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Biomedical subjects

C Egarter

Publications and source records attributed to C Egarter.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Vaginosonography in gynecology].

Vaginosonography is a new method for gynaecological diagnosis. Its special advantage is to reach the uterus and the ovaries at close range. A structural refinement of the surrounding tissue allows to better coordinate individual structures to the different organs. A further advantage is, that a filled bladder is not required. At the first time diagnostic ultrasound can be used in corpulent patients as well. Vaginosonography is of special importance in the diagnosis of the endometrium according to the event of cycle identifying different types of amenorrhea, and also informative during the climacteric period. Besides the demonstration of the endometrium the time of ovulation can be determined by folliculometry, and an exceeding follicular growth can be stopped at the right time. Transvaginal puncture of follicles is a quicker and easier technique than the usual laparoscopic approach. Early diagnosis of pregnancy is of great importance as well. Using vaginosonography, a missed abortion and an extrauterine pregnancy can be varified in a simple way. A cervical insufficiency can be evaluated in a better way by the determination of the opening of the internal orificium of the cervix. There is further use of the method in other fields of gynaecology.

Abortion, Missed↗
PubMed1989

Prostaglandin injection for termination of tubal pregnancy: preliminary results.

A variety of conservative surgical techniques is available for the termination of ectopic pregnancy with preservation of the tube. We report on a new treatment by means of intratubal prostaglandin F2 alpha application followed by intramuscular administration of a prostaglandin E2 derivative (sulprostone) for 3 days. Only 5 of the 30 patients enrolled had to undergo laparotomy later. The results were compared with those obtained by different surgical procedures during the 2 preceding years. Hysterosalpingography was performed in 12 patients of the prostaglandin treated group and 14 of the surgically treated group. Tubal patency was demonstrated in 11 patients of the PG group but only in two patients of the surgically treated group.

Abortifacient Agents↗
PubMed1989

[Treatment of tubal pregnancy with prostaglandins: a multicenter study].

In this prospective multi-centre-study, the new treatment of tubal pregnancies by means of local prostaglandin (PG) F2 alpha and systemic PG E2 application was compared to the usual surgical technique of eliminating the conceptus. In 71 patients treated with PG, the method proved to be successful in 81%; 21 patients (19%) required surgical intervention later. With an initial beta-hCG level of 2500 mIE/ml, the success rate increased to 88%. The duration of hospitalisation was significantly reduced in the PG group compared to the patients treated by primary operation (3 +/- 1 versus 6 +/- 2 days). In the PG-group, only 2 of 24 hysterosalpingograms showed tubal occlusions after treatment, whereas occlusion was present in 3 of 8 patients of the surgically treated group. Four subsequent intrauterine pregnancies in the PG-group occurred compared to none in the surgical group. PG treatment of tubal pregnancy in patients with a low initial beta-hCG value (less than 2500 mIE/ml) revealed promising results with regard to reduced postoperative morbidity and future fertility.

Abortifacient Agents↗
PubMed1989

Is induction of labor indicated in prolonged pregnancy? Results of a prospective randomised trial.

In 345 women with a favorable cervical score at due date, labor was either induced by means of intravaginal application of tablets containing 3 mg of prostaglandin E2 or spontaneous onset of labor was awaited until the 42nd week of pregnancy. Eighty percent of the nulliparae and 96.3% of the multiparae of the induction group gave birth within 24 h of the administration of the first tablet. All pertinent delivery intervals were significantly shorter in this group compared to those women where spontaneous onset of labor was awaited. The rate of operative deliveries was lower in the induction group. With the exception of 1 fetal death 3 days after due date, fetal outcome was excellent in both groups. Elective induction was at least equivalent to awaiting the onset of spontaneous labor and was not associated with higher complication rates due to the method of induction.

Clinical Trials as Topic↗
PubMed1989

Effect of beta-receptor blockers on uterine contractility in a puerperal model.

beta-receptor blockers are increasingly used in the treatment of pregnancy-induced hypertension. Hitherto an oxytocic effect on the myometrium could not be excluded. We investigated the effect of 0.8 resp 1.6 mg pindolol on uterine activity in a double blind study in comparison with a placebo group, using a puerperal model. A "paradoxical" decline in uterine activity could be demonstrated, speaking in favor of a further propagation of beta-blockers in obstetric practice.

Adrenergic beta-Antagonists↗
PubMed1988

[Successful treatment of a tubal pregnancy by local and systemic administration of prostaglandin].

