[Frankfurt Toxoplasmosis Symposium. 14 June 1990 in Frankfurt (Oder)].
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Biomedical subjects
Publications and source records attributed to G Schüssling.
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A fulminant course of HELLP-Syndrome appears without important premonitory manifestations (prodrome) many hours postpartum with an eclamptic attack. The initial available diagnostic problems and the essential therapy have been exposed. The important point of the treatment is the blood exchange (fresh blood) combined with haemodialysis. By that the life of the puerperal woman is not in danger.
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By means of two examples--one in pregnancy, the other one after an abdominal hysterectomy--we report on a rare cause of an acute mechanical ileus. In both cases an incomplete intestinal turn with distinct mobility of the colon caused a volvulus. It is pointed to the importance of an early diagnosis inspite of aggravating circumstances in late pregnancy, parturition and postoperatively after gynecologic operations. Effective operative treatment is based on careful exploration of the abdomen in order not to overlook rare causes of an ileus, among those also fetal developmental disturbances of the intestine and other abdominal viscera. Only by operative removing of the causes of an ileus in cooperation with surgeons--and that in good time--the results in gynecology can be improved especially during pregnancy but also postoperatively.
To assess health-care and quality in perinatal care a questionnaire was sent to all of the gynaecologic departments in the district of Frankfurt (Oder), GDR, asking details about prenatal care examination, fetal monitoring and perinatal mortality. The results of this pilot study indicate a high level in quality of health care in that region (perinatal mortality in 1985: 7.5%). Our findings suggest that quality-control and quality-comparisons are measures to ameliorate health, care organization, too. The reasons for the change in perinatal mortality will be analyzed in further investigations.
Two cases of symmetric incomplete two-headed four-handed conjoined twins who were delivered in the 37th and the 32nd gestational week have been demonstrated. The first case was delivered by caesarean section and the other one was delivered by forceps. These malformations are very seldom. Questions about teratogenicity and diagnosis are discussed.
Report on 37 women, who became pregnant after treatment of 100 sterile couples. 11 of all pregnancies have been terminated as abortion or tubal pregnancy. The analysis of psychological factors ascertained during treatment showed important disturbances of couple's relationship in 10 of these women. On the other hand, such factors have not been observed in women with successful pregnancies. The possible correlations, the psychosomatic mechanisms of abortion and therapeutical problems are discussed.
Pregnant women are increasingly exposed to injury. Correlations between severity of trauma and danger of obstetrical complications do not exist. Therefore, clinical observation of every case is necessary. Though maternal response to injury is changed by physiologic alterations of pregnancy the ability to withstand injury is not essentially influenced. Osteosynthesis can be recommended. Maternal life and health is of greatest importance. Termination and interruption of pregnancy demands different decisions. 12 own cases are reported. The care for the injured pregnant patient represents a situation of overlapping medical responsibility best handled in an interdisciplinary approach.
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On the background of the first All-German-Perinatal-Study in 1992 the results in obstetrics and perinatology in the Oder-Region (east part of the State of Brandenbourg) in 1990 are described. In comparison to the results in a previous study (1985) we found a drastical decline in the number of births (newborns 1985: 10244; 1990: 7723); in addition to the changing in the reproduction- and health-care behaviour, too, we have noted a decreasing perinatal mortality from 7.5% in 1985 to 4.9% in 1990. The ameliorated monitoring-rate (cardiotocography-rate) of the fetus (1985: 71%, 1990: 88.4%) and the decreasing still-birth-rate may be the main cause of this phenomenon. Clinic-births were the most common deliveries, the house-birth was the great exception; only 0.2% of all deliveries occurred at home or otherwhere. Our data support that there is no difference, except the birth-rate, in relation to the situation in the "old" Federal Republic of Germany.