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

[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

[Reinterventions on the thyroid gland: goiter recurrence].

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Goiter↗

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↗

PubMed1979

[Emergency cerclage. Definition, technical procedure and prognosis (author's transl)].

Report on 27 cases on emergency cerclage. Six infants survived. Among these were four with birth weights over 2500 grams. The high abortion rate of 59% and the high perinatal mortality of the live born infants (5 of 11) make it imperative to be highly selective in this procedure. In emergency cerclage during labor or maternal pyrexia is contraindicated. Local and systemic antibiotic profolaxsis is recommended. Proposals for the definition technique and post-operative care in cases of emergency cerclage are discussed.

Abortion, Spontaneous↗

PubMed1979

[Daytime rooming-in--a contribution to family-oriented obstetrics (author's transl)].

Rooming-in of mother and child during the puerperium is an essential step towards family-oriented obstetrics. However, the setting-up of full rooming-in wards is often prevented by problems of organisation, personnel, cost and space. It is here where the reorganisation of conventional maternity wards to daytime rooming-in wards can be regarded as a feasible alternative, since it requires low investment cost and moderate expenditure of effort required for satisfactory working. At the Freiburg University Gynaecological Hospital, 1028 women were asked to choose between a conventional ward and a daytime rooming-in ward. The article reports on experience collected during the reorganisation of this ward as well as on the behaviour, reactions and requests on the part of the mothers. The high degree of positive acceptance as well as the easy adaptability of this maternity ward system to existing conditions, favour widespread introduction of the daytime rooming-in system.

Adult↗

PubMed1979

[On the problems of prognosis in cerclage operations. A suggestion for classification according to indication groups (author's transl)].

While limiting the definition to the period between the 14th and the completed 28th week of pregnancy, it is suggested to exclusively use the anatomic functional findings with regard to the internal os uteri as a basis for valid classification by indication groups. Evaluation of the results of 262 cerclage operations at the Feiburg University Gynaecological Hospital on this basis, supports the suggested principle.

Abortion, Spontaneous↗