Mammography: attitudes and reactions.
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Biomedical subjects
Publications and source records attributed to M Beckmann.
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Osteogenesis imperfecta is one of the most frequent hereditary anomalies. One personal case is described. The literature is reviewed. The disease entity, the heredity and the possibilities of antenatal diagnosis are described. A pregnant patient with osteogenesis imperfecta needs careful antenatal care. Delivery by primary Caesarean section with gentle delivery of the infant is the method of choice. The aim of the method of delivery is to avoid spontaneous fractures during the delivery.
Two cases of pregnancy following by-pass operation from the Jejunum to the Ileum are reported. The by-pass operations were done for obesity. In 78 known pregnancies following by-pass operations many low birth weight infants were present. The weight pattern of the pregnant patients is uneven and not capable of giving clues to the birth weight of the infants. The risk for congenital malformations appears to be increased. The reason for this in unknown.
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Acute variceal haemorrhage due to portal hypertension in chronic liver disease is the most fatal maternal complication when pregnancy occurs. These risks can be avoided when a shuntoperation is performed before or during pregnancy. 26 cases of uncomplicated pregnancies after shuntoperations have been reported in the literature. Another one is added.
Jaundice, or icterus, during pregnancy is frequently a symptom of an intrahepatic cholestasis. It is evident from the literature that intrahepatic pregancy cholestasis represents a risk pregnancy with moderate risk to the mother and high risk to the foetus. Although diagnostic clarification is necessary, the authors sound a warning against liver biopsy during pregnancy.
Two deliveries in a patient combined with hereditory angioneurotic edema are reported. Although even the smallest trauma can lead to life threatening edema the tendency to edema is reduced during pregnancy. Neither in the vagina nor the vulva the deliveries caused edema. The episiotomy did not cause a concomitant edema of the vulva, despite the predilection of the external genital organs for edema. It is possible that a correlation between the gonadotrophin level and the tendency to edema exists in hereditory angioneurotic edema.
The article reports on a case of marked unilateral hyperplasia of the mammae during pregnancy. Literature references show that this is a rare occurrence. The possible complications require an intensive control. Although malignant degeneration has not been reported, the authors believe that diagnostic clarification is mandatory.
In 46 women the alpha1-fetoprotein content, the soluble fibrin monomer complexes (LFMK), and the coagulation status were determined in the maternal serum at the beginning of the second trimester before and after amniocentesis. Increases of AFP by more than 100% of the original level pointed to fetomaternal microtransfusion, the quantity of which was calculated by means of a formula. Overall coagulation tests did not show any change after the puncture. A moderate LFMK increase was seen (p less than 0.05), which, however, was not clearly correlated with the AFP increase.
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For the evaluation of the effectiveness of contraceptives the Life Table method is at present the best method. It is a disadvantage that the original method of Tietze & Potter was restricted to the evaluation of intra-uterine contraception devices. A Belgian team is now in the process of developing a modified life table method for the evaluation of the effectiveness and the side effects of oral contraceptives. The reference to the Pearl-index for the effectiveness of contraceptives is unclear and in the way in which it is at present used scientifically untenable.