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J Deutinger

Publications and source records attributed to J Deutinger.

At least 73 records · Page 4Linked to original sources
PubMed1993

An analysis of the prediction of cephalopelvic disproportion.

Since cephalopelvic disproportion inevitably leads to cesarean section it seems to be mandatory to identify patients with an absolute discrepancy between the size of the fetus and the birth canal in order to avoid unnecessary trials of labour. In a case control study, comparing a group of patients who delivered by cesarean section because of cephalopelvic disproportion with an age matched control group, routinely assessed pelvic measurements and measurements of the newborn were correlated to cephalopelvic disproportion. Multivariate linear regression was applied to each group to determine, which of the maternal and fetal factors had the strongest influence on the mode of delivery. In the study group external conjugate showed the strongest positive relation to maternal body height (P < 0.01), the biparietal diameter of the newborn was negatively correlated (P < 0.01). None of the analyzed variables reached statistical significance in the control group. Differences between the two groups were marginal, thus providing no safe basis for decision making even in a population at high risk for developing cephalopelvic disproportion.

Adult↗
PubMed1993

The risk of malignancy with an apparently simple adnexal cyst on ultrasound.

We received data of 144 patients, who had been operated upon in the 2nd Department of Obstetrics and Gynecology in Vienna because of persisting sonographically detected "simple" adnexal cysts. Only 3 cysts were malignant (one of them borderline). All three patients were postmenopausal. The mean diameter of the malignant cysts were 7, 11 and 18 cm, respectively. 82 sonographically simple cysts were histologically benign. We found 27 cysts associated with chronic pelvic sepsis (hydrosalpinx and pseudocysts), 22 were benign cystadenomas and 10 were endometriotic.

Adult↗
PubMed1993

Fetal pulmonary cyst treated by repeated thoracocentesis.

This is a report of prenatal diagnosis and successful therapy of a septated fetal pulmonary cyst by repeated puncturing. This treatment was performed under ultrasonographic guidance for signs of fetal cardiac decompensation. This made normal development of the lungs possible.

Adult↗
PubMed1993

Vaginosonography for recording of cycle-related myometrial contractions.

It has been recognized from experimental or invasive studies that the nonpregnant human uterus has an inherent contractibility. We used vaginosonography for imaging contractions of the inner third of the myometrium. The direction, frequency, and symmetry of contractions were noted. We studied 53 women and subdivided them into four groups based on the cycle phase. During menstruation we found contractions toward the cervix with irregular frequency varying between 1 and 3/min. In the periovulatory period we noted the highest frequency of 10/min of regular contractions toward the fundus. The results showed that active myometrial contractions can be detected sonographically throughout the whole menstrual cycle. Increased myometrial contractions toward the fundus in the periovulatory period may be involved in sperm transport to the tubes.

Adult↗
PubMed1993

[Sonographic determination of the malignancy of ovarian tumors and therapeutic consequences].

Any Ultrasound investigation cannot reveal a histological diagnosis. There is a close correlation between sonographic characterisation of ovarian tumours and malignancy. Facts as size and structure of tumours, as well as papillarities on septae or walls of the cysts have much influence on the risk of malignancy. In cases with presence of papillarities in ovarian tumours a malignancy rate of 90% has to be expected. Contrary, simple, completely anechogenic ovarian cysts are benign with a probability of 98%. To improve the accuracy of prediction, we have to consider all other clinical aspects (age, anamnesis, tumour marker, etc.) We have to differentiate three steps concerning the risk of malignancy of ovarian tumours with subsequent different therapeutic management: the so called "simple Cyst", the "benign adnexal tumour" and the "malignant ovarian masses".

Biomarkers, Tumor↗
PubMed1993

[Echographic evaluation of the integrity of adnexa tumors].

The preoperative diagnosis of pelvic tumours is getting more and more important. This has special relevance to the increasing possibilities of conservative management of adnexal tumours and cysts (puncturing or operating by laparoscopy). We reviewed sonographical and histological data of 514 patients, who were operated on in the 2nd Department of Obstetrics and Gynaecology in Vienna because of pelvic masses. We correlated sonographical parameters like size of tumour, distinctness of margins, different kinds of internal echo pattern, papillary vegetation on the cystic wall or septa, with the defined histopathological diagnosis. A close relationship between size of tumour and tumour status could be found. The size of benign tumours was 7.1 cm. Malignant tumours had a size of 10.7 cm. The size of the high-echogenic area within the tumour, as well as its homogeneity, seemed to be of great importance. Such tumours with high-echogenic areas within, and especially those who had nonhomogeneous structures of these areas, proved to be malignant in 81% of the cases. Similarly, we found a close correlation of papillary vegetation either on cystic walls or on septa with the confirmed diagnosis of malignancy. Septa without papillarities or changing of their thickness were less important. By means of using our criteria a less experienced sonographic examiner could reach as good results as an experienced one in predicting malignancy.

Adenocarcinoma↗
PubMed1993

[Minimizing scar expansion using the B technique in form correction of the breast].

