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V Briese

Publications and source records attributed to V Briese.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Diabetes mellitus--an epidemiologic study of fertility, contraception and sterility].

MATERIAL AND METHODS: Data from 672 female patients with diabetes mellitus between 17 and 42 years of age were collected by questionnaire. Mean manifestation age was 19.9 years (min. 1, max. 38). RESULTS: 72.39% of the patients were treated with insulin; one third had successful pregnancies. Only one of ten diabetics delivered more than once after diabetes had become manifest. At the time of the study, 126 (19.1%) of the patients attempted pregnancy; about one-fifth of these for more than 2 years. Diabetes manifestation occurred significantly earlier in patients who did not achieve conception. Correlation between daily insulin dose and infertility was proved, whereas duration of diabetes had no significant influence on fertility. Habitual abortion was found in 0.62%, among nulliparous patients 1.64%, respectively. Contraception was performed in 64.2% (32.8% hormonal contraceptives, 18.6% IUD, 1.8% natural family planning, 11.0% tubal sterilisation or hysterectomy, 35.8% no contraception). 47% of the used oral contraceptives contained a reduced oestrogen dose (30 micrograms estradiol). In one third of the users, IUD were longer than 5 years in place. Tubal sterilisation was found in 69 (10.44%) of diabetic patients; in 51 cases before the age of 30 years. CONCLUSIONS: Contraceptive methods should be selected carefully. Diabetic patients unsuccessfully attempting pregnancy should be referred early to a centre for reproductive medicine.

Abortion, Habitual↗
PubMed1995

[Current aspects of premature labor].

Six to eight percent of all newborns are born prematurely. Preterm delivery remains the most severe event regarding morbidity and mortality of the premature infants. The most serious complications in the treatment of prematurity are intracerebral bleedings that lead to progressive hydrocephalus and neurological handicaps in those newborns who survive. To our knowledge, about 50% of premature births with cerebral bleedings of stage I-II show normal or slightly decreased postnatal development. Both, a sufficient oxygen utilisation and a regulation of cerebral blood perfusion are necessary to prevent periventricular leucomalacia and cerebral bleedings with impairment of parenchymatous tissue. Endothelial swellings with decreasing blood flow into the cerebral parenchyma were found only in cases of prolonged oxygen deficiency. Vasoconstriction may produce a circulus vitiosus. However, it is important to know that more than 50% of the premature infants probably suffer from initial cerebral bleedings already in the prenatal stage. During the last 10 years the infectious pathogenesis has resulted in better understanding of pathophysiologic factors for prematurity. The local cervical activation of interleukins (IL 1, 6, 8) caused by cervical infections stimulate the prostaglandin synthesis and cervical maturity.

Brain↗
PubMed1995

[Perinatal and neonatal mortality and morbidity in newborn infants up to 1,000 g].

World-wide intensive efforts have been made for more than 20 years to reduce the rate of preterm delivery, but so far without remarkable success. Preterm delivery accounts for 6-9% of all deliveries and very-low-birth-weight infants (< or = 1000 g) total up to about 60% of perinatal mortality. This study reports on a retrospective analysis of fetal outcome with 33 very-low-birth-weight-infants (< or = 1000 g) delivered at the Women's Hospital (University of Rostock) during the time from 1986 to 1992. The rate of early mortality was at 45.2%, survival rate was at 33% (n = 11). Caesarean section with preservation of fetal membranes proved to offer better results of fetal outcome than spontaneous delivery. Comparing the fetal outcome of all patients concerned, it became obvious that newborns whose mothers enjoyed intensive prenatal care had better chances than those newborns whose mothers came to hospital not before onset of preterm labour. From our experiences we conclude that intensive antenatal care with very early assessment of all possible risk factors for preterm labour is the prerequisite to reduce the rate of preterm delivery.

Birth Weight↗
PubMed1995

[Cholesterol, HDL-cholesterol, triglycerides and beta-lipoprotein in diabetic pregnancy].

