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Biomedical subjects

W Eppel

Publications and source records attributed to W Eppel.

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

Management of supraventricular tachycardia during hexoprenaline therapy for preterm labour: benefit of cardioselective beta blockade?

A 29-year-old woman presented with preterm labour at 32 weeks of gestation. Tocolytic treatment was started with intravenous hexoprenaline. Twenty-four hours after initiation of treatment, the patient developed supraventricular tachycardia, resistant to digoxin and verapamil. Medical treatment with metoprolol finally restored sinus rhythm. We observed no adverse effects on the fetal heart rate nor on the umbilical cord blood flow.

Adult↗
PubMed1994

[Fetal ultrasound--retrospect and prospects].

In a historical review the situation in obstetrics was shown in the last 3 decades. Compound-scans and "real-time-scan" were the fundamental instruments for the first sonographical diagnosis and changes in clinical practice. The demonstration of the foetal body and organs allows numerous measurements of length, areas, and volumes. Signs of foetal vital functions were studied in different aspects. Doppler-flow-measurements in different parts of the foetal circulatory system had brought to light new information. In future especially colour-coded flow measurement will show signs of foetal life such as drinking, vomiting, and urinating and will enable us to study these functions of foetal life.

Congenital Abnormalities↗
PubMed1994

[Vaginal sonography of the cervix in twin pregnancies].

In a prospective study of 97 uncomplicated twin pregnancies, vaginosonographic cervix measurements of length, thickness and width of the internal os were performed. Furthermore, a group of 113 uncomplicated primipara was measured by vaginosonography. The twin pregnancies were examined sonographically at 4-5 week intervals between the 14th and 34th week of gestation. The results of the measurements were correlated between these two groups in accordance with duration of pregnancy and the number of deliveries. The results showed in general, that the cervical length of multipara-multiple pregnancy is longer than in the primipara-multiple pregnancy. Between the 13th and 17th week of gestation the cervix of primipara showed a length of 48.1 +/- 2.1 mm, the multipara twins showed a length of 52.3 +/- 3.4 mm. Between the 18th and 22nd gestational week, the primipara showed a cervical length of 49.4 +/- 3.6 mm and the multipara a length of 49.6 +/- 2.6 mm. In the 23rd to 27th week, the primipara had a cervical length of 39.4 +/- 2.4 mm, the multipara of 49.3 +/- 3.7 mm. From the 28th to 33rd week, cervical length was reduced in primipara to 31.2 +/- 2.9 mm, and in multipara to 42.7 +/- 5.1 mm. In the normal group of multipara, the cervical length was slightly longer. The assessment of cervical thickness showed the widest cervices in multipara gemini followed by the primipara gemini, the smallest cervices were found in primipara-single pregnancies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Endovaginal Doppler flow measurements of the ovarian artery in patients with a normal menstrual cycle and with polycystic ovary syndrome during in vitro fertilization.

Women with a normal menstrual cycle (n = 21, controls), polycystic ovary syndrome (n = 10) and hypogonadotropic amenorrhea (n = 3) were stimulated with clomiphen-citrate (4th day to 8th day of the cycle) and with human menopausal gonadotropin (8th day to 11th day). The vascular impedance of the ovary carrying the dominant follicles was monitored by endovaginal pulsed Doppler flow measurement. Simultaneously, serum levels of LH, E2 and 17-OHP were assayed. Contrary to controls, women with polycystic ovary syndrome or hypogonadotropic amenorrhea showed decreased hormone levels and no lowering of the vascular impedance. In controls, the lower pulsatility index is caused by neovascularization around the dominant follicle and by E2-induced vasodilatation in the ovarian artery.

17-alpha-Hydroxyprogesterone↗
PubMed1993

Serum prostaglandin F2 alpha (PGFM) and oxytocin levels correlate with sonographic changes in the cervix in patients with preterm labor.

This is a study on the correlation of maternal serum oxytocin and prostaglandin F2 alpha (PGFM) levels with sonographically measurable changes in the cervix and the internal cervical os in patients with preterm labor. Oxytocin levels significantly correlate (P = 0.03) with the width of the internal os and the PGFM values significantly correlate with the length of the cervix (P = 0.008). An increase in the oxytocin level resulted in a measurable widening of the internal os and an increase in the prostaglandin level resulted in a measurable shortening of the cervix.

Cervix Uteri↗
PubMed1993

[Umbilical blood flow relations in pregnancy complications. Part 2. Pathologic index constellations].

In a study comprising a total of 700 pregnant women, umbilical resistance was examined. Measurements were taken at both sides of the cord. A decline in resistance was registered from the fetal abdominal wall to the placental insertion of the vessels. According to a collective of 500 patients with a normal development and outcome of their pregnancies a physiological constellation of the resistance indices could be confirmed. It was taken as a basis for the definition of pathological cases. Different pathologies were related quite clearly to a special (unphysiological) constellation of the indices.

Abnormalities, Multiple↗
PubMed1993

[Blood flow measurements of neovascularization in tubal pregnancy].

