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Biomedical subjects

W Henrich

Publications and source records attributed to W Henrich.

At least 37 records · Page 2Linked to original sources

Antenatal diagnosis of placenta percreta with planned in situ retention and methotrexate therapy in a woman infected with HIV.

Placenta percreta is a rare obstetric condition associated with potentially life-threatening hemorrhage. Diagnosis in advance of delivery permits a planned delivery and preparation for blood transfusions and planned Cesarean hysterectomy, which is the common treatment. We report a case of placenta percreta in an HIV-positive patient which was diagnosed in the second trimester using conventional and extended field of view ultrasound imaging and color Doppler. At 36 weeks the infant was delivered by Cesarean section and the placenta was left in situ. Postoperatively the patient was treated with methotrexate. Four weeks later, the patient delivered the placenta spontaneously. Early or late postpartum hemorrhage did not occur and postoperative recovery was uneventful.

Adult↗

Recurrent cytomegalovirus infection during pregnancy: ultrasonographic diagnosis and fetal outcome.

Fetal infection as a consequence of recurrent disease is uncommon. We present a case of recurrent cytomegalovirus infection in the second trimester of pregnancy. Fetal infection was detected through severely abnormal findings on ultrasound examination and verified by detecting cytomegalovirus DNA in the amniotic fluid and cytomegalovirus-specific immunoglobulin M antibodies in the fetal blood and associated pancytopenia. Because of the severity of the infection, a fatal outcome was predicted. A Cesarean section was performed at 33+5 weeks of gestation; the child died shortly after birth.

Adult↗

Isolated fetal ascites caused by primary lymphangiectasia: a case report.

We present a case of isolated fetal ascites diagnosed by ultrasonography at 29 weeks' gestation. Cordocentesis revealed a normal karyotype and negative viral titers. Postnatally, the diagnosis of primary lymphangiectasia was made by intestinal biopsy. To our knowledge this is the first description of prenatal manifestation of primary lymphangiectasia.

Adult↗

Acute iliac vein thrombosis in pregnancy treated successfully by streptokinase lysis: a case report.

BACKGROUND: Postthrombotic syndrome is an important late complication after deep vein thrombosis in pregnancy. Thrombolytic agents are more efficient in preventing this condition but are rarely used in pregnant women. CASE: A 22-year-old woman at 29 weeks of gestation presented with acute iliac vein thrombosis. After application of a heparin bolus, systemic streptokinase lysis was performed. Low-dose heparin therapy was continued for the remainder of the, otherwise unremarkable, pregnancy. Spontaneous delivery of a healthy girl was without complications and thromboprophylaxis with low-molecular heparin was continued. CONCLUSION: Thrombolysis in pregnancy is possible and may help to prevent severe long-term sequelae of thrombosis in young women. Bleeding is a major risk, which must be considered and therapy should only be administered under close observation.

Adult↗

Prenatal therapy of non-immunologic hydrops fetalis caused by severe aortic stenosis.

Congenital aortic stenosis is a rare cause of congestive heart failure and hydrops fetalis. This report describes a case of prenatally diagnosed critical aortic stenosis and endocardial fibroelastosis leading to a severe hydrops fetalis at 27 weeks of gestation. Successful transplacental digitalization was performed and all signs of hydrops resolved within 2 weeks. The pregnancy continued with normal development of the fetus and birth was induced at 39 weeks of gestation. After an uneventful vaginal birth, the child was transferred for cardiac catheterization, and balloon dilation of the aortic valve was performed successfully. Follow up at the age of 2 years showed only mild left ventricular cardiac hypertrophy, a moderate elevated pressure gradient of 50 mmHg at the aortic valve and mild aortic and mitral regurgitation. No further interventions were necessary at this point.

Adult↗

[Gynecological ultrasound network: new concepts].

Digital data processing and storage are advancing in many medical settings. Some ultrasound machines process, store and provide images digitally. For many obstetrical and gynecological ultrasound units electronic filing and reporting are essential parts of their documentation. However, patient data are often entered redundantly into the different systems (admission and billing, encoding of diagnoses, medical reports etc.). Bi-directional exchange of textual data is the first step towards successful integration. Additionally, affordable central digital video storage from different sources within a department or hospital will soon become available.

Computer Communication Networks↗

[Intact unilateral twin pregnancy--sonographic diagnosis and laparoscopic treatment].

Ectopic twin pregnancy is rare. Most frequently it occurs as a heterotopic pregnancy located simultaneously in the the fallopian tube and in the uterus. An unusual case of an intact unilateral ectopic twin pregnancy in the 7th week of gestation was diagnosed at this early stage by TVS (transvaginal ultrasound). The patient was successfully treated by laparoscopic salpingectomy. A review of the current literature is discussed.

Adult↗

Activated protein C resistance shows an association with pregnancy-induced hypertension.

A common mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause of resistance to activated protein C (APC). Recent studies have shown that the prevalence of APC resistance is associated with severe pregnancy-induced hypertension (PIH). Our objective was to determine whether the factor V Leiden mutation is more prevalent in patients who developed severe PIH than in normotensive pregnant women. In 70 women with a history of severe PIH, of whom 15 had pre-eclampsia, we investigated common coagulation factors as well as APC resistance (factor V related). We found that seven of these 70 women showed low values for APC. Out of these, five were heterozygous and none was homozygous for factor V Leiden mutation. In a control group of normotensive pregnant women we found a 3.0% rate of APC resistance and a 3.0% rate of carriers of the Leiden mutation. These results indicate a significantly higher prevalence of both APC resistance and factor V Leiden mutation in women with severe PIH. Placental infarctions and micro-embolisms are considered to be one of the principle pathophysiological changes in severe PIH. Our results suggest that APC resistance is a risk factor for severe PIH, in addition to its well-known role in macrothrombo-embolism.