For the last two years, the B-technique has been used in mammaplasty to minimise the extent of scars, if the expected resection weight is 700 g or less. 33 patients were operated by means of this technique. Scar formation and areola sensation were examined and compared with 188 patients operated by the techniques of McKissock, Strömbeck or Pitanguy. 19 of those patients and 3 patients, who had been operated on by the B-technique, developed hypertrophic scars. The widths of the scars was significantly smaller after operation by the B-technique, than by other techniques. After operation by the B-technique, the areola sensation was unchanged in 67% compared to 46% after operation by above mentioned and other techniques. In cases, where the expected resection weight does not exceed 700 g, the B-technique is superior to other techniques, because the medial scars can be avoided.

Adolescent↗
PubMed1993

Breast feeding after aesthetic mammary operations and cardiac operations through horizontal submammary skin incision.

In most aesthetic mammary operations, a certain amount of tissue remains connected with the areola complex. When performing horizontal submammary skin incision for median sternotomy, no mammary tissue is removed. Therefore, lactation should not be impaired after these operative procedures. We examined 107 patients after aesthetic mammary operation and 27 patients after horizontal submammary skin incision and asked for breast feeding attitudes. Only two of 22 patients with a delivery after operation could not breast feed their infants because of agalactia. In four patients, insufficient support might have been the main reason for primary ablactation. In 12 patients, we found reduced areola sensibility; however, asensibility was not observed. We did not find any correlation between areola sensibility and attitude of breast feeding. No patient reported severe complications because of breast feeding. From the current data, we can conclude that breast feeding is possible after aesthetic mammary operation or after a horizontal submammary skin incision for cardiac operation. Patients should be instructed before the mammary operation and encouraged during pregnancy to breast feed their infants. Scars in the region of the breast should not be a reason for primary ablactation.

Adolescent↗
PubMed1992

Current status of vaginosonography: a world-wide inquiry.

In the last 5 years, vaginosonography has become a routine procedure in obstetrics and gynecology. Many obstetricians, gynecologists, radiologists and ultrasonographers have recognized the advantages of this method. Nearly all manufacturers of ultrasound equipment offer several types of vaginal probes. The rapid spread of vaginosonography has also led to some disadvantages concerning the lack of standardized terminology and image display. In this study, we collected data about the current standards of vaginosonography. To obtain data, questionnaires were sent out to the 1107 Departments of Obstetrics and Gynecology in the FIG0 Registry 1985. In the accompanying letter, the chairman was asked to hand over the questionnaire to the appropriate specialist. The questionnaire was designed to gather information about the personnel performing vaginosonography and the techniques, transducer frequency, position of the patient and image display used. A total of 369 responses were received. Vaginosonographic investigations were performed in 84% of the University Departments of Obstetrics and Gynecology. In 90% of these, vaginosonography was performed by the obstetrician or gynecologist, in 4% by the radiologist and in 6% by the technician. Most departments preferred end-firing transducers. The numbers of electronic and mechanical probes were nearly identical (56% vs. 44%). The preferences for a scanner with a narrow (less than 120 degrees ) or wide angle (more than 120 degrees ) were very similar (53% vs. 47%). More than half of the responders (54%) used a transducer frequency of 5 MHz, while 46% preferred scanners with a frequency between 5.5 and 7.5 MHz. In 55%, the gynecological examination table was considered to be superior to a flat table. Of the responders, 52% projected the apex of the vaginal probe to the bottom of the ultrasound monitor. This was particularly the case in Europe (63%). Questioned about a preference for a particular orientation in the future, an additional 7% voted to change to this mode of image display world-wide. When performing a sagittal section, if the probe was projected to the bottom of the screen, dorsally located to the structures were projected twice as often to the left of the screen as to the right.

Journal Article↗
PubMed1992

Meconium peritonitis: extrusion of meconium and different sonographical appearances in relation to the stage of the disease.

By chance, we had the opportunity to make serial sonographic observations of the extrusion of meconium in a case of meconium peritonitis. Inflammation leads to exudative processes and production of fluid (ascites) in the fetal abdomen. Sonography at that stage of the disease may lead to a misdiagnosis such as 'fetal ascites' or 'non-immune hydrops'. After bowel perforation and extrusion of meconium, the latter appears as a solitary mass inside fetal ascites or as disseminated echogenic masses distributed subdiaphragmatically or perihepatically. Within a couple of days, in most cases the echogenicity of the masses increases. Calcifications lead to distinct shadowing. These calcifications are often the only visible signs of a previous meconium peritonitis. Serial sonograms are essential for the management of pregnancies with meconium peritonitis. If the amount of fetal ascites does not increase and no signs of cardiovascular stagnation appear, no invasive intrauterine diagnostic and therapeutic steps are required. In none out of the nine cases was a cause found.

Adult↗
PubMed1992

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↗
PubMed1992

[The diagnostic value of rectal ultrasound in the assessment of parametrial infiltration of cervix cancer].

In addition to rectal palpation, rectosonography seems to be a promising method in pretherapeutic examination of the parametrium in patients with cervical carcinoma. To evaluate the usefulness of this examination we determined the sensitivity and specificity of rectal palpation performed by one examinator, rectal palpation performed by changing examiners, and rectal sonography. The results of the clinical examination of 128 parametria (64 women) were compared to histological findings following Wertheim-Meigs operation. Sensitivity and specificity were as follows one examiner 48% and 96%, changing examiners 44% and 94%, rectosonography 55% and 99%. In conclusion, we suggest that rectal sonography is a careful and moderate method that can be an important supplement to rectal palpation in pretherapeutic staging of cervical cancer.

Cervix Uteri↗