Biomedical subjects
Publications and source records attributed to F Nagl.
Fat cell tumors of the uterus are extremely rare; they occur with an incidence of 0.03-0.2%. These tumors are almost invariably benign. We present the exceptionally rare case of a low-malignant liposarcoma of the uterus. The histogenesis of these tumors is not completely clear. In the literature, the theory of 'tumor metaplasia', a well-recognized phenomenon, is favored.
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For the near future two routine examinations by sonar for every pregnancy in Austria were announced by government. Therefore an analysis of 3076 ultrasonographic examinations of 1217 pregnancies seen in 1984 may lead to an estimation of the frequency of pathological factors to be expected. More than 90% of all pregnant women seen in our department for delivery or other indications had had sonographic examinations during pregnancy, 74% of them as outpatients. The most common pathological factors diagnosed were discrepancies between sonographic estimated and anamnestic gestational age (14.1% of cases), pathological fetal growth (11.0%), pathologics of placenta and umbilical cord (8.6%), pathological presentation (5.9%). Accompanying pathological factors as a cervical length less than 30 mm, an uterus myomatosus, uterine malformations, cystic adnexal masses were found in 1-2% of cases each. Fetal malformations and anomalies were seen in 0.8%. Problems arising from low frequencies of certain rare pathological findings, especially for their detection by office sonographiers or small departments, are discussed. For solution of such problems the multiple step programs as well as an intensive interdisciplinary local or countrywide collaboration is proposed. In Upper-Austria, such collaboration takes place organized by the collaboration group for antenatal detection of fetal malformations, which was founded in 1985 by the Upper-Austrian part of the Osterreichische Gesellschaft für Ultraschall in der Medizin (OGUM).
Between July 1st, 1975 and June 30th, 1985 9669 deliveries seen were evaluated according to parameters of obstetric efficiency, particular risk factors, perinatological proceedings including a trend analysis. A significant diminuation of perinatal mortality and morbidity could be registered. Since there has been an obvious augmentation of cases with higher obstetrical risks in the time mentioned, these results may be underlined positively. After all, the high taint of the results by preterm deliveries still remains an unsolved problem.
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In our series of vaginal breech deliveries the morbidity from hypoxia and acidosis showed no difference to the same type of morbidity in our series of breech deliveries by Caesarean section. The correct selection of cases, intensive monitoring during labour and the management of the second stage of labour as outlined in our paper are the most important perequisites which permit to plan and justify a vaginal breech delivery in present obstetric practice.
A critical study based on 3291 analyses of blood from the umbilical cord, and the consequences. In routine analyses acidosis (pH 7.10) was found in 2.03%. This percentage is considered too high. Protracted labor carries special risks. Conventional and intensive care supervision, when risks are foreseen, are often ineffective, since 48.8% of acidoses were recognized only post partum. More general intensive observation with internal cardiotocography and microinvestigations of blood appears to be the only way in which the frequency of acidosis could be decisively reduced.
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