The recent trend towards conservative management of tubal pregnancies, as well as first reports on the efficacy of systemic or local administration of prostaglandins prompted us to investigate the therapeutic effect of PGF2 alpha injected directly into a non-ruptured tubal pregnancy, followed by systemic administration of a synthetic longer-acting PGE 2 derivative for 3 days. Serial determinations of hormone parameters in the follow up of this patient verified that this combination treatment is capable of dealing with tubal pregnancy without further surgical treatment. Hysterosalpingography performed 6 weeks afterwards showed tubal patency on both sides.

Administration, Topical↗
PubMed1988

Prophylactic perioperative use of clindamycin and metronidazole in vaginal hysterectomy without pelvic floor repair.

We studied the effect of perioperative clindamycin (3 x 600 mg in 100 ml 0.9% saline), metronidazole (3 x 500 mg in 100 ml 0.9% saline) and a placebo (3 x 100 ml of 0.9% saline) in 120 patients having a vaginal hysterectomy without colporrhaphy. The rate of postoperative urinary tract infections was significantly higher in the placebo group, but there was no significant difference between the three groups in the days of postoperative fever (a temperature above 37 degrees C) or in the length of hospital stay. One patient on placebo had a vault infection and another had a fever of unknown origin.

Adult↗
PubMed1988

Beta-endorphin levels during the climacteric period.

Hot flushes are not caused by hypergonadotrophinaemia. This is apparent because peaks of gonadotrophin in the serum do not coincide with cutaneously measured hot flushes while such flushes still occur in hypophysectomized women. Gonadotrophin-releasing hormone and other neurotransmitters (possibly beta-endorphin) affect thermoregulation. The following hypothesis is advanced. During the climacteric period neurotransmitter changes, a decrease in catechol oestrogens, a decrease in alpha-2-adrenoceptor activity and cessation of ovarian steroid production may lead to alterations in endogenous opiate activity and thus to disturbances of thermoregulation, resulting in the occurrence of hot flushes. Low beta-endorphin levels in the peripheral plasma, which rise again following oestrogen treatment, are observed during the climacteric. On the other hand, women with severe hot flushes caused by a stress event show enormously increased beta-endorphin values, which are normalized by hormone substitution therapy acting via still unknown neuroendocrinological feedback mechanisms.

Body Temperature Regulation↗
PubMed1988

[Hormonal status in patients with Mayer-Rokitansky-Küster syndrome].

A characteristic and comparatively frequent malformation of the female genital tract is the congenital absence of the vagina and a rudimentary uterus, known as Mayer-Rokitansky-Küster syndrome. Since we employ the modified surgical technique according to Vecchetti we have a relatively large incidence of patients with this syndrome. Thus, a total of 15 patients were hospitalised for a thorough endocrinological examination including a GnRH test with 2 bolus injections of GnRH, TRH-test, the determination of testosterone, DHEAS, androstendione and gonadotropin as well as prolactin fluctuation over a 4-hour period. The values of 4 patients without any endocrinological disorder served as control group. 2 of the 15 patients showed an increase in androgenic hormones; 8 patients a slight hyperprolactinaemia disclosed by the TRH test. The gonadotropin fluctuation in all patients was restricted and the stimulation of the pituitary gland with GnRH bolus injections was diminished. The naloxone test led to a significant increase in peripheral gonadotropins. It remains to be determined whether this endocrinological disorder is the cause or the outcome of the rudimentary inner genitals.

Adolescent↗
PubMed1988

[Treatment of tubal pregnancy by local and systemic administration of prostaglandin. Initial experiences].

The present study reports on the treatment of 6 tubal pregnancies established by laparoscopy intratubal PGF2 alpha injection accompanied PGE2 applied systemically. The method was successful in all cases avoiding the usual surgical procedure. Concerning the side effects one patient exhibited higher postoperative temperature, whilst another showed hypertony and tachycardia immediately after PGF2 alpha injection which lasted a few minutes. Further studies should clarify whether this technically simple procedure is superior to the existing methods.

Corpus Luteum↗
PubMed1988

[The beta-endorphin level in climacteric women].

UNLABELLED: Hot flushes are not caused by a hypergonadotrophinemia. Peaks of gonadotrophin in the serum do not coincide with the cutaneously measured hot flushes. There is an occurrence of hot flushes in hypophysectomized women as well. GnRH and other neurotransmitters (beta-endorphin?) effect the thermoregulation. - HYPOTHESIS: During the climacteric period changes of neurotransmitters, a decrease of catecholestrogens, a decrease of alpha-2-adrenoceptor activity and the ceasing of the ovarian steroid production lead to changes of the endogenous opiate activity and thus to disturbances of the thermoregulation resulting in the occurrence of hot flushes. Low beta-endorphin levels in the peripheral plasma, which increase again after a treatment with estrogens, are found during the climacteric period. On the other hand women with severe hot flushes as an expression of a stress event show enormously increased beta-endorphin values, which normalize again after a hormone substitution therapy, effected by still unknown neuroendocrinological feedback mechanisms.