UNLABELLED: Follow up studies regarding lipid metabolism in diabetic pregnancy are important in maternal and fetal morbidity. OBJECTIVE: With this background it is particularly opportune to consider the difference of cholesterol, triglycerides and HDL-cholesterol of diabetics and nondiabetics in pregnancy. In addition the correlation of lipids to the glycosylated hemoglobin (HbA1), White groups and other clinical parameters is of interest. Attention is given to the comparison of insulin dependent diabetics (IDDM) and gestational diabetes (GDM) in the 3rd trimester. PATIENTS: A diabetic group of 84 patients (IDDM, GDM) was used for the prospective study over a two years period. The lipid metabolism was estimated preconceptionally, during pregnancy and on 7th day after delivery. 36 pregnant healthy women served as controls. The information obtained from each patient was entered into an SPSS data base. Statistical analysis were done by Mann-Whitney U and Kruskall-Wallis test and by means of Pearson's correlation coefficient to correlate with age, parity, body mass index, creatinin, albumiuria, HbA1, blood pressure. RESULTS: There were no any correlations between lipid parameters cholesterol, triglycerides, HDL-C, beta-lipoprotein and HbA1 as well as White groups (Pearson's coefficient). The triglyceride levels were significant lower in diabetic pregnants compared with healthy controls (p = 0.0095; Wilcoxon Test); diabetes: mean = 1,831 mmol/l; min 0.35; max 5.99 and control group mean = 2,133 mmol/l; min 0.36; max 4.70. Cholesterol levels were higher in the 3rd trimester of GDM patients than values of IDDM's (p = 0.0017; Wilcoxon Test). The longitudinal study during diabetic pregnancy resulted in significantly progressive increase in cholesterol and triglyceride levels (p = 0.0035 bzw. p = 0.0099; Kruskal-Wallis Test). CONCLUSIONS: Significant lower triglyceride levels had been found in diabetic pregnants than in healthy controls. There was no any correlation between lipid parameters cholesterol, triglycerides, HDL-cholesterol, beta-lipoprotein on the one side and HbA1 and White groups on the other side. Increased cholesterol levels were noted in the 3rd trimester of pregnancy in the gestational diabetes in comparison of insulin dependent pregnant diabetics.

Adolescent↗
PubMed1995

[Diagnosis and therapy of toxoplasmosis infections in pregnancy at the Rostock University Gynecologic Clinic 1986-1994].

Over a period of eight years, 61 patients with toxoplasmosis infection in pregnancy were examined retrospectively at women's hospital. Diagnosis of maternal infection was based on seroconversion, positive IgM, raising IgG--titers above twofold, and very high primary titers in SFT. In 20 patients (32.8%) diagnosis was found with seroconversion. In 15 patients (24.6%) the first examination revealed very high titers (SFT > or = 1:2000, KBR > or + 1:40)> Using a score, time of infection was grouped into: periconceptional (24.59%), 1st Trimester (34.43%) 2nd Trimester (31.14%), 3rd Trimester (4.92%), not specified (4.92%). The latency phase between first suspect titer and treatment did vary markedly. Duration of latency phase was longer than 6 weeks only in 10% and 20% of cases identified via seroconversion or very high titers respectively. Of all cases with different diagnostic attempts 73.9% were treated later than 6 weeks after the first suspect titer. Therapy was performed with either a combination of pyrimethamine-sulfadiacine or spiramycin monotherapy. In 18/53 newborns (33.9%) fetal infections were proven with IgM-detection post partum. Clinical evaluation was normal in 48 children (77.5%). 6 newborns (9.7%) had dilated cerebral ventricles; 3 (4.8%) had irregularly dense intracerebral structures, one newborn (1.6%) had intracerebral calcifications. Primary neurological check-up of the newborn was normal in 91.9%. 2 children (3.2%) had facial paralysis or reduced muscle tonus. In 2 newborns (3.2%) opthalmological examination of the fundus revealed signs of retino-chorioditis.

Adult↗
PubMed1994

[Fetal outcome after local prostaglandin E2 administration in a risk patient group--comparison of morbidity with a normal patient sample].