In a retrospective study the results of vagino- and colour flow Doppler sonography of 23 tubal pregnancies verified by surgery were documented. Due to the neovascularisation in the trophoblast tissue the vascular impedance was elevated in all cases. The mean value of all pulsatility indices was 0.85 +/- 0.2. The direct signs of tubal pregnancy were seen in only 20 cases with vaginosonography alone. The combination of vagino- and colour flow Doppler sonography offers the chance of an earlier detection (5th week of pregnancy) of a tubal pregnancy.

Adult↗
PubMed1992

[Umbilical blood flow relations in different segments of the umbilical cord. Part 1. Physiologic index constellation].

Based on a collective of 500 women with normal singleton pregnancies we examined the indices of flow resistance along the umbilical cord. Measurements were taken at the foetal abdominal side of the Aa. umbilicales on the one hand and at the placental insertion of the vessels on the other. According to our results we were able to establish a physiological constellation of the indices for each week of gestation, and - subsequently - for the whole duration of pregnancy. These constellations could be considered physiological. They may serve as a basis for the definition of pathological conditions.

Blood Flow Velocity↗
PubMed1992

[Diagnosis of cephalothoracopagus--a case report].

Cephalothoracopagus twins were diagnosed at 22 weeks' gestation, hence this case was diagnosed early enough antenatally to allow vaginal pregnancy termination. This case underlines the need for exact ultrasound screening during early pregnancy.

Adult↗
PubMed1992

[Umbilical blood flow relations in patients with gestosis-- gestosis-specific Doppler phenomenon].

A collective of 48 pregnant women, whose pregnancies showed signs of a pregnancy-induced hypertension or gestotic tendencies was examined by Doppler ultrasound. The subject of interest was the resistance along the umbilical cord. Measurements were taken both ends of the umbilical cords. Usually, a decline of the indices is seen, which makes the difference between the two ends (Delta F) turn out positive. Pregnancies with any sign of a gestotic development, showed elevated resistances at the placental end of the cord. The indices of the foetal abdominal insertion were just about the same. Delta F changed significantly in our group of patients. Here, the values of both sides either did not differ from one another or the placental indices even exceeded the foetal ones. We called this special constellation of umbilical indices a Doppler phenomenon characterising gestotic pregnancies.

Blood Flow Velocity↗
PubMed1992

[The significance of prostaglandin F2 alpha (PGFM)--and plasma oxytocin level in patients with premature labor].

In the present study, plasma oxytocin and prostaglandin F2 alpha metabolite (PGFM) concentrations were measured in 46 patients admitted for preterm labour. Gestational age ranged from 20-34 weeks. Samples were collected 12 hours before and after initiation of tocolysis. Patients with a premature rupture of the membranes and/or intra-amniotic infection were excluded in this study. There was a significant difference in the oxytocin (p = 0.05) and PGFM levels (p = 0.007, after 12 hours: p = 0.004) between a control group without preterm labour and women with preterm labour. No differences were seen between the successfully treated (delivery more than 5 days after start of tocolysis) and the failure group. There was no significantly different increase or decrease in PGFM and Oxytocin plasma levels between treatment failures and successfully treated patients.

Birth Weight↗
PubMed1992

[Vaginal ultrasound studies of cervix closure with special reference to parity].

In this study, the cervical length, thickness, the width of the internal os, the cervical canal and the external os of 62 primipara and 77 multipara were measured vaginosonographically. Only patients with normal pelvic scores were examined. The measurements were carried out approx. every fortnight between the 16th and 34th gestational week. In the primipara group, the average cervical length was 36.8 mm +/- 12.0 mm, the thickness 27.8 mm +/- 4.4, the width of the internal os 6.3 +/- 2.1 mm, the cervical canal 4.2 +/- 2.0 mm and the external os 5.4 +/- 2.2 mm. In the multipara group, an average cervical length of 40.1 mm +/- 7.4 mm, a thickness of 29.3 +/- 3.9 mm, an internal os of 5.1 +/- 2.6 mm, a cervical canal of 4.3 +/- 1.3 mm and an external os of 5.8 +/- 1.8 mm were found. Contrary to our expectations, there was no statistically significant difference between the two groups. Furthermore we did not find any correlation between the internal and the external os.

Cervix Uteri↗
PubMed1992

[Prognostic factors of radically operated stage Ib cervix cancer].

The present retrospective study attempts to evaluate the significance of factors such as age, histological type, histological grading, tumour size, lymph node metastases and tumour infiltration of the corpus uteri. Between 1975 and 1988, 312 patients were operated at our department or referred to postoperative radiotherapy. They fulfilled the inclusion criteria: histopathological stage Ib and radical hysterectomy with pelvic lymphadenectomy. The multivariate analysis confirmed, that the factors histological grading (G3 vs G1 + G2: relative risk (RR) = 2.66; 95% confidence interval (CI) = 1.36-5.18), tumour size (tumour infiltration of the cervix greater than 2/3 vs less than 2/3: RR = 2.36; 95% CI = 1.07-5.17), and pelvic lymph node metastases (positive vs negative: RR = 5.36; 95% CI = 2.70-10.65) are of significant importance for the survival. The results show, that patients with a cervical carcinoma in FIGO stage IB, with an infiltration of more than two thirds of the cervix with a more or less differentiation and with or without positive lymph node status, should be classified as high risk patients. In these unfavourable situations, a prospective randomised study should clarify the success rate of adjuvant therapy.

Adult↗