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Biomedical subjects

L Quaas

Publications and source records attributed to L Quaas.

26 records · Page 2Linked to original sources
PubMed1983

Urinary protein patterns and preeclampsia.

A retrospective study of urinary protein patterns, as determined by SDS-PAA-disc-electrophoresis was performed in 107 patients in third trimester of pregnancy because of preeclampsia. The aim was to determine whether the protein patterns allow a differentiation between nephropathies associated with genuine toxaemia of pregnancy and those in which toxaemia was superimposed on preexisting renal glomerular or tubular disease. The magnitude and type of proteinuria was related to the mean arterial pressure (MAP). 47% of all patients showed a mixed protein pattern independent of the MAP-severity. This form of proteinuria is probably associated with a genuine toxaemia of pregnancy. It was not possible to determine if pure glomerulopathies whose frequency rose with MAP, had already been present before pregnancy. In a third of the 22 patients followed-up post-partum pathological protein patterns or increased protein excretion was detected. This implies that 35% of the nephropathies were present before pregnancy. However, differentiation between preexisting and toxaemia associated nephropathy was not always possible. SDS-PAA-analysis of urinary protein should be carried out in earlier stages of pregnancy in cases of increasing MAP and proteinuria.

Blood Pressure↗
PubMedDate not supplied

[Experiences with HELLP syndrome].

Between 1988 and 1991 thirty-nine pregnant women suffering from HELLP-Syndrome were treated in our hospital. A retrospective analysis of clinical course and of the changes in the relevant laboratory values was performed. The incidence of the HELLP-Syndrome at Freiburg University Hospital was 0.85% for all pregnancies or 17% of the patients with toxaemia. 90% of the women were primipara, there was no prevalence of a certain group. The clinical course was characterized by the perseverance of symptoms for more than two weeks in 18% of the cases and a perinatal mortality of 25%, the latter mainly due to prematurity of the infants. This suggests that perinatal mortality due to respiratory distress syndrome can be reduced by conservative and expectative management of these patients. However on the other side a high rate of caesarean sections (77%) and sometimes even induced abortions were necessary to avoid maternal mortality and severe pre-or postpartal complications for these women.

Adult↗
PubMedDate not supplied

[Fetomaternal transfusions in early pregnancy].

Fetomaternal bleeding is the major cause for rhesus immunization in pregnancy. This study evaluates the amount of fetomaternal bleeding in 345 pregnancies before 28th week of gestation. Fetomaternal bleeding was of clinical relevance (HbF greater than 0.015%) in 2.2% of all uncomplicated pregnancies. In case of abortion or vaginal bleeding in early pregnancy we observed a statistical significant increase of transplacental hemorrhage. The need for anti-D-prophylaxis in this patients is obvious.

Abortion, Spontaneous↗
PubMedDate not supplied

[Interaction of sex steroids, prostaglandins (6-keto-PGF1 alpha, PGF2 alpha) and beta adrenergic agonists (adrenaline, fenoterol-Partusisten) in the human non-pregnant myometrium in vitro].

The in vitro effects of epinephrine and fenoterol (Partusisten) on contractility and prostaglandin (6-keto-PGF1 alpha, PGF2 alpha) production of human, non-pregnant myometrial strips dependent on the phase of the menstrual cycle and after pretreatment with estrogens and progesterone are reported. Superfusion of epinephrine (100 ng/ml) stimulated contractility and PG-synthesis of myometrial tissue from the proliferative phase of the cycle, whereas fenoterol (10 ng/ml) had only a little inhibitory effect. After pretreatment with conjugated estrogens (Presomen) the maximal epinephrine-stimulated contractions were correlated to a further increase in PGF2 alpha-synthesis even during fenoterol superfusion. In myometrial tissue obtained during the secretory phase of the cycle, both epinephrine and fenoterol had a significant inhibitory effect on spontaneous contractions associated with an increase in 6-keto-PGF1 alpha-production. After pretreatment with an estrogen-progestin combination (Primosiston) fenoterol superfusion resulted in a complete inhibition of myometrial contractions. These results demonstrate that estrogens increase the myometrial sensitivity to catecholamines leading to increased contractility and increased PGF2 alpha-synthesis, whereas progesterone probably mediates the beta-adrenergic inhibitory effect on myometrial contractions. Thus, the contractions inhibiting effect of the betamimetic drug fenoterol associated with decreased PGF2 alpha- und increased prostacyclin (PGI2) synthesis depends on the effect of progesterone in human, non-pregnant myometrium.

6-Ketoprostaglandin F1 alpha↗
PubMedDate not supplied

[The course of labor in very young and older pregnant patients].

The course of pregnancy and delivery and the fetal outcome were analyzed in 23 women aged less than 16 years and 151 women aged 42 years or more. Most of the adolescent mothers were delivered spontaneously without any major problems. In patients aged 42 years and more there was a higher rate of pregnancy complications due to predisposing risks and a high incidence of prolonged labour, correlated to an increased frequency of operative deliveries and in general more active obstetrical management. Fetal outcome was good in both groups. The results demonstrate the necessity of intensive prenatal care in both groups. Whereas in young gravidae spontaneous delivery can be expected in most cases, the women with advanced maternal age do need an active obstetrical management including all the abilities of modern perinatal medicine. Intensive antenatal and perinatal care provided, the prognosis for mother and child can be estimated as good in both groups.

Adolescent↗
PubMedDate not supplied

[Perinatal medical possibilities and limitations of the obstetrical center--an analysis of the causes of perinatal mortality 1982-1985].

Based on the analysis of 4,881 deliveries during 1982-1985 the perinatal statistical data of a regional perinatal center (level 3) are presented. There is high percentage of pregnancies at risk (57%), preterm deliveries (11%), and increasing incidence of multiple pregnancies (3%). The rate of spontaneous deliveries amounts to more than 70%, the frequency of cesarean sections reached a maximum of 19%. As causes of 82 perinatal deaths (16.8% mortality rate) were found above all fetal malformations (42%), multiple pregnancy (18%), severe intrauterine growth retardation (17%), and premature rupture of membranes with septic complications (10%). Further causes of perinatal death were severe umbilical cord complications (5%), diabetic pregnancy (5%), abruptio placentae and maternal high risks. After detailed analysis 55% of all perinatal deaths proved to be unavoidable, 18% possibly avoidable, and 27% avoidable. The presentation of the avoidable perinatal deaths demonstrates the shortcomings and possible improvements of the obstetrical management and organization. The possibly avoidable cases could be solved in future. According to the purged perinatal mortality rate there are 4 remaining avoidable cases for which the perinatal center proved to be responsible. The perinatal mortality risk in the regional center is therefore less than 1%o.

Congenital Abnormalities↗
PubMedDate not supplied

[Value of antepartal cardiotocogram in risk pregnancies--comparative evaluation of the non-stress test and oxytocin stress test].

247 patients with risk of uteroplacental insufficiency were monitored by 434 oxytocin challenge tests (OCT) and non-stress-tests (NST). A non-reactive NST was found in 20% of the patients. Late decelerations in the OCT were observed in 19%. With respect to late decelerations and loss of reactivity in the OCT, the results of the stress tests were pathological in 29% of the patients. Based on the evaluation of late decelerations only, the OCT does not appear to be superior to the NST. Only when the reactivity criterion is additionally taken into account can the diagnostic rating of the OCT be given more value than that of the NST. Furthermore, it could be established that the loss of reactivity is of greater importance than late decelerations in the presence of reactivity.

Apgar Score↗