Biomedical subjects

A Bolte

Publications and source records attributed to A Bolte.

At least 91 records · Page 5Linked to original sources

PubMed1976

[The abdominal fetal EKG for the analysis of pre- and subpartual heart frequency (author's transl)].

The application possibilities of abdominal fetal electrocardiography for pre- and subpartual continuous registration of the fetal heart frequency are examined. For this purpose the technical quality of 403 abdominal FEKG-registrations were checked in the individual stages of pregnancy and during birth. The average time spent looking for the best position with the greatest R-wave amplitude amounting to 2.6 min. The abdominal longitudinal position and the right hand oblique abdominal position proved to be advantageous with longitudinal presentation of the fetus. With fetal oblique to transverse presentation and in the 6th to 7th month of pregnancy the transverse abdominal position was likewise favourable. The technical quality of the supervision varied in the individual months of pregnancy. The best results were achieved in the 6th and 11th month of pregnancy. The worst technical quality was registered in the 8th month. In the 7th and 9th month two thirds of registrations were at least adequate. Sub partu the registrations during the first stage of labour were in two thirds of the cases very good and good, in a quarter satisfactory, in approx. a sixth adequate and fairly bad. In the second stage the registrations were considerably worse, 10.7% were satisfactory, 28.6% adequate and 59.8% deficient. Prepartually the technical quality was dependent on the fetal R-wave amplitude. In the second stage of labour no correlation between fetal R-wave amplitude and technical quality could be ascertained. The rupture of the amnion only influenced the quality of the registrations, if the satisfactory of labour increased. Adiposis and the position of the placenta did not affect the technical quality of the registrations. The lateral positions of the patient led to unusable registrations in 26.2%, in 46.9% the left and in 44.6% the right lateral position could be accepted without loss of quality. The comparison of the subpartual parallel registrations by means of phonocardiography/abdominal fetal electrocardiography, as well as direct/abdominal fetal electrocardiography showed no differences in the baseline. Differences in the floating-line in the case of simultaneous phonocardiography/abdominal fetal electrocardiography concerned the phonocardiographic registrations and in the case of simultaneous abdominal/direct fetal electrocardiography the abdominal registrations. They were caused by reduction in the technical quality. The fluctuation types of the abdominal and direct registrations were identical. In the case of simultaneous phonocardiography/abdominal fetal electrocardiography differences were found both in the oscillation amplitude and the oscillation frequency. The difference in the oscillation frequency was caused by a bad technical quality. The lower oscillation amplitude in abdominal fetal EKG-registrations was defined by the more exactly signal of the fetal R-wave...

Abdomen↗

PubMed1976

[Children's development after placental dysfunction (author's transl)].

Katamnestic neurological and electroencephalographic studies were performed on a group of 6 to 11 year old children who had been born in the years of 1960 to 1966 with the signs of placental dysfunction. Of a total of 288 children (2,8% of the deliveries at the department of obstetrics & gynecology of the Cologne university) 177 were analized katamnestically and 152 uncerwent a clinical examination. For comparison a group of 384 children were studied who had been born in the same years spontaneously from vertex presentation after a maximum duration of labour of 16 hours. At the time of delivery these children were mature and eutrophic. 133 children of this group were studied katamnestically and 114 underwent clinical examination. The katamnestic studies showed that the group with symptoms of placental dysfunction differed in their development from the control group: these children learned later to sit, to walk, to speak, to dress without help, and to control urination. No differences were found in the ability to write and to read or in their results at school. However a larger percentage of the control group was found to attend a higher educational institution. No differences were found in the incidence of disease or behavioral abnormalities. Sleeping problems and lact concentration were more often observed in the group of children with symptoms of placental dysfunction. The general clinical examination showed no differences between the two groups. The applied different tests to examine grow movements were performed less perfect in a higher percentage by the children born with signs of placental dysfunction. Even greater differences were found in testing the voluntery skilled movements. The electroencephalogram of children of both groups showed a normal basic activity, a distinct blocking effect and a significant activation upon hyperventilation. An abnormal and pathological EEG was however significantly more often found in children born with symptoms of placental dysfunction. The results of the examination of the individual children and the combination of these results in the groups of symptoms showed that children with signs of placental dysfunction demonstrated a significantly higher incidence of symptoms. It was furthermore obvious that these symptoms were not singular but part of a complex disturbance which was manifested in the obstetrical characteristics as well as in the katamnesis and in the clinical examination. Thus, these studies have demonstrated a higher rate of morbidity in children with placental dysfunction in addition to the known high perinatal mortality. This points the necessity of an early prepartual diagnosis in particular in pregnancies with predisposition, in order to reduce not only the perinatal mortality but also to avoid the described complications in children born after placental dysfunction.

