[Can progress in obstetrics be measured?].
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Biomedical subjects
Publications and source records attributed to J Bretscher.
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Cerebral malnutrition as well as a markedly increased rate of lethal malformations constitute the major problems of retardation. During the daily routine the question "retardation of growth or premature birth" poses itself time and again. Different methods of determining the period of gestation are being discussed: Two of the best methods used in combination during the last trimester of gestation are: 1. L/S-ratio-creatinine-ultrasonics, 2. creatinine-ultrasonics. But none of these methods is as efficient as the ultrasonic diagnosis in the first trimester of pregnancy (amniotic cavity, length of the foetus). The earliest possible examination of all pregnancies by ultrasonography is highly recommended. This method generally allows for a differentiation in symmetrical assymmetrical retardation of fetal growth. The author introduces different ultrasonic parameters and their limit of error for the middle and last trimester. The exclusive measurement of the biparietal diameter should belong to the past, one should strive to obtain the combination of two measurements. He recommends the combination of head and abdominal measurements as well as the combination index including the hight of the truncus; the determination of the measurements of the placenta is to be rejected. The author is hopeful that by improved technology the thickness of the subcutaneous fatty tissue can be measured in the future.