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Biomedical subjects

H Schaffer

Publications and source records attributed to H Schaffer.

13 recordsLinked to original sources

Survey of computerized obstetric information systems in Austria.

The aim of this study was to evaluate obstetric electronic data processing (EDP) in Austria and to analyse its problems, advantages and acceptance in a single big obstetric department. We sent questionnaires to every obstetric department in the country. The overall response rate was 77% (73 departments). Only 24 (33%) were using computer aided documentation, but these covered 63% of deliveries in Austria. The proportionate times spent on documentation were 57% for physicians and 43% for midwives, with physicians playing a bigger role in larger departments using electronic documentation. Sixty-five percent of physicians and 31% of midwives readily accepted computerization. We also studied an obstetric department with over 3000 births per year. Twenty-five percent of the medical staff did not believe that computerization saved time, although they appreciated its value to administration and for producing printouts. Advantages in completeness (92%) and accuracy (76%) were recognized. After 6 month's use acceptance of EDP documentation improved significantly.

Attitude of Health Personnel

[Comparison of biochemical and Doppler sonographic monitoring of high-risk pregnancies].

We performed in 113 patients at least three simultaneous determinations of serum-HPL and oestriol in 24-hour urine samples, as well as Doppler flow studies at the arcuate artery (AA), umbilical artery (UA), foetal aorta and internal carotid, because of suspicion of IUGR. The diagnostic value was studied with regard to IUGR, placental weight and mode of delivery. Concerning the detection of IUGR, the superiority of Doppler parameters (AA, UA) is shown. In the total number of patients, the rates for sensitivity and specificity for UA (78/91%) and AA (58/89%) exceed the hormone parameters. Oestriol, in particular, (13/63%) shows a marked difference, but even HPL (37/63%) cannot compete with respect to diagnostic value.

Acidosis

[Doppler examination as an indication for surgical delivery. A case report].

Pathological alterations in foetoplacental circulation can lead to zero flow or even to reverse flow in the diastole. In these cases, a high fetal risk can be expected. Based on our Doppler measurements, we recommend by zero flow in the umbilical artery or foetal aorta, that the childbirth could be postponed under an observant attitude using intensive controls (CTG, foetal movements), but pregnancy has to be terminated immediately by Caesarean section at the first sign of reverse flow.

Adolescent

[Clinical value of a decrease in diastolic flow in obstetric Doppler sonography].

Doppler ultrasound in obstetrics is being increasingly accepted in foetal surveillance. For clinical practice, a good correlation between Doppler findings and biochemical data such as blood gas analysis and lactate as a metabolical parameter, would be desirable. To clarify this question, these results have to be compared. Prepartal Doppler results which are correlated with postpartal blood gas analyses of umbilical vessels cannot be a satisfactory criterion due to the influence of labour on these parameters. Therefore, we depend on results from foetal blood sampling procedure. The five cases presented here should be a contribution to this discussion. In summary it can be concluded, that in cases of a highly pathological Doppler analysis in the umbilical artery, intrauterine growth retardation must be expected. If there is an acidosis in the foetal organism, it can be assessed via the foetal carotid findings. This, therefore is our contribution to the discussion on the indication for Caesarean section in cases of absent diastolic flow: Absence of diastolic flow in the umbilical artery and foetal aorta only without centralisation by increased perfusion in the foetal carotid, is, in our opinion, not an indication for Caesarean section. We believe, that foetal acidosis confirmed by foetal blood gas analysis indicated by the Doppler result, is an efficient completion of obstetrical management in risk pregnancies. Any further decision on conservative management or termination of pregnancy can be taken more easily on the basis of biochemical data, especially in situations, where conventional methods of foetal surveillance cannot clarify the perinatal risk sufficiently.

Adolescent

Functional reconstruction of abraded canines by resin-bonded all-ceramic guiding elements.

A method for establishing canine guidance is described. The individual functional angulation of the guiding plane should be calculated from the data of a computer-assisted diagnostic analysis. All-ceramic guiding elements are fabricated on removable refractory dies in mounted casts. Minimal preparations facilitate transfer of the all-ceramic resin-bonded guiding elements from the die to the tooth. Initial clinical experience up to 1 year has shown excellent esthetics and stable functional improvement.

Cuspid