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Biomedical subjects

H G Hillemanns

Publications and source records attributed to H G Hillemanns.

At least 19 recordsLinked to original sources
PubMed1979

[The special case: squamous epithelial carcinoma of the cervix after cryotherapy in a 23 year old patient].

A case report is given of a 23 year old woman with an invasive squamous cancer of the uterine cervix 10 months after cryotherapy of an "ectopic area". The development in this case is reason for stressing the indispensable points in cryo-, thermo- and laser-therapy of the cervix: 1. proper pretherapeutic evaluation and documentation by means of cytology, colposcopy, and histology; 2. adequate extent of therapy; 3. exact follow-up after treatment.

Adult↗
PubMed1979

[Side effects of drug for thromboembolism prophylaxis. Results from the University Women's Clinic Freiburg/Br].

It is reported on the side-effects of the antithrombotic prophylaxis in 10611 gynecological operations and caesarean sections at the University Hospital Freiburg/Br. Because of multiple side-effects a risk-free method of antithrombotic prophylaxis does not exist. The main problem in using heparin and oral anticoagulants are the complications caused by bleeding. Two cumarine necroses were observed. Two severe anaphylactoid reactions were seen under dextran prophylaxis resulting in the death of one newborn. Wound healing is delayed under low-dose heparin due to an increase in hematomas. Additionally two fatal pulmonary embolisms were caused by the so-called "rebound effect" after use of low-dose heparin.

Adult↗
PubMed1979

Cervical ripening prior to induction of labor (intracervical application of a PG E2 viscous gel).

In 38 pregnant patients at term with unfavorable cervices labor induction was initiated with PG-E2 after a preceding intracervical application of 0.1, 0.2 or 0.3 mg PG-E2 in 1 ml viscous gel. The mean Bishop score improved from 3.36 to 7.0 in an average time of 2 h 37 min. The cervical diameter increased from 14 mm to 22.7 mm. 31 patients delivered their babies spontaneously, while 7 patients were delivered by cesarean section due to cervical dystocia and delayed labor. Fetal outcome was normal in all cases, with an average Apgar score of 8.7 and an average pH-value in the umbilical artery of 7.245. The study indicates that local application of PG-E2 induces cervical dilatation, and is of particular use in patients presenting a low Bishop score. A possible local effect of PG E2 is discussed.

Dilatation and Curettage↗
PubMed1979

The stilbestrol-adenosis-carcinoma syndrome.

For the development of the DES carcinoma syndrome, two different mechanisms may be assumed. 1. Indirect effect via teratogenesis: squamous cell carcinoma develops from adenosis vaginae with the assistance of cofactors (Fig. 6). Till now, a conversion of adenosis to clear cell carcinoma has never been observed (Hilgers, 1977). Adenosis is probably a precancerous lesion only for squamous cell carcinoma. 2. Transplacental terato-oncogenesis: clear cell carcinoma as a mesonephric carcinoma develops from persisting wolffian ducts with a latent period of 15 to 20 years. DES here acts only as a promoter by way of the transplacental teratogenic mechanism, thus as a terato-co-carcinogenic factor (Fig. 6).

Abnormalities, Drug-Induced↗
PubMed1979

[Telemetric monitoring of delivery when inducing labour by prostaglandin E2 tablets (author's transl)].

The article reports on 75 patients in whom labour had been introduced by means of oral administration of prostaglandin E2 tablets (35 patients were controlled at the bedside and 40 patients were monitored telemetrically.) Telemetric monitoring is preferable in oral application of ecbolics, since this entails a saving in ecbolics (4.7 as against 5.4 tablets), regular labour is induced more rapidly (after 57 as against 72 minutes) and total delivery time is shortened (4 hours 24 minutes as against 5 hours 15 minutes). There were no serious side effects neither in the mother nor in the neonate. 6 of the 75 patients complained of slight gastrointestinal side effects. The Apgar scores and pH levels of the children were in the normal range. The post-partum period was identical in both groups, namely, 11 minutes.

Apgar Score↗
PubMed1979

[New considerations in therapeutic abortions using a second generation prostaglandins (author's transl)].

The results of 98 therapeutic abortions in the first and second trimester of pregnancy using F prostaglandins are reported. The prostaglandins were eigher administered by fractionated extra-aminotic PGF2 alpha, intramuscular 15-methyl PGF2 alpha or extra-amniotic or intracervical single shot 15-methyl PGF2 alpha. The induction abortion time of 13 hours and 15minutes for the single shot and 14 hours and 28 minutes for the intramuscular administratic with the prostaglandin derivatives is shorter than with natural prostaglandins which showed a mean induction to abortion time of 19 hours and 30 minutes. The blood loss was low in all groups at approximately 75 mls. Side effects are least with the single shot method (11%). Two patients had nausea, two patients had vomiting, three patients had flush or lower abdominal cramps. The intramuscular administration showed the highest frequency of side effects (80%). In the first trimester the single shot method always leads to sufficient cervical dilatation although the abortion rate was low at 59%. During the second trimester a high abortion rate is found. Therefore this method can be recommended for therapeutic abortions.

Abortion, Induced↗
PubMed1979

[History and course of pregnancy in a group of cerclage patients. A comparative study (I) (author's transl)].

The previous history and course of pregnancy in 357 women with variable births, in whom cerclage had been performed during 1966-1976 at the Freiburg University Gynaecological Hospital, were compared with a group of 380 women without cerclage, the age, parity and period during which birth had occurred, being identical. The high average of the patients with cerclage (29.3 years), the low percentage of primigravidae (17.1%), the threefold increased rate of abortions and early births (28.4%) as well as the high perinatal mortality (21.5%) during the preceding pregnancies, confirmed these women as a "risk" group. After cerclage, births before the 38th week were reduced from 41.1% to 24.6% (p less than 0.001.) 52.3% of the premature births occurred between the 36th and completed 37th week. Perinatal mortality dropped to 5.6% (p less than 0.00l.). A clinically relevant gestosis was less frequent (0.8%;p less than 0.00l.). The fact that the rate of premature births in the cerclage group (p less than 0.001) continued to be elevated, is mainly attributed to the frequency of rupture of the amnion before the 38th week (21.0%).

Abortion, Spontaneous↗
PubMed1979

[Labor and delivery, fetal and maternal risk following cerclage. A comparative study (author's transl)].

In a comparative study of the course of pregnancy and delivery of 357 patients who delivered live infants between 1966-1976 following cerclage operation were compared to a control group of 380 without cerclage who were matched in age, parity and delivery time to the group under study. The high prematurity rate in the pregnancies preceeding the cerclage of 28.4% decreased following the cerclage to 16.8% (p less than 0.001). The perinatal mortality was reduced from 21.5% to 5.6% (p less than 0.001). This effect was especially achieved by the lower incidence of deliveries of infants with a birth weight of less than 1500 grams (p less than 0.05). The difference to the controls regarding prematurity (8.2%) and perinatal mortality (1.6%) remained significant (p less than 0.001). An increased rate of malformations in the cerclage children was not noticed. The maternal risk is low and consists mainly of a increase of cervical lacerations (4.9%) and problems of wound healing (2.2%). The duration of labor and type of delivery, the type of third stage of labor, and the post-partum course were not different from the control group.

Birth Weight↗