Climacteric↗
PubMed1988

[The medroxyprogesterone acetate serum level following various medroxyprogesterone acetate dose schedules in gynecologic oncology].

Medroxyprogesterone acetate (MPA) is used as an adjuvant hormonal medication in patients with different kinds of carcinomas. Since adequate serum levels are thought to be essential we determined the individual, postoperative MPA levels in 36 patients with endometrial carcinoma over a period of 12 weeks. The patients received either an oral dose of 3 X 100 mg MPA or a weekly changing scheme with 2 X 10 mg Tamoxifen and 3 X 100 mg MPA. An additional small group of 4 patients with ovarian carcinoma was enrolled receiving an oral dose of 1000 mg MPA daily. The peripheral serum levels of MPA exhibit enormous inter- and intraindividuell variations and only the high dosage schemes yield levels above 90 ng/ml which are claimed necessary by some authors. The cortisol concentration measured at the same time were within the normal range and did not correlate with the MPA values.

Antineoplastic Agents↗
PubMed1988

[Sensitivity test in labor induction with prostaglandin E2 vaginal tablets].

The study was designed to evaluate whether an oxytocin sensitivity test in addition to pelvic scoring would increase the predictive value concerning successful induction in cases of elective induction by means of prostaglandin (PG) E2 vaginal tablets. Furthermore we investigated if this test could lead to a further reduction in the already low rate of protracted labour and operative deliveries. In order to establish the optimal dosage we compared the endocervical application of 1.5 ml PG E2 with 3 mg intravaginal. 160 pregnant women without any risks were included at due date; 73% decided spontaneously to have labour induced by means of PG E2 tablets. In these induction groups the delivery intervals were significantly shorter and the rate of operative deliveries was reduced. The fetal outcome, however, was the same as in those women who decided to await spontaneous onset of labour. The endocervical application did not prove any better. The oxytocin sensitivity test yielded additional information about the chances of inducing labour successfully. The results confirmed again the efficacy and acceptance of this method of labour induction.

Administration, Intravaginal↗
PubMed1987

[Differentiation of an outcome sample in elective labor induction with PGE2 by the oxytocin sensitivity test].

The goal of the present study was to evaluate whether the implementation of an oxytocin sensitivity test in addition to pelvic scoring would improve prediction of successful induction and could lead to a further reduction in the already low rate of protracted labour and operative deliveries in cases of elective induction by means of prostaglandin (PG) E2 tablets. In order to establish the optimal dosage we compared the endocervical application of 1.5 mg PG E2 with 3 mg intravaginally. Out of 158 women without risk factors examined at term 73.5% decided to have labour induced. In the induction groups given endocervical or intravaginal PG E2 the delivery intervals were significantly shorter and the rate of operative deliveries was reduced. In comparison with those women who decided to await spontaneous onset of labour, the fetal outcome was, however, the same. The endocervical application of 1.5 mg PG E2 did not prove any better than 3 mg given intravaginally. The performance of a pretherapeutic oxytocin sensitivity test yielded additional information about the chances of inducing labour successfully. The results confirmed the efficacy and acceptance of this method of inducing labour.

Administration, Intravaginal↗
PubMed1987

[Comparison between prostaglandin E2 gel and oxytocin in medically indicated labor induction].

The use of prostaglandins (PG) increasingly replaces the "classical" method of induction of labour by means of oxytocin and amniotomy, the last-named method being associated, especially in women with an unripe cervix, with side effects like prolonged labour and a higher rate of obstetric surgery. In this study the point of interest was whether prostaglandins offer any advantages over the classical method in respect of efficacy and maternal and foetal tolerance. 99 patients subdivided into primiparae and multiparae were randomly assigned to group A or B. In group A labour was induced with 1 mg resp. 2 mg PGE2 intravaginally at an interval of 6 hours. In group B the method of induction consisted of intravenous oxytocin and amniotomy. The success rate of induction was almost equal in both groups. However, in those patients where PGE2 induction did not succeed and who could not be delivered within 12 hours the cervical score was significantly improved in comparison to the oxytocin group. Based on the experience reported in the literature, one might speculate that an increased dosage could still improve the results of vaginally administered PGE2 gel.

Administration, Intravaginal↗