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H Hepp

Publications and source records attributed to H Hepp.

At least 55 records · Page 3Linked to original sources
PubMed1993

Combined intra-uterine and extra-uterine pregnancy in the contralateral tube after gamete intra-fallopian transfer.

A case of combined intra-uterine and contralateral tubal pregnancy after gamete intra-Fallopian transfer (GIFT) is presented. Laparotomy with partial tubal resection was performed after tubal rupture. The intra-uterine pregnancy is still ongoing without complications. Heterotopic pregnancies are dangerous conditions for the patient and should be taken into account after transfer of multiple oocytes. To our knowledge this is the first report of a heterotopic pregnancy in the contralateral tube after GIFT.

Adult↗
PubMed1993

Duration of the multifetal gestation, birth weight and infant prognosis.

For the higher numbered multifetal gestation, duration of gestational age decreases in spite of different medical activities. On the other hand increasing gestational age often strongly suggests the need for delivery by caesarean section for maternal indications. After the 32nd week of gestation in general no serious respiratory problems should be expected, and there may be no essential increase in fetal weight, but the risk of intrauterine death increases due to placental insufficiency. Therefore, for logistic reasons we propose liberal indications for caesarean section after the 32nd week of the multifetal gestation.

Birth Weight↗
PubMed1992

[Hormonal and ultrasound monitoring of early pregnancy--differential diagnosis of extrauterine pregnancy and multiple pregnancy].

In this study sonographical and hormonal findings in 63 patients with intrauterine singleton pregnancy were compared with 18 patients with multiple pregnancies and 28 patients with ectopic pregnancy. The earliest detection of the intrauterine gestational sac was obtained with a HCG level of 659 mlU/ml. The sonographical development correlated well with HCG values. There was no statistically significant correlation between gestational age and HCG. In multiple pregnancies with sonographical findings comparable to the development in singletons HCG values were remarkably elevated. A discrimination between multiple and ectopic pregnancies by sonographical and hormonal criteria cannot be performed sufficiently in a HCG zone of 1500 mlU/ml. Close sonographical and hormonal follow-up until diagnosis of the intrauterine pregnancy is necessary.

Chorionic Gonadotropin↗
PubMed1992

[Age-related differences and changes in clinical aspects and follow-up of cervix cancer since 1973].

In an attempt to clarify, whether the malignant potential of cervical cancer is age-dependent and whether this has changed in the last decade, we analysed the data from 1496 patients suffering from cervical cancer. The patients were treated between 1973 and 1988 at the second Universitäts-Frauenklinik, Lindwurmstrasse and at the Frauenklinik Grosshadern, both of the Ludwig-Maximilians-Universität München. After 1973, the total number of patients with cervical cancer decreased, whilst at the same time, the percentage of young patients increased. In the sub-group of surgically treated patients (n = 555), the percentage of patients with lymph node metastases increased after 1973. The increase in lymph node involvement was most pronounced in young patients with small tumours (stage Ib disease, 35 years of age). In this group, the percentage of lymph node involvement rose from 6.3% in 1973 to 38.6% in 1988. Lower stage disease was significantly more frequent in the young patients. Accordingly, the overall mean survival time was longer in the young patients. In the sub-group of surgically treated patients, however, when comparing equal stages, the survival time was shorter in the young patients. In small tumours (confined to the uterine cervix), pelvic lymph node involvement was more frequently seen in the younger patients. Secondary metastases developed more rapidly and significantly more often in the young patients. Our data supply evidence to indicate an enhanced malignancy of cervical cancer in young patients.

Adult↗
PubMed1992

[Prognostic significance of the CA 125 half-life for the further outcome of ovarian cancer].

Since only approx. 30% of patients with ovarian carcinoma present themselves in the early stages, and as a result of the lack of effective screening methods, primary interest has been applied to the improvement of the treatment quality in the later stages. Improvement of therapeutic strategies implies an adaptation of specific characteristics of the patient and the tumour. For instance, in cases of primary progression during chemotherapy, it is not justified to continue an aggressive treatment, which causes additional serious side effects. Surprisingly, it has not been possible, to utilize established or suspected prognostic factors for treatment strategies in ovarian cancer. This might result, in part, from the uncertainty of criteria such as stage of disease, residual tumour and histological grading. The single most relevant prognostic factor today is the residual tumour mass. In 1988 van der Burg suggested for the first time a potential prognostic relevance of the CA 125 half-life. This study was designed, to investigate the use of CA 125 half-life in therapeutic strategies. From January 1984 to June 1990, 346 patients with primary ovarian cancer were treated at our institution. Preoperative CA 125 levels were determined in 292 patients; in 220 patients the levels were complete for a period of more than 6 months so that the CA 125 half-life could be calculated. Survival times of patients with a half-life of less than 20 days were significantly (p less than 0.0001) different from patients with a half-life of more than 20 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1992

[Operation of acute dissecting aortic aneurysm in the 25th week of pregnancy using hypothermic extracorporeal circulation].

We report on a 24 + 2 weeks pregnant woman with Marfan's syndrome, who acutely developed a dissecting aortic aneurysm with aortic valve insufficiency. Emergency surgery was performed by using hypothermic extracorporeal circulation, whilst the aortic valve and ascending aorta were replaced by a synthetic graft. Foetal heart rates, continuously monitored by using Doppler ultrasound, were shown to be closely correlated with perfusion pressures. By applying perfusion pressures of 90-100 mmHg, we were able to maintain foetal heart rates of approximately 100/min. During the first postoperative day, the CTG was normal for gestational age and no contractions were noted. During the second postoperative night, the patient prematurely delivered a dead 820 g infant (Apgar score 0/0/0/0). In view of this case report, opportunities and problems associated with an application of extracorporeal circulation during pregnancy are discussed.

Adult↗