Intracervical application of prostaglandin E2 gel is considered to be effective in the induction of cervical ripening (priming). Within an 2-years period 244 perinatal risk patients primed with PGE2 were compared with matched paired controls retrospectively. These 244 controls were matched for age, gestational age, parity, birth weight and maternal body mass index and delivered spontaneously. PGE2 gel (Prepidil) was administered intracervically. Basis criteria of perinatal quality, such as neonatal umbilical cord pH and APGAR-score were significantly (p < 0.01) worse in the patients treated with PGE2 gel. In the priming group cord pH was 7.28 (+/- 0.085) and 7.30 (+/- 0.070) in the control group. APGAR 1 min. was found to be 7.56 +/- 1.86 (priming) and 8.18 +/- 1.23 (control); APGAR 5 min. 8.56 +/- 0.90 (priming) and 8.78 +/- 0.54 (control). Contraction disorders, such as hyperactivity and dyscoordination, combined with cardiotocographic pathology was found in 42% (priming) and 19% (control) resp. Severe bradycardia occurred significantly more often in the priming group, whereas no differences were found concerning fever under labor and in puerperium.

Acid-Base Equilibrium↗
PubMed1994

[Expectant management of premature rupture of fetal membranes before completion of the 35th week of pregnancy--retrospective analysis of 44 cases].

44 cases of preterm premature rupture of fetal membranes (PPROM) before 35 completed weeks of gestation were analyzed retrospectively. Expectative management was based on infection diagnosis, vaginal disinfection and in case of signs of infection on systemic antibiotic therapy. Glucocorticoids for induction of lung maturity were generally administered. Perinatal mortality was 11.4%, after exclusion of one congenital anomaly 9.3% respectively. Lung immaturity was the main cause of neonatal death. Only 5 neonates developed clinical infection, with 4 of these showing prepartal maternal signs of infection. Maternal signs of infection are not a specific signal for later neonatal infection. Cerebral bleeding complications and pathological neurologic status occurred in 10/39 and 8/39 cases respectively. Cesarean section rate amounted to 15/44 (34%).

Adolescent↗
PubMed1994

[Anemia in puerperium--a retrospective analysis].

In 10,393 patients delivered in our hospital between 4/1986 and 8/1992 prevalence of anemia post partum was determined retrospectively. Post partum anemia was classified according to blood hemoglobin content: mild to moderate anemia (6.0-7.0 mmol/l) and severe anemia (< 6.0 mmol/l). After exclusion of patients with high intrapartal blood loss and/or febrile puerperium overall prevalence of anemia increased from 33.78% in 1986 to 49.46% in 1992 (p < 0.01). The portion of patients with blood hemoglobin < 5.4 mmol/l remained stable with 5.6% during observation period. The presented data stress the need for general iron supplementation during pregnancy and puerperium.

Adult↗
PubMed1994

[Analysis of 122 twin deliveries with special reference to morbidity and mortality of the second twin].

122 consecutive twin deliveries between 1986-1992 were analysed retrospectively under special consideration of morbidity and mortality of the second twin. 13.9% of the twin deliveries occurred before the 33rd week of gestation. The cesarean section rate amounted to 49.2%, the first twin was delivered in 5.7%, the second twin in 27%, by vaginal operative methods. Perinatal mortality of the first twin was 3.3%, of the second twin 6.6% (p < 0.01); thus resulting in an overall twin mortality rate of 4.9%. The acidosis-rate of 16.4% in the second twin was significantly above the 9.0% in the first twin. The vaginal operative mode delivery especially contributed to the impaired outcome of the second twin. There was no correlation between the morbidity of the second twin and the time interval between the two deliveries.

Adolescent↗
PubMed1994

[Thrombocytopenia in pregnancy--a case report].

A report is given on a rare case of a 25 years old pregnant women with hepatosplenomegaly, thrombocytopenia and elevated liver enzymes. Because of an abnormality of the Truncus coeliacus and A. mesenterica superior and portal hypertension there has been performed the end-to-side portocaval anastomosis.

Adult↗
PubMed1993

Semiquantitative determination of IL-1 alpha, TNF-alpha, PDGF-A, PDGF-B, and PDGF-receptor in term human placenta using polymerase chain reaction (PCR).

