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Biomedical subjects

K P Lüscher

Publications and source records attributed to K P Lüscher.

At least 19 recordsLinked to original sources
PubMed2004

Umbilical endometriosis.

We report two women who presented with a recurrent, mildly painful, bluish nodule in the umbilicus. Both patients complained of local tenderness and occasional bleeding that increased during menstruation. Neither patient had had previous pelvic surgery. Excision of the lesions revealed a primary umbilical endometriosis; in one case, a simultaneous laparoscopy showed a pelvic endometriosis. We review the current literature and discuss the possible etiopathogenesis and when a laparoscopy is indicated to diagnose a concomitant pelvic endometriosis. Umbilical endometriosis is a very rare disease but should be considered in the differential diagnosis of umbilical lesions.

Adult↗
PubMed1999

[Medically indicated termination of pregnancy in giant uterine myoma and mono-amniotic twin pregnancy: a case report].

We report the rare combination of a monoamniotic twin pregnancy with giant uterine leiomyomas in a 33-year-old para 0, gravida 1. Considering the restricted capacity of uterine expansion during pregnancy and the known complications associated with myomas, as well as the elevated morbidity and mortality of monoamniotic twin pregnancies, we opted for a medically indicated abortion at 12 weeks' gestation. After abortion the patient developed fever and abdominal pain. In differential diagnosis we considered endomyometritis and necrosis of the myomas. Despite adequate conservative treatment the symptoms persisted and myomectomy was performed in view of the patient's desire to maintain fertility.

Abortion, Eugenic↗
PubMed1999

Prenatal assessment of Wharton's jelly in umbilical cords with single artery.

OBJECTIVE: To investigate whether the amount of Wharton's jelly in non-malformed fetuses with a single umbilical artery is different from that of fetuses with a normal umbilical cord. METHODS: We evaluated patients with singleton pregnancies, non-malformed fetuses and single umbilical artery undergoing sonographic evaluation at a gestational age ranging from 19 to 41 weeks' gestation. The cross-sectional areas of the umbilical cord and of the umbilical vessels were measured. The amount of Wharton's jelly was calculated by subtracting from the total cross-sectional area of the umbilical cord the areas of the artery and of the vein. The umbilical cord cross-sectional area, the umbilical artery and vein areas as well as the amount of Wharton's jelly were plotted on previously published nomograms. RESULTS: Twenty-two patients met the inclusion criteria. The umbilical cord cross-sectional area was within the normal range in 20 (90.1%) cases. The umbilical artery and vein areas were above 2 standard deviations from the mean in 20 cases and in 11 cases (50%), respectively. The amount of Wharton's jelly was below 2 standard deviations from the mean in all cases. An abnormal insertion of the umbilical cord (marginal, velamentous) was present in five cases (22.7%). CONCLUSIONS: A reduction of Wharton's jelly is frequently present in cases of single umbilical artery. The increased perinatal morbidity and mortality observed in cases of single umbilical artery, even in the absence of congenital or chromosomal abnormalities, could be in part the consequence of a reduced amount of Wharton's jelly.

Adult↗
PubMed1997

Higher rate of fetal acidemia after regional anesthesia for elective cesarean delivery.

OBJECTIVE: To determine the prevalence of fetal acidemia associated with regional anesthesia for elective cesarean delivery in healthy paturients with uncomplicated singleton term pregnancies. METHODS: This was an epidemiologic study using the data base of the Swiss obstetric study group (Arbeitsgemeinschaft Schweizerischer Frauenkliniken). After the exclusion of cases with extraneous factors that may have affected the health of the neonate, we analyzed the umbilical artery pH, Apgar score, and other neonatal outcome measures after cesarean delivery with reference to the anesthetic technique. RESULTS: From 1985 to 1994, 327,763 deliveries, including 40,858 (12.47%) by cesarean, were registered in the data base. Of these, 5806 patients fulfilled the study criteria. The study population included 1002 spinal, 2155 epidural, and 2649 cases of general anesthesia. The frequency of fetal acidemia (pH less than 7.10) was significantly increased in the spinal-anesthesia group (odds ratio [OR] 4.67; 95% confidence interval [CI] 2.73, 8.01) and in the epidural group (OR 2.39; 95% CI 1.42, 4.04) compared with the general-anesthesia group. CONCLUSION: The rate of fetal acidemia is significantly increased after regional anesthesia. This risk must be judged in light of the risks inherent with general anesthesia.

Adult↗
PubMed1997

Duration of pregnancy after carbon dioxide laser conization of the cervix: influence of cone height.

OBJECTIVE: To determine if carbon dioxide laser conization of the cervix is a risk factor for preterm delivery in subsequent gestations and to evaluate whether there is any relationship between cone height and duration of pregnancy. METHODS: Patients of fertile age who had carbon dioxide laser conization were followed for reproductive events. Cases were matched one-to-one with controls for known risk factors for preterm delivery. Pregnancy duration, rate of preterm birth, and mode of delivery were studied. Parametric and nonparametric tests were used for statistical analysis. Logistic regression analysis and Cox proportional hazard modeling were used to investigate the relationship between cone height and subsequent preterm delivery. RESULTS: Sixty-four women with singleton pregnancies after carbon dioxide laser conization and 64 controls were included in the study. Overall, no difference was found in the rate of preterm delivery and duration of pregnancy. However, women with cone height of at least 10 mm had a higher rate of preterm delivery than either those with cone height less than 10 mm (five of 23 versus one of 41, P = .01) or the controls (five of 23 versus three of 64, P < .05). Cone height of at least 10 mm remained significant in predicting the occurrence of preterm delivery and the duration of pregnancy after adjusting for known risk factors (odds ratio 11.1, P < .05). CONCLUSION: Cone height of at least 10 mm is an independent risk factor for the duration of pregnancy and for the occurrence of preterm delivery in the subsequent gestation.