Adult↗

Prenatal diagnosis of a Currarino triad.

Prenatal diagnosis of the Currarino triad by means of obstetrical ultrasonography is described. Three related cases are presented. A literature review regarding the therapeutic, ultrasound-guided approach are discussed. The Currarino triad is a genetically transmitted syndrome consisting of an anorectal malformation, a sacral boney defect and a presacral mass. Prenatal diagnosis aids the early recognition and surgical management of persistent spinal-rectal fistulas, thus potentially avoiding life-threatening bacterial meningitis. Copyright 1997 Elsevier Science Ireland Ltd.

Journal Article↗

[Bacterial pathogen colonization of the uterus in puerperium].

In a prospective study the spectrum of bacteriological organisms in the uterus was analysed within the first 3 days post partum. Smears were taken from the ectocervix and from the cavum uteri from 80 asymptomatic puerperae (70 had delivered spontaneously and 10 had had a vaginal-operative delivery). The smears were achieved using an endometrium catheter with a pilot cap. After the specialised sampling had been undertaken, in 47 of the 70 patients with spontaneous delivery and in 1 of the patients with operative delivery, no bacterial invasion was found in the cavum uteri. After prophylactic administration of antibiotics prenatally, bacterial organisms were found significantly less often (p < 0.05). On the other hand, intrauterine bacterial organisms were found significantly more frequently in patients who had had cervix priming with PGE2 and where foetal blood analysis had been performed sub partum (p < 0.05). Contrary to the smears from the cavum uteri, all ectocervical smears were positive. In 13 of 23 cases with positive proof of intrauterine bacterial organisms, a difference was found in the bacteriological spectrum compared with the parallel cervical smear taken. Further obstetrical factors play a role in influencing the bacterial invasion, however, there were no complications in any of the cases due to the smears being taken and no infections were observed during the rest of the lying-in period.

Adult↗

[Effect of competitive sports on the menstrual cycle and sexuality--results of a survey of the West German team for the Olympic games in Los Angeles].

The present investigation attempts to analyse exact data on the menstruation cycle, contraception and the sexual behavior of competitive sportswomen. Since the West German participants at the Olympic Games of 1984 in Los Angeles were chosen for this investigation, the patients are unquestionably highly selected. For this reason, the results cannot claim to be representative in all respects. The objective of this study was primarily to register and to analyse the gynecological aspects of women's competitive sport, to reveal interrelationships and if appropriate to point out disadvantageous tendencies. The Olympics participants were subdivided into five different groups on the basis of the type of sport: I. take-off power/speed II. anaerobic endurance III. aerobic endurance IV. technique/dexterity V. team games. A control group was formed of middle-distance and long-distance runners. The data were analysed with regard to competitive sport and age, number of days of training and training minutes per week, menarche, duration and length as well as intensity of menstrual bleeding, menstruation symptoms, influence of menstrual bleeding on sport performance, dependence of peak performance on the menstruation cycle, sexual behavior, contraception behavior.

Adult↗

[Association of low 50 g glucose screening test in pregnancy and fetal retardation].

BACKGROUND: The connection between elevated blood sugar and macrosomia is sufficiently well known and studied. The following study, however, examines whether patients with lower blood sugar values--based on the result of the 50 g-glucose screening test--delivered smaller children than patients with normal blood sugar based on the current criteria of blood sugar levels. PATIENTS RESPECTIVELY AND METHODS: In this study, all patients were included who visited our Prenatal Counseling Center between September 21, 1994 and July 31, 1996. Not included were patients with one-hour values greater or equal to 140 mg/dl. For assessing the 50 g-screening tests, percentiles were used. Based on the tables of Voigt, children below the 10th percentile were considered to be growth retarded. The student's t-test and chi-square test were employed as statistical tests. RESULTS: Of the 1416 participating patients in the study, 868 fulfilled the aforementioned criteria. A significant statistical correlation was shown between the development of fetal retardation and nicotine consumption, weight gain, and maternal height. It was also shown that patients with a lower (< 93 mg/dl) 50 g-screening test more often delivered a retarded child than patients with a normal value (23% vs. 12%, p = 0.034). No significant connection was found between the screening test groups and the described influencing factors. The clinical outcome, measured by the Apgar-scores and the transferal rate, was statistically significantly worse with the retarded children. CONCLUSIONS: The maternal glucose metabolism influences the fetal growth not only with respect to macrosomia but also growth retardation. The growth curves that have been used until now wrongly do not take into consideration the maternal anthropometric data. In light of this, the former ought to be re-evaluated. The data of this study emphasize the necessity of need-adapted nutrition. Maybe also pregnant women with a growth retarded child need a dietary consultation.

Adult↗

[Massive placental hemorrhage in partial molar pregnancy due to hypotriploidy (68,XX)--prenatal diagnosis and clinical course].

BACKGROUND: Triploidy describes the presence of threefold haploid chromosome set and is a frequent cause of early abortion. Only few pregnancies reach the second trimester. CASE REPORT: Prenatal diagnosis of a fetus in the 28th week of gestation with a hypotriploidy and with characteristic ultrasonographic features is presented. An enlarged placenta with molar changes, an oligohydramnion, severe growth retardation and minor cardiac anomalies were observed by ultrasound. Before prenatal karyotyping could be performed, immediate cesarian section was necessary due to massive intraplacentar hemorrhage resulting in a decrease of the hemoglobin level. The diagnosis of triploidy was confirmed postnatally by cytogenetic analysis of lymphocytes, the child died after 3 days. DISCUSSION: Ultrasonographic and clinical features for the diagnosis of triploidy are presented. Etiology of the rare karyotype 68,XX is discussed.

Abnormalities, Multiple↗