[Stress fracture of the sacral bone].
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Athletic Injuries↗
Biomedical subjects
P Hohlweg-Majert
Publications and source records attributed to P Hohlweg-Majert.
[Clinical aspects of vaginal hysterectomy].
From 1971-1982 4,179 hysterectomies have been performed by vaginal route on the department of gynecology and obstetrics of the Klinikum Mannheim. 46.5% of these women were between 20 and 40 years old, 7.2% were older than 60 years. The mean age was 41 years, 5.6% of the patients were nulliparae, 21.0% uniparae and 73.4% multiparae. 4.8% had a history of a previous gynecologic operation, adipositas was present in 8.7%, and a severe varicosis was present in 8%. The most frequent indications were uterus myomatosus (36.2%) and descensus uteri (26.8%). In 62% of all patients only hysterectomy was performed, in 31.4% hysterectomy with an additional colporrhaphy was performed. Morcellation of the uterus was necessary in 3.4%. The most frequent intraoperative complication was the lesion of the bladder in 0.4%. The postoperative morbidity was 15.8%, two third of these patients had an inflammatory disease of the urinary tract. The mortality was 0.07%.
Adult↗
[Conization of the uterine cervix. A study of 900 cases].
In the years 1968 till 1982, 900 conisations of uterine cervix were performed, 90% of which were diagnostic interventions. During the follow-up period, the mean age of the patients with carcinoma in situ decreased 4 years, the mean age from patients with microcarcinoma 3.2 years. In 64% the conisation was carried out due to a positive or suspekt smear. Conisations, performed during pregnancy, were not associated with any additional complications for mother or child. Taking a big conus resulted more often in a total extirpation of the neoplastic changes, without increasing the complication rate. The average hospital stay was 8.7 days. It was only prolonged in patients with secondary hemorrhage. 33% of all neoplastic changes were extirpated totally. In 85% of the women who had follow-up only after incomplete extirpation of the neoplasia by conisation, there was no recurrence. The rest did show the neoplasia again, often in a more serious way. The overall complication-rate was 7.4%.
Adolescent↗
[Cesarean section with subsequent hysterectomy].
We had 65 Caesarean hysterectomies from 1960-1982 at our hospital. 43 patients were elected for various reasons: contraception 26, fibromatosis 13, intraepithelial neoplasia 4. 22 had vital indications: rupture of the uterus 12, placenta increta/percreta 5, abruptio placentae 3, atony 2. The time we needed for the operation was up to 100 minutes in the elective group, 160 minutes in the non-elective group. In vital indications, postoperative morbidity was higher than when treatment was elective. In the group of vital indication, 4 patients died, whereas no patient died if operation was performed on an elective basis.
Adult↗
[Infusion therapy after vaginal hysterectomy (author's transl)].
The applicability of a complete solution containing amino acids, electrolytes and calories for post-operative infusion therapy after vaginal hysterectomy was investigated. In the 16 patients examined it was found that using this solution it is possible to maintain a smooth nitrogen balance to a large extent. In a control group of 6 patients who only received an infusion of electrolytes and calories, the nitrogen balance was clearly noncompensated. As even with the complete solution compensation of the nitrogen balance is not achieved until the second day, it is recommended that for patients at risk the infusion treatment should be commenced on the day prior to operation.
Adult↗
[Gynaecological operations in patients over 60 years of age (author's transl)].
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Age Factors↗
[Psychomotor development of children born operatively by Caesarian section, vacuum or forceps in the period between 3 and 7 years (author's transl)].
In the period between 1966 and 1977 9,591 children were born at the UFK, Mannheim, and of these 1.008 were operative deliveries (10.5%). Out of these children, 99 of those delivered by section, 39 by forceps, 140 by vacuum and 67 spontaneous births were examined in an alphabetically determined group (R) for mental and motor development. The means used for the follow-up investigation were the Kramer-Binet Intelligence Test, and careful questioning of the parents on their children's early development. No connection between the type of delivery and intelligence quotient could be determined. A mean IQ of 114.4 was found for those delivered by section, 116.6 for those by forceps, and 117.7 for thos delivered by vacuum. The spontaneously-born children had an IQ of 108.7. The IQ results determined were correlated with the following data: EPH-gestosis, alteration in the child's heart sounds, protracted birth and Apga. No significant differences in the intelligence or any delayed motor development could be found in relation to the comparative group.
Adult↗
[A comparative follow up study about intellectual and motoric development of premature births at three to eight years of life (author's transl)].
In a study involving 361 cases an average IQ for 101 was noted; the premature birth groups showed an average IQ of 99 and the control group an average IQ of 102. Statistically significant was the occurrence of mental retardation in the premature birth group when compared with the control group. In the premature birth group an delayed walking ability showed a correlation to a diminished birth weight. A correlation between a low asphyxion-Index and IQ could not be ascertained. In the areas of speech development, walking ability and bladder control no significant differences were noted between premature birth and control group.
Apgar Score↗
[Results of the Wertheim-Meigs hysterectomy with special regard to postoperative complications].
From 1965 to 1975, 232 radical hysterectomies (using the Wertheim-Meigs method) were performed in the Department of Obstetrics and Gynecology, University Hospital, Mannheim. Statistical evaluation showed that the average patient was 43,3 years old. In more than 50 percent of all cases the reason for admission to hospital was given as bleeding problems and contact bleeding, in 30 percent of the cases the readon was given as suspicious cervical os findings. 80 percent of all patients were operated on in stage Ia or Ib. An indwelling catherer was in place for an average of 14.96 days. Postoperative complications occurred in 194 (83.62%) patients. Of those, a majority (71.55%) was found to be an urological problem. Wound healing disturbances amounted to 12 percent of all cases. The mortality rate was 1.29 percent.
