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Biomedical subjects

G K Döring

Publications and source records attributed to G K Döring.

At least 19 recordsLinked to original sources
PubMed1991

Effectiveness and acceptibility of the symptothermal method of natural family planning in Germany.

Throughout Germany, 851 women who were instructed in natural family planning participated in a prospective study. Of these, 255 women with 3174 cycles used only natural family planning for family planning and 274 women with 3995 cycles occasionally used barrier methods in the fertile phase. For natural family planning--only users, the Pearl rate for unplanned pregnancy was 2.3 and for mixed-method users 2.1. Most pregnancies resulted from unprotected intercourse during the fertile phase, and the use of barrier methods does not reduce risk-taking.

Body Temperature↗
PubMed1988

[Experiences with the sympto-thermal method of family planning].

Evaluation of 2,276 cycles in 439 patients who had been employing the double-check family planning method described by Thyma. The average length of the hyperthermic phase was 12 days. A tendency to longer hyperthermic phases was recorded in case of cycles of longer duration. In 74% of all cycles, the mucus peak was observed 1 to 3 days previous to the temperature rise. In 2,242 cycles, 3 pregnancies occurred which had not been planned, which corresponds to a Pearl index of 1.6. The temperature curves originally evaluated according to Thyma's criteria, were also assessed according to Roetzer's criteria. This analysis yielded 89.8% evaluable temperature curves according to Roetzer, in contrast to 77.8% evaluable curves according to Thyma. An additional disadvantage when using the "coverline" as suggested by Thyma, is the shortening of the post-ovulatory infertile phase which may occur occasionally.

Adult↗
PubMed1988

[Changes in breech delivery].

From 1965 to 1981, 1042 singlets born in breech position were recorded out of 25,004 deliveries, at the München-Harlaching City Hospital. The Caesarean section rate was of 48.3%, the perinatal mortality of children weighing more than 1000 g was 3.8%, the perinatal mortality of prematures born in breech position was 19.7%. We subdivided our group of patients in two subgroups: 500 breech deliveries from 1965-1973, and 542 breech deliveries from 1973-1981. In the first subgroup, the Caesarean section rate was 38%, the perinatal mortality 5.6%, and the perinatal mortality of prematures born in breech position 29.6%. In the second subgroup, the Caesarean section rate was of 57.7%, the perinatal mortality was 2.2%, and the perinatal mortality of premature breech deliveries 8.4%. Since the prospective management of delivery, the perioperative conditions, the reanimation possibilities, and the close contact to a newborn intensive care unit, remained unchanged throughout the entire observation period, we tend to correlate the different results obtained in the both subgroups with the different Caesarean section rates recorded. We therefore consider that the consistent prospective delivery management with ample indication to Caesarean section, is also in the Management of a breech delivery even more important than the obliged indication to Caesarean section.

Birth Weight↗
PubMed1987

[Conservative procedures in 64 pregnant patients with myoma: the course of pregnancy, labor, and the puerperium].

During this period, the number of deliveries was 28235. Our results contradict the wide spread opinion concerning the high risk of a pregnancy in a myomatose uterus. In two thirds of the cases, the pregnancies showed a normal course, this applying also to myoma nodes of 8 cm or more dimater. Threat of premature delivery was ovserved in 11 cases; in two cases premature delivery did occur. More than nine out of ten pregnancies reached the 38th week of gestation. Spontaneous delivery was twice as frequent as Caesarean section. This, however, does not apply to myoma nodes with diameters of 8 cm or more, in which case the frequency of Caesarean section represented 50%. Puerperium was normal in 47 cases; complications were observed in 13 cases due to retarded uterine retraction. In 2 out of 4 cases with atonic post-partum haemorrhage, curettage was performed. Pregnancies in a myomatose uterus are high-risk pregnancies which require close observation. Sonography plays an important role in such cases. One of the authors (D.) proposes high-dose gestagen treatment as a useful therapy when threat of abortion is observed in myomatose uteri. In cases of menacing premature delivery, hospitalisation and tocolysis are highly recommended.

Adult↗
PubMed1986

[Reliability of the vaginal diaphragm as a contraceptive method].

With a failure rate of between 2 and 4 in recent statistics, the vaginal diaphragm can be considered a relatively reliable method of contraception. The physician can therefore recommend this method as an alternative if, e.g., ovulation inhibitors are contraindicated and the patient rejects an intrauterine pessary. In such cases diaphragms are as acceptable as condoms, the more so because the two methods are completely harmless. (Table 9 summarizes the advantages and disadvantages of diaphragms.) Whether, in the final analysis, the condom or the diaphragm is accepted, will largely depend on whether the man or the woman assumes the responsibility for family planning. The physician can use his influence when explaining the contraceptive principle of the diaphragm and showing the patient how to use it to keep the failure rate to a minimum. The present authors consider that even today, good, objective counseling on reliable family planning is one of the physician's most important tasks in the sphere of preventive medicine.

