of our multiparae with the total group of 3251 parturients in respect of these parameters in a retrospective study. The results were as follows: Pregnancy of multiparae is characterized by an increased incidence of monosymptomatic or polysymptomatic EPH gestosis and by diabetes mellitus. In multiparae it was considerably less often necessary to induce labour than with the other parturients. There was in increased incidence of premature rupture, meconium-stained fluid, funicular complications, vagino-operative birth and delivery in sectio. Reduced desire to nurse the baby was significant sign in multiparae. There was also a significant increase in stillbirths and in the delivery of children with a birth weight of more than 4000 g. There was no increased incidence of monstrosities.
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