Abdominal Muscles↗
[Pregnancy and labor in guest-workers].
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Adult↗
[Cervix insufficiency].
Between 1965 and 1975, Shirodkar operations were performed on 144 patients (mean age 28,6 years). The most frequent diagnosis was incompetence of the internal cervical os, which accounted for 90% of the operations, the remaining 10% being prophylactic. Sutures were performed between the 14th and 16th week of gestation and 72,5% of these patients had normal births (mean gestation time 39 weeks). Without Shirodkar operation, out of 291 pregnancies studied, 26% resulted in normal birth; whilst with Shirodkar, 82% of 137 pregnancies were successfully delivered at term.
Adult↗
[Intensive care in obstetrics and gynecology. Indications for transfer to the intensive care unit].
Between the years of 1969 and 1974, 68 patients were transferred from our Department of Obstetrics and Gynecology to the Intensive Care Unit. This figure represents 0,5% of all operative cases. 50% were high risk patients, previously under the care of our physicians. 11,8% occurred because of problems arising from latent diseases not previously diagnosed. The main reasons for transfer were septic shock, coagulopathy arising from abruptio placenta, placenta praevia, embolism and pneumonia. Interdepartmental cooperation is indispensable for correct diagnosis and a timely transfer.
Acid-Base Imbalance↗
[Obese patients in obstetrics].
The results of two studies about the course of pregnancy and delivery in adipose women in our hospital are combined and discussed. We found a higher rate of EPH-gestosis in overweight patients. The frequency of Cesarean section was increased. Belated uterine involution post partum is more frequent in adipose women, also the occurrence of urinary tract infections. There is a significant increase in perinatal mortality, mainly due to an increase in still-born. Pneumonia due to aspiration and birth traumata occur more frequently as well and endanger the children.
Female↗
[Epidemiology of endometrial hyperplasia and adenocarcinoma].
In a retrospective study characteristics of 729 climacteric and postmenopausal women with hyperplasia and adenocarcinoma of the endometrium are compared with those of 82 women with atrophic endometrium and 96 women with carcinoma of the cervix. In a prospective study 225 women with glandular-cystic, adenomatous and atypical hyperplasia of the endometrium have been checked by a control-curettage within a period of two months until four years following the first diagnosis. Low parity, disturbances of menstruation with anovulatoric bleedings during fertility period, adipositas, hypertension and diabetes mellitus in climacteric and postmenopausal women indicate a high risk of carcinoma of the endometrium. Hyperplasias of the endometrium in climacteric women cannot be considered as precursors of corpus carcinoma. They are the result of a temporary hormonal dysfunction. Prophylactic hysterectomy, however, should be performed, if adenomatous or atypical hyperplasia appears in older postmenopausal women with the indicators of high risk of endometriumcarcinoma as mentioned above.
Adenocarcinoma↗
[Mortality of premature infants].
Mortality of 908 immature births (newborn infants under 2501 g; stillbirths with crown-heel-lengths 35 cm plus) were studied and compared with a random selection of newborn infants with birth weights of at least 2500 g. Total mortality was 27,75%; 8,7% being stillbirths and 21,2% postnatal deaths; perinatal mortality was 26,98%. In mature groups a perinatal mortality of 0,64% was recorded. 90% of immature infants died within the first 3 days. In 30% of these cases cause of death was unknown, 30% died from immaturity, approx. 16% from apnoe and approx. 6% from cerebral haemorrhage.
Birth Weight↗
[Legal abortions at the University-Gynecological Clinic Mannheim during 1971-1974].
Between 1971 and 1974 142 legal abortions were performed. Methods used were determined by gestational age, size of the uterus and whether or not abortion in conjunction with sterilization was indicated. Dilatation and evacuation was employed in 46% of cases; in 8% of these sterilization was performed at a later date. A further 55% were treated by means of primary hysterectomy, 38% via the vaginal route, 17% via the abdominal route. Complications were observed in 4 cases (3 perforations, 1 post-operative haemorrhage, 1 case of endometritis). The complication rate was not higher than in non-pregnant women.
Abortion, Induced↗
[Pregnancy in obese women (A'uthor's transl)].
Between 1969 and 1971 4,749 antenatal patients were observed. Compared to the tables for ideal weights of the Metropolitan Life Insurance Company Statistical Bureau, 26.76 percent of the patients were above ideal weight and 11.35 percent of the patients were obese. It was found that complications and illnesses during the pregnancy increased progressively with weight groups above the ideal weight. Hypertension was five times as frequent in obese women than normal, edema and proteinuria were common. Pre-eclampsia was more common in the obese. Varicosities occurred much more often in the maternity cases above normal weight and with obesity.
Adolescent↗
[A comment about premature births (author's transl)].
Prenatal case histories and labours of 908 mothers who delivered prematurely at the University of Heidelberg, Department of Gynaecology and Obstetrics in Mannheim, between the years 1966-1971 were compared with a freely selected group of 782 mothers who delivered healthy mature infants with birth weights over 2500 g. (Premature infants -- under 2501 g; Stillborn infants -- under 2501 g and a minimum 35 cm crown-heel length). A tendency to premature delivery was observed in primipara, multipara with at least 4 previous deliveries, unmarried mothers, and in women with a preceding miscarriage or with closely spaced pregnancies less than 24 months apart. Bleeding during pregnancy, EPH-Syndrome, inadequate prenatal care, premature amnion rupture, abruptio placentae, pathological presentation and complications during labour were more frequently observed in mothers who delivered prematurely than those at full term. Histo-pathological changes of the placentas were found in 11,2% in cases of premature births as opposed to 3,6% in full term cases.
Abruptio Placentae↗