Biomedical subjects
Publications and source records attributed to H Halle.
In cases with a low pelvic score (Bishop) before induction of labour a gel was locally applied consisting of 1 mg prostaglandin F2 alpha in 2 ml. The single dose was 1.5 to 2.5 mg prostaglandin F2 alpha. In cases with insufficient effect this therapy was repeated once up to three times. This method reduced the duration of delivery. No maternal side-effects were observed in a total of 220 cases.
Indomethacin has been tested, in addition to betasympathicomimetic therapy, in cases with an insufficient inhibition of premature labour. An oral dose of 200 mg indomethacin per day was given for two days, 150 mg for additional two days and, subsequently, 100 mg for the subsequent days. The mean duration of therapy was 8 days. No maternal or foetal side-effects were observed.
A case is reported of a successful pregnancy of a woman with advanced renal failure treated nutritionally. The importance of an intensive interdisciplinary medical co-working is stressed, and the individual adaptation of the dietary treatment to the special nutritional requirements in pregnancy is discussed.
Extracts were prepared from macrocysts of Sarcocystis gigantea, an animal parasite, by sonication and high speed centrifugation. Mononuclear cells were obtained from the blood of 14 adults and 5 newborns and used for transformation assays. Addition of Sarcocystis extracts (equivalent to 400 micrograms protein/ml) to these cells increased the lymphocyte proliferation approximately 71 fold over the background. The control with Pokeweed mitogen (5 micrograms/ml) gave a stimulation index of 58. There was no difference in the response to the Sarcocystis extract between the lymphocytes of adults and those of newborns. This findings show that the effect of the extract is mitogenic and not due an anamnestic reaction.
Retroplacental blood samples (between 3 ml and 290 ml) which had been obtained from 327 recently delivered women were tested for the presence of HLA-A, B, C, DR antibodies. The approaches taken by the examiners were the NIH microlymphocytotoxicity test according to Terasaki and the two-colour fluorescence test according to van Rood. The examiners established 66 sera with cytotoxic reactions, and 18 of these serum samples (5.5 per cent) contained good to very good antibodies of the HLA-A, B, C, and DR series (correlation coefficients being between 0.55 and 1.00). Advantages offered by this search test over conventional pregnancy screening are discussed in some detail.
A gel which contained prostaglandin F2 alpha was locally applied to women with low pelvic score, prior to induction of labour. Doses were between 1.5 mg and 2.5 mg PG F2 alpha. Each of the patients received a total amount of 3.3 mg. Treatment had to be repeated once to three time for 30 per cent of the patients. The approach helped in improving pelvic scores from 2.4 to 7.3, on average, in 214 patients, within 2.1 days. Overall duration of labour as well as the rate of caesarean sections were reduced.
The cardiotocographic findings recorded from 146 expulsions were analysed and related to the condition of the newborns. Melchior's cardiotocographic distribution diagram proposed for the expulsion period, 1973, is checked for its applicability.
Reported in this paper is the intravenous application of prostaglandin F 2-alpha in the placental period and in cases of severe postpartum haemorrhage. -- Intravenous infusion of per-minute amounts between 40 and 80 micrograms in cases of atonic haemorrhage or between 30 and 45 micrograms in the placental period, in general, produced uterine contraction and clearly reduced blood loss.
Beta-adrenergics have recently come in the focus of clinical, physiological, and pharmacological research. The side-effects of tocolytically active substances are under thorough study at present. The authors checked the laboratory values recorded from 45 patients in pregnancy. Electrocardiographic follow-up checks were also conducted, with the view to establishing the effects of Dilatol and Partusisten on both the electrolyte balance and myocardium.--The results are described and discussed, and conclusions are suggested.
Indometacin was administered as additional tocolyticum in 42 women between the 27. and 36. week of pregnancy. Patients received indometacin oral, of a complete tocolysis could not be achieved by application of beta-sympathicomimetica. A complete tocolysis always could be achieved with a daily dose of 200 mg indometacin. The mean time of therapy was 7,5 days, the mean total dose 1100 mg.
A report is given about the efficacy of prostaglandin F2alpha for induction of labour after inefficient application of oxytocininfusion. In all cases induction of labour was indicated or labour should be supported. 80 of the 104 women with weak labour finally delivered on vaginal way. Only 9 of 24 caesarean sections were performed by reason of weak labour in spite of application of prostaglandin F2alpha. There was no influence on the state of the newborns, this was the result of postnatal judgment by Apgar-score.
The authors report the application of the amniofetography in the field of the antenatal diagnostic of fetale deformities. All pregnant women were investigated by Ultrasonic-B-scan. In cases of unambiguous hydramnios and in cases of pathological findings or findings which are not clear in Ultrasonic-B-scan an amniofetography was made. This method was carried out in 14 patients between the 28th and 37th week of pregnancy. It was found changes in 8 cases which in control of pregnancy and delivery were important.
15(S)-15-methyl-prostaglandin F2alpha was administered by the intramuscular route in 10 patients between 12. and 18. weeks gestation. All these patients aborted within 20 hours, with mean induction-abortion intervall of 14,1 hours. 250 microgram 15(S)-15-methyl-prostaglandin F2alpha was administered 3 hourly. 8 patients had side effects, mainly nausea, vomiting and diarrhea.
42 pregnancies were monitored by transabdominal amniocentesis followed by karyotyping. Biochemical assays of cultured amniotic fluid cells, 50 analysis of alpha1-fetoprotein and estimations of the number of y-bodies in the amniotic fluid cells was also made. One chromosomal aberration (47, XY, + 18) was found in 13 pregnancies tested because of advanced maternal age. In 6 pregnancies with a recurrence risk of Down's Syndrom, one fetus with abnormal karyotype (46, XY, 5p-) was detected.
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From 1971 to 1974 in the Department of Gynecology and Obstetrics of the Humboldt-University of Berlin we monitored 1132 fetuses. The extent of the analysed groups runs to 306 to 632 cases, according to the completeness of the investigations and documentation. We have compared our CTG-findings with those of other authors. We found relationships between the risk factors and the CTG findings: for low weight fetuses more frequent Dip I, for maternal vitium cordis more frequent fetal tachycardia, for meconium stained liquor more frequent smooth baseline (silent) for EPH-gestosis (toxemia) more frequent Dip II (late deceleration) and variable deceleration. The relationships between the risk factors and the CTG findings are loose and not suitable to verify the great differences in frequency of the CTG pattern, published in the literature. We believe, that these differences are caused by different definitions and subjective interpretation of the CTG.
In the years from 1971 to 1974 the rate of fetal monitoring of high risk deliveries rose from 3.0% to 23.7%. In this time our clinic become a center of high risk pregnancies (reproductive failure and prematurity). By this way we could not show a decrease of the perinatal and intranatal mortality. The increase of caesarean sections from 3.0% (1968) to 6.0% (1974) was caused by the increasing of high risk patients. Fetal monitoring is not a cause for rising of operative frequency. By means of fetal monitoring the Apgar score of the newborns from mothers with severe diseases is not significant worse than from newborns of mothers with more easy diseases.
The parameters of the intrapartal fetal CTG and the actual pH are related to each other and to the Apgar score of the newborn. The interpretation was carried out by means of groups of 300 to 600 cases. The actual fetal pH has the most compact relation to the Apgar score of the newborn (C equals 0,31). But also this contingence is unsatisfactory. At fetal acidosis most of the Apgar scores are pathological, in that manner the pH is the most important test for indication of operative delivery. The rare CTG pattern as dip II and variable decelerations combined with tachycardia of bradycardia, the bradycardia with 80 bpm or less, are likewise indications of urgent delivery.