Adolescent↗
PubMed1986

[Experiences with the Shirodkar-McDonald cerclage in the treatment of cervix insufficiency].

A clinical-statistical study of 1040 pregnancies after cerclage between 1965 and 1982. Over the same period 28,033 births were registered. Frequency of cerclage was 3.7%. Of 1682 pregnancies in the same patients without cerclage, 47.3% of the children survived, while of the 1040 pregnancies with cerclage, 92% of the children survived. The rate of abortion sank from 44% to 5.8%, the frequency of premature birth from 17.6% to 13.1%. The mothers' course of pregnancy, delivery and puerperium were normal. The relative frequency of Caesarean sections and vacuum extractions was slightly lower than that of the whole group. An attempt is made to ascribe the high success rate of 92% to the following facts: that in 75.4% of the cases, these were prophylactic cerclages; that in all cases the bladder was displaced; that, on the day of surgery, nearly all patients received a tocolytic slow drip infusion as prophylaxis; and that the low mortality rate (10.5%) among premature infants is due to excellent collaboration with the intensive care ward for premature infants in the same hospital. As regards indication, surgical techniques, antenatal counselling and management of delivery, the homogeneity of the group observed over this 17-year period is presumably another positive factor.

Abortion, Habitual↗
PubMed1986

[Report on 3,186 laparoscopic tubal sterilizations].

Between 1976 and 1984, 3,186 laparoscopic tubal sterilisations were performed in the Department of Gynaecology of the City Hospital at München-Harlaching. No death was registered. One severe late complication was observed, but its connection with the laparoscopic intervention is doubtful. 71 minor complications were analysed statistically. During the subsequent observation period of 8 1/2 years, 12 pregnancies were registered, representing a failure rate of 3.8 per thousand. 11 out of these 12 pregnancies were tubal pregnancies. We think that laparoscopic tubal sterilisation is an important contraceptive method, comparable, in terms of safety and mortality risk, to taking the pill. Its application is suitable after family planning has been finalised. The mean age of our patients was 36.5 years.

Adult↗
PubMed1979

[Can we defend a 10 per cent rate of cesarean sections? Experiences with 2000 cesarean sections (ending)].

During a period of 13 years 2000 Caesarean sections were performed in a total of 20 584 deliveries. That means a frequency of 9,7%. Maternal mortality was zero. Maternal morbidity was 72% if one includes all minor complications. Counting only the major postoperative complications the morbidity in our Caesarean sections was not higher than 1%. Perinatal mortality was 2,2%. If one excludes all premature children and not viable malformations, a perinatal mortality of 0,65% results. Conditions for good results in mother and child after Caesarean section are: prospective management of delivery, consequent prenatal care, optimal supervision in the delivery room, favourable peri-operative circumstances, elective prophylaxis with antibiotics and elective prophylaxis against thromboembolism.

Anti-Bacterial Agents↗
PubMed1979

[Further results about pregnancy and childbirth after use of oral contraceptives (author's transl)].

In a total of 11,026 prenatal case patients there were 1000 patients who became pregnant following the cessation of the use of oral contraceptives. Results were compared with the pregnancies of 500 patients who never had employed contraceptive steroids. Comparison shows that in both groups the incidence of premature birth, perinatal mortality, congenital anomalies and twins were similar.

Abnormalities, Drug-Induced↗
PubMed1978

[Arguments for a hesitamt attitude in the management of retroflexion of the pregnant uterus].

Among 5036 pregnant patients under prenatal care of a gynecologist, a retroflexion of the pregnant uterus was found in 438 cases (8.7%). The incidence of spontaneous abortion in the cases with retroflexion was 10.4%. This corresponds to the expected mean incidence of spontaneous abortion. In a control group of 1000 pregnancies without retroflexion of the uterus, the incidence of spontaneous abortion was 9.2%. The rate of premature delivery in cases with retroflexion was 5.3% and showed no difference to the control group without retroflexion (5.5%). Spontaneous anteflexion was awaited in all cases with retroflected pregnant uterus. Because of overflow incontinence manual anteflexion of the uterus at 15 weeks of gestation became necessary in one case. This pregnancy went to term. Because of our good results, we make a plea for expectant management of retroflexion of the pregnant uterus. Regular control examinations are necessary so that the lack of spontaneous anteflexion is not overlooked. Among 378 cases with a retroflected pregnant uterus which were followed to term, manual anteflexion became necessary in only one case.

Female↗