Child↗

PubMed1976

[Indications and results of antenatal karyotyping (author's transl)].

From 1972 to 1975, 64 genetic amniocenteses and 72 cell cultures from amniotic fluids were done for antenatal karyotyping. In 3 cases a therapeutic abortion for genetic indication was carried out. The indications for antenatal karyotyping, the technique and complications of genetic amniocentesis in early pregnancy and the methods of cell cultures of amniotic fluid are discussed. A compilation of the results of 1918 antenatal karyotypings reported in the literature shows the following probability for the presence of an unbalanced chromosomal anomaly in the fetus: in mothers over age 40 4.25%, in mothers age 35-39, 1.45%, in cases with trisomy-21 in a previous sibling 0.73%, in cases with balanced chromosomal anomalies in the parents, 15.2%. In the next few years an increase of antenatal karyotyping in the different risk groups can be expected. In the individual case the indication for genetic amniocentesis must be balanced against the risk of complications.

Abortion, Legal↗

PubMed1976

[Advantages and disadvantages of deliveries after induction of labour by convenience (author's transl)].

The development of 601 deliveries after induction of labour by convenience, 92 births after induced labour following pregnancies at risk and 1829 births after spontaneous onset of labour were examined and compared. The data were recorded retrospectively and submitted to an electronic data processing. Patients with whom the labour was induced had the shortest birth times, the difference amounted on average to 2 hours. In the comparison collective with spontaneous setting in of labour a hypotonic uterus motility was found to be the most frequent pathological labour activity. Pathological pattern of heart frequency, especially late decelerations were most frequently registered with fetuses of the risk group. The frequency of the operative deliveries amounted to 13% in the case of the collective of the induced labour, 35,9% in the case of patients in the risk group, and 10% in the case of the comparison collective. Threatening fetal asphyxia and protracted extrusion period were in the case of primiparas after induced labour equally often the indication for a vaginal-operative delivery, whereas with the comparison collective, in the risk group and also with multiparas after induced labour, the threatening fetal asphyxia was primarily for the carrying out of a forceps delivery or a vacuum extraction. Concerning the birth weight and size the new-borns of the collectives examined showed no significant differences. The best Apgar-score was achieved by the new-born induced labour babies. Only 0,5% of these babies showed pronounced signs of placental dysfunction, in the risk group 9,6%, and in the comparison collective 1,6% of the babies were born with a pronounced Clifford-syndrome. Induced labour babies did not need any pediatric treatment. There were no perinatal deaths. In the case of comparison collective, long term pediatric treatment was necessary for 8 babies, 1 baby died subpartual, another one in the pediatric clinic, that means a perinatal mortality of 0,1%. In the risk group 3 babies needed pediatric treatment, 1 baby died of the consequences of a serious erythroblastosis, the perinatal mortality amounted to 1,1%. In a critical evaluation of the without exception favourable obstetrical results after induced labour, the technical, personal and organisational efforts should not be overlooked. This stands in the way of a widespread use of the process in the near future. The results hitherto permit the temporary inference that 1) psychologically positive prerequisites for the birth are created if the pregnant woman knows a firm date for the delivery, 2) the whole partus can be continuously supervised and the maternal and infantile emergencies prevented in good time and 3) through the calculability of risks during pregnancy and birth, perinatal mortality and morbidity can be reduced considerably.

Apgar Score↗

PubMed1973