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Biomedical subjects

H Rüttgers

Publications and source records attributed to H Rüttgers.

At least 19 recordsLinked to original sources
PubMed1988

Course and predictive value of fetal heart rate parameters.

The present study concerns the developmental character of the fetal heart rate (FHR) pattern and the implications of predicting the perinatal outcome. Data from 443 patients undergoing 2193 nonstress tests were analyzed retrospectively. We found a significant increase of accelerations more than 15 beats/min, of accelerations associated with fetal movements, of fetal movements registered by the tocotransducer, the frequency of oscillations, and of the Fischer score values throughout gestation. The number of short FHR decreases and the mean baseline level declined throughout gestation. A long duration of absent or reduced baseline variability registered even 6 weeks before delivery was associated with low Apgar score values. Late decelerations and contractions registered early in pregnancy were also correlated to a poor outcome. Tachycardia and a low number of accelerations were only correlated to a poor perinatal outcome shortly before the delivery. Fetal movements not associated with FHR accelerations were an early indicator of a poor neonatal outcome. Scoring systems did not generally improve the predictive value of FHR patterns.

Apgar Score↗
PubMed1988

Bacterial vaginitis: protection against infection and secretory immunoglobulin levels in the vagina after immunization therapy with Gynatren.

In a prospective, randomized double-blind study the prophylactic effect of the immunotherapeutic agent, Gynatren, against reinfection was investigated in 192 patients with bacterial vaginitis (95 treated with the active preparation versus 97 with placebo). In 30 and 25% of the patients in the two groups, respectively, it was the third or even more frequent infection in a period of 12 months. In a further 46 and 39%, respectively, it was the second infection in the course of a year. All the patients were given local treatment with tetracycline-amphotericin B vaginal suppositories and at the same time vaccinated with Gynatren or placebo. One month after the start of treatment, 85% of the patients in the active-treatment group and 83% in the placebo group were asymptomatic and free from pathogenic bacteria. After 3 months 78% in the active-treatment group and 60% in the placebo group were free from infection. After 6 months 76 and 40%, and after 12 months 75 and 37% of the women in the active-treatment and placebo groups, respectively, were free from clinical symptoms and pathogenic bacteria. These results correlated with the concentrations of local antibodies (secretory immunoglobulin) detectable in the vaginal secretion.

Adult↗
PubMed1987

Treatment of bacterial infections of the female urinary tract by immunization of the patients.

In an open comparative study 400 patients with urinary tract infections were randomly allocated to two treatment groups. In 202 patients an immune stimulation against uropathogenic bacteria was produced with a new preparation, SolcoUrovac, and only in exceptional cases with pronounced symptomatology was antibiotic therapy given, while in the control group (n = 198) all patients were treated with nitrofurantoin or with another appropriate antibiotic, according to the antibiogram. In the subsequent 12-month observation period 28 infections occurred in 23 patients of the immune-stimulated group and 84 in 47 patients of the control group. This difference is statistically significant (p less than or equal to 0.001). The preventive effect of the SolcoUrovac therapy was particularly impressive in patients with recurrent urinary tract infections. Thirty-two patients from each group with similar case histories, as matched pairs, were evaluated separately. The relapse rate in the 12-month observation period amounted to 2 re-infections in the group treated with immunotherapy and to 29 in the control group. All side-effects were recorded. No adverse effects were observed in pregnant women or in their offspring.

Bacterial Infections↗
PubMed1987

Urinary tract infections in women. Current unsatisfactory situation and prospects of a new therapeutic concept.

The prevalence, pathogenesis and clinical aspects of bacterial infections of the female urinary tract are described and the efficacy of therapies used at present is discussed. Based on a retrospective compilation of data on 142 female patients with urinary tract infections, the pathogen spectrum is defined and the therapeutic results achievable with antibiotics are quantified. In uncomplicated urinary tract infections a cure rate of 73% was achieved. In 12% of the cases the infection persisted, and relapses or re-infections occurred in 15% of the cases. The high proportion of unsatisfactory clinical results justifies the search for new treatment methods. The body's own infection defence mechanisms are discussed and the possibility of stimulating the local immune reaction in the urinary tract is presented as a possible future therapeutic measure.

Anti-Bacterial Agents↗
PubMed1987

Elevation of secretory IgA antibodies in the urinary tract by immunostimulation for the pre-operative treatment and post-operative prevention of urinary tract infections.

The effect of SolocoUrovac for the treatment of pre-operative urinary tract infections and for the prevention of post-operative infections of this type was investigated in an open, comparative study in two groups, each consisting of 14 patients in whom a hysterectomy was planned. The aim of this new preparation is to produce an immunostimulation leading to an increased secretion of secretory IgA (sIgA) antibodies in the urinary tract and thus to a defence against infection. Fourteen patients with existing bacterial urinary tract infections were cured by use of the preparation before the operation. Fourteen other patients without bacteriuria were not treated and served as controls. After the operation a urinary tract infection occurred in 2 of the treated patients and in 4 of the 14 control patients. In the patients treated with immunotherapy urine sIgA increased significantly, on average from 2 to 5.7 mg/g creatinine, while in the control group the values remained constant.

