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O Dubler

Publications and source records attributed to O Dubler.

8 recordsLinked to original sources

The development of children born by vaginal or abdominal breech delivery (author's transl).

The early and late development of children born by the breech either by vaginal breech delivery or by caesarean Section is compared. The early and late morbidity of the two groups is discussed in detail. Considering the recently published data by Hagberg (6) theinterpretation of findings classified as secondary morbidity is very dificult. There are numerous especially antenatal factors which interfere with the interpretation. The conclusion is presented that it is a present not possible to make a definite statement on the value of vaginal or Caesarean Section delivery in breech presentation. It is still considered to be safe to do Caesarean Section delivery in breech presentation. It is still considered to be safe to do Caesarean Sections in breech presentations on an individualized basis.

Acidosis↗

The effect of modern intensive monitoring in obstetrics on infant mortality and the incidence of hypoxia and acidosis.

UNLABELLED: We consider intensive monitoring to be fetal monitoring during labor and in the newborn period of all births using the most efficient methods. During the last ten years we have sequentially used the following techniques: Amnioscopy, blood analysis, estrogen determinations in urine, external and internal cardiotokography and internal pressure determinations, gas analyses of umbilical blood. amniotic fluid analyses (phospholipids), ultrasound (B-apparatus) and HCS determinations. All clinics dealing with risk pregnancies should have these techniques available. Total perinatal mortality decreased to below 2% after introduction of cardiotokography. During the last year it decreased to 0.89%. Premature mortality shows the same decrease and is 50% of total mortality. The frequency of premature deliveries remained unchanged at 6.2%. Both improved intensive monitoring and neonatal reanimation and intensive care contributed to the reduction of perinatal mortality. Continuous heart rate recordings make it possible to uncover hypoxic and acidotic states in time and this is of particular value for the premature infant. The incidence of acidosis (pH less than 7.10) was 2.03% before monitoring was introduced and fell to 0.45% this year when intensive monitoring became the rule. No pH lower than 7.0 was found this year. It is thus not sufficient to monitor only cases at risk, since in about 50% of infants born with acidosis no alarming symptoms were found that would have indicated the need for intensive monitoring. CONCLUSION: Infant mortality should be reduced to less than 1% if the diagnostic tools available are applied. Below this nonviable infants limit further improvement. Perinatal hypoxia and acidosis (below pH 7.10) should also be lower than 0.5% but at least lower than 1%.

Acidosis↗

[Is a vaginal breech delivery still justified? (author's transl)].

In our series of vaginal breech deliveries the morbidity from hypoxia and acidosis showed no difference to the same type of morbidity in our series of breech deliveries by Caesarean section. The correct selection of cases, intensive monitoring during labour and the management of the second stage of labour as outlined in our paper are the most important perequisites which permit to plan and justify a vaginal breech delivery in present obstetric practice.

Acidosis↗

[Hypoxia and acidosis--morbidity (author's transl)].

A critical study based on 3291 analyses of blood from the umbilical cord, and the consequences. In routine analyses acidosis (pH 7.10) was found in 2.03%. This percentage is considered too high. Protracted labor carries special risks. Conventional and intensive care supervision, when risks are foreseen, are often ineffective, since 48.8% of acidoses were recognized only post partum. More general intensive observation with internal cardiotocography and microinvestigations of blood appears to be the only way in which the frequency of acidosis could be decisively reduced.

Acidosis, Respiratory↗