Eight placenta samples derived from normal term human placenta were examined for the expression levels of Il-1 alpha+, TNF-alpha+, PDGF-A+, PDGF-B+, and PDGF-receptor+ using a semiquantitative PCR protocol. The expressional level of beta-actin was proven to be constant, therefore beta-actin could serve to equilibrate sample size in our procedure. Differences were found in the mRNA levels of IL-1 alpha and TNF-alpha. The expression of PDGF-A, BDGF-B and PDGF-R seemed to be relatively constant in our group of samples. Further investigation and improved quantitative PCR protocols are needed to correlate clinical outcome of pregnancy with cytokine expression at the placental level. +Il-1 alpha (interleukin-1 alpha) +TNF-alpha (tumor necrosis factor-alpha) +PDGF-A (platelet derived growth factor A) +PDGF-B (platelet derived growth factor B) +PDGF-Rezeptor (platelet derived growth factor-rezeptor).

Actins↗
PubMed1993

[Pre-conception counseling and pregnancy in chronic inflammatory bowel diseases--Crohn disease and ulcerative colitis].

Since chronic inflammatory diseases start to develop during the fertile years, the possibility of a mutual influence of pregnancy and bowel disease obviously must be considered. The knowledge about the interference between disease and pregnancy influences the management of pregnancy and delivery as well as of the disease itself. Intensive care, including genetic counseling, dietary management, and drug therapy ought to start even before pregnancy. In the care of the pregnant patient with Crohn's disease or ulcerative colitis corticosteroids and sulphasalazine may be used just as in the nonpregnant patient. An increased activity of the disease in the beginning of pregnancy causes high rates of prematurity, spontaneous abortions, and stillbirths. Frequency of defects in embryonic development varies between 0 and 4% and is even higher in severe cases of Crohn's disease. Prophylactic drug administration in pregnancy is not suitable to decrease the risk of exacerbation. Several studies revealed that the risk of exacerbation is not increased during pregnancy. Low activity in the onset of pregnancy is continued in 61%. Higher rates of abdominal and vaginal operative deliveries (26% in Crohn's disease) seems to be associated with active intervention on the base of activity indices.

Colitis, Ulcerative↗
PubMed1993

[HELLP syndrome in the 26th week of pregnancy].

The HELLP-syndrome is the most severe form of pre-eclampsia. Fetal and maternal life is threatened because of missing prodromi and sudden onset of complications. This case report describes the development of HELLP-syndrome in a 26 y/o G1P0 in the 26th week of gestation. Clinical signs and changes in laboratory parameters lead to the diagnosis. No hypertension was stated. The pregnancy was terminated by cesarean section resulting in a viable 900 g female newborn, who was transferred to the neonatal intensive care unit. The patient's condition stabilized quickly after the delivery, symptoms decreased within 4 days.

Adult↗
PubMed1992

[New methods for diagnosing infection in pregnancy].

Maternal infections during pregnancy are of special relevance because of the risk of transmission to the fetus. Besides serological methods of diagnosing acute maternal infection, new approaches to assess fetal involvement have been made by invasive procedures, such as ultrasound-guided fetal blood sampling or amniocentesis. The most relevant infections in pregnancy are briefly reviewed with their incidence, consequences of fetal infection, and standard diagnostic procedures. Immunological methods are handicapped by the immaturity of the fetal immune system; direct culture is complicated and time-consuming. The application of molecular biological methods to directly identify the RNA- or DNA-sequences of the infectious agent may be an alternative. Two methods, polymerase-chain-reaction (PCR) and in-situ hybridization (ISH) are explained. Broad clinical use is still hindered by problems in specificity and quantitative accuracy. Nevertheless, successful diagnosis of most of the relevant infections in pregnancy by these molecular biological methods, is published, and discussed in a review of the recent literature.

Cytomegalovirus Infections↗
PubMed1992

[Diabetes and pregnancy--optimal management].