Autoantibodies↗
PubMed1986

[Effects of routine administration of methylergometrin during puerperium on involution, maternal morbidity and lactation].

The objective of the prospective randomized study reported here, based on 880 puerperae, was to study the effects of methylergometrin on involution, puerperal morbidity, and lactation. Over 4 weeks 444 mothers were given 0.125 mg of methylergometrin 3 times a day, while 436 were given the same dose of placebo. The following differences were found: in the treated group involution of the uterus was accelerated in the first few days following birth, but after 4 weeks there were no longer any significant differences. Post-partum pains were almost twice as intense in the treated group as in the untreated group. It proved impossible to reduce the number of cases of infection (lochiostasis, axillary temperature over 37.5 degrees C) by administering Methergin during the puerperium; following spontaneous births there were actually more cases of endometritis in the treated group. The number of patients with severe afterbleeding after spontaneous birth was also higher in this group. Lactation among untreated puerperae averaged 880 g during the first six days, while among treated patients it was only 563 g. Even after 4 weeks there were still differences in the quantity of milk produced. The incidence of infection and afterbleeding was significantly lower in mothers who breast-fed their children, irrespective of whether they had taken Methergin or not. We therefore consider that routine treatment of puerperae with methylergometrin is no longer justified; we continue to advocate breast-feeding, not least in view of the fact that it reduces maternal morbidity.

Breast Feeding↗
PubMed1985

Twin pregnancies: an 11-year review.

From 1971 to 1981, 16752 women were delivered at the University Women's Clinic in Heidelberg; 228 of these were twin pregnancies (1.36%). The relationships between sex, gestational age, birthweight, mortality, and fetal outcome were investigated. For the reason of grading, so-called chi 2 curves are used. These curves show the strength and the course of relationship between two parameters. Mortality of the twin (8.3%) depended on birthweight and on sex of the infant, but not on the mode of delivery. All twins were 'small-for-date' (25th weight percentile of single births). Starting at the 35th week of gestation, the increase in weight decelerated additionally. So, immaturity as well as twin-related factors led to the high mortality rate for twins. Fetal outcome was evaluated in respect to the birthweight and to the delivery interval.

Apgar Score↗
PubMed1984

[Preventive treatment of respiratory distress syndrome in newborn infants with antepartal glucocorticoid administration (betamethasone). Clinical results and changes in the lecithin/sphingomyelin ratio of the amniotic fluid].

Betamethason was administered to 105 patients with threatened premature labour at risk for respiratory distress syndrome (RDS) of the newborn. The most important indications were premature rupture of the membranes (30%) and premature labour (40%). The betamethason treatment was given between the 27. and 35. week of gestation. 79% of the patients delivered prior to 36 weeks of gestation, over 50% prior to 34 weeks gestation. The total incidence of RDS was 25%. Severe types of RDS (stage III and IV) were rare (7%). The mortality of RDS after betamethason treatment was 5.4%. After 32 weeks gestation the mortality from RDS was 0%. Severe types of RDS appear to occur more often in male than in female infants. The incidence of RDS was not lowered further by premature of the membranes. The lecithin/sphingomyelin(L/S)-ratio in the amniotic fluid following treatment with betamethason increased to over 2 in only 2/3 of the cases. The predictive value of the L/S ratio that respiratory distress syndrome of the newborn only occurs rarely with values over 2 was maintained after treatment with betamethason. Our rate in cases with an L/S ratio over 2 was 7.9%.

Amniotic Fluid↗
PubMed1982

[Clinical experience using solco trichovac in the treatment of trichomonad infections in women].

A lactobacillus vaccine was administered to 102 women with vaginal trichomonad infections. In about half of these patients a local trichomonacidal treatment using Nitroimidazol derivatives was also carried out. After completion of the primary course of treatment 84% of the women were free of symptoms and no trichomonads could be demonstrated; within one year this figure had risen to 96%. Reinfections after completion of the primary course of treatment and after booster vaccination occurred in only 4-5% of the cases. The bacterial status of the vagina as described by Jirovec and Peter improved markedly, the degree of improvement being related to the number of vaccine treatments performed. After only one vaccination an improvement from Grace V (= trichomoniasis) to Grade I or II was seen in 64% of the patients. Six months after the primary course of treatment the vaginal status of 82% of the women was rated Grade I or II, and six months after the booster vaccination given after one year the corresponding figure was 80%. The lactobacillus vaccine treatment described represents a promising development in the therapy of trichomonad and bacterial infections in women.

Adult↗
PubMed1982

A contribution to the monitoring of fetal arrhythmias.

Antepartum and intrapartum monitoring problems are discussed with reference to a case history of a fetal AV-block detected during the 36th week of pregnancy. CTG instruments where the internal logic criteria can be turned off are suitable for monitoring arrhythmias. During labor the direct fetal ECG permits exact diagnosis as to the type of arrhythmia. The necessity of antepartum diagnosis in regard to postpartum pediatric management and hypoxic states during labor justify the large expenditure on monitoring apparatus. During labor continuous tissue pH measurement via the fetal scalp give added information as to fetal condition.

Adult↗