Adult↗
PubMed1995

[Intravenous leiomyomatosis].

A 49-year-old woman presented with a uterine tumour with solid and cystic parts. Extension of the tumour into the broad ligament was noted at the operation with wormlike plugs of tumour within the veins. The histological diagnosis of intravenous leiomyomatosis was evident. The disease turned out to be far advanced: a long continuous intraluminal mass extending from the iliac veins to the right ventricle made a second operation with thoracotomy and laparotomy mandatory. Postoperative follow-up showed so far, 1.5 years after operation, no evidence of recurrence. Intravenous leiomyomatosis is a very uncommon finding. Though it is histologically a benign smooth-muscle tumour, the biological behaviour with intravenous growth which may involve the right side of the heart, is quite aggressive. About 100 cases were reported in the literature; in no case could the diagnosis be made before surgery.

Female↗
PubMed1994

[Prenatal diagnosis of umbilical cord hemangioma in increased alpha fetoprotein].

In a patient with elevated serum alpha-fetoprotein a little haemangioma of the umbilical cord is diagnosed by ultrasound in the 21st week of pregnancy. So far only nine reports exist of prenatal diagnosed haemangiomas of the cord. Severe complications like rupture, cord haematoma, non-immune hydrops fetalis and polyhydramnions as well as a perinatal mortality of 35% have been reported. Therefore, intensive surveillance during pregnancy is mandatory.

Adult↗
PubMed1991

[Ovarian cancer in ovarian remnant syndrome].

We present the second published case of an ovarian cancer in Ovarian Remnant Syndrome. Only explorative laparotomy confirms the diagnosis. Conservative treatment is often without success and may conceal the diagnosis of a malignant process.

Cystadenocarcinoma↗
PubMed1990

[Pregnancy in diabetes insipidus--a case report with review of the literature].

A 32 year old I P II G with preexisting diabetes insipidus was treated with 1-(3-mercaptopropionic acid)-8-d-arginine vasopressin (DDAVP) during pregnancy. An otherwise normal pregnancy was marked only with an excessive weight increase. A healthy girl was delivered by secondary cesarean section at term. Postoperative the mother developed a water intoxication accompanying oxytocin-infusion. During nursing the diabetes insipidus improved significantly whereby DDAVP doses could be reduced to 20-10 percent. We suppose an overreaction to endogene oxytocin with an antidiuretic effect.

Administration, Intranasal↗
PubMed1989

[Spontaneous vaginal rupture with prolapse of the small intestine].

Spontaneous rupture of the vaginal vault is a rare event. Patients at risk are postmenopausal. Very often they show symptoms of an enterocele or have been operated before vaginally. Treatment is always by surgery. Whether it can be done vaginally or by laparotomy, depends on the local situation. To prevent recurrence, a double closure of the lesion is necessary, often combined with colpocleisis, colpectomy, sacropexie or obliteration of the "cul-de-sac".

Aged↗
PubMed1988

[Bronchus cancer and pregnancy].

The association of bronchogenic carcinoma and pregnancy is a rare event. If current smoking patterns of women continue, it will be seen with increased frequency. We discuss the diagnostic problems in such a case. Therefore too suspicious symptoms in pregnancy need to be evaluated.

Adult↗
PubMed1987

[Laparoscopy in gynecology and obstetrics].

Thanks to the statistics of the Arbeitsgemeinschaft Schweizerischer Frauenkliniken (Swiss Gynecological Clinics' Working Group) it has for the first time become possible to report on larger numbers of laparoscopies performed in Switzerland. In contrast to most international statistical records, data relating to this subject are gathered prospectively; there is no doubt that this improves the quality of the data. The authors report on a total of 18,186 laparoscopies performed in 1983/84/85, in 50% of the cases for sterilization. The various sterilization methods employed are discussed. As far as diagnostic laparoscopies are concerned, the indications and techniques are described. Serious intraoperative complications occurred in 15 cases, which corresponds to one serious complication in every 1,212 laparoscopies. Fortunately, not a single patient died as a direct result of the laparoscopy. The results are compared with those in the international literature. With regard to late-onset morbidity it is evident that there are more complications with the more complex procedure of diagnostic laparoscopy.

Female↗
PubMed1987

[Double uterus malformation with unilateral kidney agenesis].

When double uterus is observed, absence of one kidney is common. These rare congenital anomalies are known in literature. In the years 1980-1984 we observed four cases. Symptoms, diagnosis and therapy are described. Preoperative diagnosis is now much better by ultrasonography. Nevertheless operative procedure has to be adapted to the real anatomic situation at first within the intervention. In one case a second operation was necessary because of a recurrence. This case is described in detail.

Abnormalities, Multiple↗