[Amniocentesis and chorion biopsy].
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Biomedical subjects
Publications and source records attributed to E Brusis.
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A case of acute hemolytic streptococcal gangrene is presented. Typical signs of this disease are local pain, erythema, edema, formation of blisters, and gangrene. Malaise and fever are more unspecific. The special clinical feature of this postpartum case is discussed and compared with the literature. The therapy comprised extended incision of the vulva, application of antimicrobial agents, and exchange transfusion.
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Little is known about the influence of hydramnios on the alphafetoprotein (AFP)-concentration in the amniotic fluid. We therefore investigated in 19 patients with hydramnios the diagnostic value of the sonographic evidence and the AFP-concentration in the amniotic fluid in relation to prenatal diagnosis of fetal malformations in two independent series. An anlysis of the AFP-concentration in the amniotic fluid can corroborate the diagnosis of a malformation made by sonography and influence decisions concerning the management of pregnancy and delivery. If ultra-sonic tests show no anomalies, significantly increased AFP-concentrations in the amniotic fluid of patients with hydramnions can merely confirm a suspicious of an existing malformation and influence decisions on further diagnostic steps.
From December 1975 to July 1979 28 fetoscopies were made in the I. UFK Munich, 25 in local anaesthesia and under ultrasonic control using the real time scanner. 20 fetoscopies were made up to the 24th week of pregnancy, preceding an interruptio for medical or genetic reasons. 8 fetoscopies were made between the 26th and 38th week of pregnancy for diagnostic reasons. The best results were obtained before the 20th week of pregnancy, following a special fetoscopy score, developed by us. In consideration of the present state of the art, fetoscopy cannot be recommended as a clinical routine method for diagnosing external malformations. An application of substances directly into the fetal blood circulation by fetoscopy methods is not yet possible. Up to the 24th week of pregnancy fetoscopy methods can be used in specialised centres after properly weighing the risks, for the purpose of fetal blood sampling from the vessels of the chorionicplate or from umbilical vessels near the insertion of the chord to the placenta, for diagnosing genetical enzyme defects.
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From 1970 to 1972, there were 216 perinatal deaths among 5595 newborns at the I. Frauenklinik der Universität München. 54 of these deaths were children of foreign workers (so-called "Gastarbeiter"). The data have been processed on punch cards and analysed by a computer. The differences noted underwent significance testing by the CHI-Quadrat test. Only statistical significant results are published. The perinatal mortality in the above period shows no difference between foreign and German ward patients. There is, however, a significant lower perinatal mortality in private patients. We feel that this difference is due to a significant lower rate of prematures in the private patient group. The cocial status as well as higher interest and motivation in health resulting in better prenatal care are discussed as causal reasons for this fact.
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