Current classification, diagnostic and therapeutic guidelines of diabetes in pregnancy are briefly reviewed in this paper. Obstetricians mainly are confronted with the insulin-dependent diabetic (IDDM) prior to conception and during pregnancy. Intensive interdisciplinary co-operation is considered a prerequisite for treatment of the diabetic patient planning or carrying a pregnancy. The following subspecialties should work together in diabetic pregnant care: Reproductive Medicine incl. high-level endocrinological diagnostics, Diabetology with a teaching facility, and--within a perinatal center--an obstetric and neonatal department experienced in diabetic care. Preconceptional metabolic adjustment as well as surveillance of fetal and maternal condition during the first trimester of pregnancy are considered the mainstay in diabetic patient's care. Possible complications of diabetic pregnancy are described. Only in rare cases, pregnancy is contraindicated because of retino- or nephropathy. The screening program for gestational diabetes is based upon the patient's history, fasting-blood-glucose-levels, 50-g-oral-glucose-tolerance-test (OGTT) and a 24-h-blood-glucose-profile. Measurement of insulin levels in amniotic fluid are recommended for cases that remain yet undiagnosed.

Diabetes Mellitus, Type 1↗
PubMed1992

[Fetomaternal signal transduction by growth factors].

An attempt was made to review the current knowledge on the role of growth factors in the field of fetomaternal interaction. Of special interest was the relation between maternal T-lymphocytes and fetal growth. Stimulation of cytotrophoblast growth is effected by: IGF I/II (insulin-like growth factor), CSF-1 (colony stimulating factor), EGF (epidermal growth factor), FGF (fibroblast growth factor), IL-1, IL-3 (Interleukin), PDGF (platelet derived growth factor). TNF (tumor necrosis factor) inhibits trophoblast cell growth. TNF is synthesized in both decidual and chronic cells. CSF-1 considered the most potent stimulator of the induction of trophoblast cell growth. Cytotrophoblast itself produces IGF I/II, EGF, PDGF, TGF (transforming growth factor). Furthermore, it is known that HCG-secretion is mainly stimulated by IL-1. Whereas intra- and paracrine mechanisms in the placenta will remain in the field of basic research for the next future, animal experiments proving the positive impact of IL-3 and GM-CSF (granulocyte/macrophage-colony stimulating factor) on trophoblast growth should give reason for clinical investigations. It is assumed, that maternal T-lymphocytes realize paternally inherited alloantigenic structures resulting in local response of IL-3 and GM-CSF production.

Embryonic and Fetal Development↗
PubMed1991

Serum concentration of secretory IgA during pregnancy and in gynaecological diseases affecting glands and mucosas.

Secretory IgA (S-IgA) was measured in serum samples from pregnant women by means of radial immunodiffusion according to Mancini with an antiserum against the secretory component and an S-IgA standard. The results neglect the differentiation in SC, S-IgA, and S-IgM. The study includes S-IgA serum levels during pregnancy and post partum as well as in patients with cervical carcinoma and inflammation of the genital tract. The S-IgA serum levels of pregnant women (2nd and 3rd trimester) and after delivery were increased significantly in comparison to nonpregnant women (p less than 0.01). The S-IgA levels in genital inflammation diseases and cervical carcinoma were only sometimes elevated. Pregnant women, 1st trimester: means = 40.0 mg/l (s = 12.2); pregnant women, 2nd trimester: means = 60.13 mg/l (s = 18.9); pregnant women, 3 rd trimester: means = 73.5 mg/l (s = 17.4); post partum: means = 77.5 mg/l (s = 29.52); cervical carcinoma: means = 41.9 mg/l (s = 17.3); adnexitis: means = 46.46 mg/l (s = 16.8); controls: means = 38.61 mg/l (s = 10.5). In a second part S-IgA could be estimated in serum samples of pregnant women by means of an enzyme-linked immunosorbent assay (ELISA). The levels ranged from 7.1 mg/l to 19.3 mg/l in the 1st trimenon and from 16.8 mg/l to 82 mg/l in the 3rd trimenon (means = 11.72 mg/l; s = 4.419; n = 21 and means = 40.01 mg/l; s = 15.117; n = 60). This increasing was significant too (p less than 0.01).

Adult↗