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Biomedical subjects

J Deutinger

Publications and source records attributed to J Deutinger.

At least 91 records · Page 5Linked to original sources
PubMed1992

Vaginosonographic velocimetry in uterine arteries before and after administration of beta-mimetics.

OBJECTIVE: To investigate the effect of surgical procedures at 15 weeks gestation (amniocentesis or cervical cerclage), with or without post-operative ritodrine prophylaxis, on uterine blood flow velocity waveforms and maternal heart rate. DESIGN: A quasi-randomized observational study. SETTING: University Department of Obstetrics and Gynaecology, Vienna. SUBJECTS: Sixty women having a genetic amniocentesis for advanced maternal age and 57 women having elective cervical cerclage for previous preterm labour or recurrent miscarriage. INTERVENTIONS: The women in each group were allocated either to receive prophylactic ritodrine postoperatively or to receive no ritodrine treatment. Allocation used the year of birth of the woman (odd years received ritodrine, even years received no treatment). All the women had vaginal ultrasound velocimetry studies in both mainstem uterine arteries through the parametrium before the surgical procedure and again after the procedure. The ritodrine-treated women in the cerclage group received intraveneous ritodrine hydrochloride (0.2 mg/min) and those in the amniocentesis group received 60 mg ritodrine/day orally. MAIN OUTCOME MEASURES: Uterine artery blood flow velocity waveform indices: A/B ratio and pulsatility index (PI) and maternal heart rate before and after the surgical procedure. RESULTS: The only statistically significant difference in haemodynamic values between those obtained before the procedure and those obtained after the procedure with or without prophylactic ritodrine was seen in the women who had cervical cerclage with postoperative intravenous ritodrine. The mean A/B ratio decreased from 2.69 (SD 1.17) to 2.11 (SD 0.44), and the mean PI from 1.62 (SD 0.47) to 1.21 (SD 0.3) and the mean maternal heart rate increased from 82.6 (SD 11.1) to 99.4 (SD 15.7). There were no other statistically significant differences between before and after haemodynamic values. CONCLUSIONS: There are no clinically relevant effects of amniocentesis and cervical cerclage on uterine blood flow velocity waveforms.

Adult↗
PubMed1991

Vaginosonographic Doppler velocimetry in both uterine arteries: elevated left-right differences and relationship to fetal haemodynamics and outcome.

Blood flow velocity was measured in both main stem uterine arteries by means of a transvaginally inserted Duplex scanner (240 degrees sector, pulsed Doppler) and visual vessel recognition to investigate normal and abnormal uterine perfusion. Its relationship to fetal circulation and fetal outcome was studied. Fetal vessels were investigated transabdominally. One hundred and seventy-six pregnancies with a high-risk for fetal malnutrition were examined between the 27th and the 40th week of gestation. In 113 (64%) patients we found normal uterine perfusion (A/B ratios in both uterine arteries less than 3, left-right difference less than 1) and in 63 (36%) cases the A/B ratios were outside our limits. A single abnormal A/B ratio in one of the uterine arteries or an abnormal left-right difference was classified as a mild form of abnormal uterine perfusion. Involvement of both uterine arteries was classified as a severe form. The severe form was associated with a higher frequency of pathological waveforms in fetal arteries and reduced fetal outcome. Clinically, velocimetry in both uterine arteries is of paramount importance when the degree of abnormal uterine perfusion is to be classified precisely.

Adult↗
PubMed1991

[Current status of vaginal ultrasound--a worldwide survey].

In the last five years, vaginosonography has become a routine procedure in Obstetrics and Gynaecology. Many obstetricians, gynaecologists, radiologists and ultrasonographers have recognized the advantages of this method. A number of manufacturers of ultrasound equipment offer several types of vaginal probes. Nevertheless, the rapid development of vaginosonography has led to some disadvantages concerning a standardised terminology and image display. In this study we collected data on the current standards of vaginosonography. To gain data on the current use of vaginosonography, we sent out questionnaires to the 1107 departments of Obstetrics/Gynaecology in the FIGO Registry of 1985. In an accompanying letter we asked the chairmen to pass on the questionnaire to the appropriate specialist. The questionnaire was designed to gather information about the personnel performing vaginosonography and such as technique, transducer frequency, position of the patient and image display used. We received 366 responses. Vaginosonographic investigations are performed in 84% of the Obstetrics/Gynaecological University Departments, of which 90% of vaginosonography was performed by an obstetrician or gynaecologist, 5% by a radiologist and 5% by a technician. Predominantly end firing scanners were preferred. The number of electronic and mechanical scanners were nearly identical (55% vs 45%). The preference for a scanner with a narrow (less than 120 degrees) or wide angle (greater than 120 degrees) was very similar (53% vs 47%). More than half of the replies indicated (54%) used a transducer frequency of 5 MHz, 46% preferred scanners with a frequency between 5.5 and 7.5 MHz. In 55%, the gynaecological examination table was considered superior to a flat table.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross-Cultural Comparison↗
PubMed1991

Prenatal diagnosis of a complex fetal cardiac malformation associated with asplenia.

A case of a complex fetal heart malformation with left isomerism, a "right sided" double outlet ventricle, and aortic isthmus stenosis combined with asplenia was diagnosed by ultrasonography at 26 weeks' gestation. The pregnancy was terminated at the request of the parents in the 27th week of gestation. Because the prognosis for a fetus with cardiosplenic syndromes depends mainly on the severity of the cardiac abnormality cases of visceral heterotaxy should be classified according to the predominant feature, the heart malformation.

Adult↗
PubMed1991

[Delivery of quadruplets after in vitro fertilization: perinatologic and ethical aspects].

Progress in modern reproductive medicine has brought much success to infertile couples. A side effect of IVF procedure are multiple pregnancies with clinical, ethical, perinatal and social problems. We report about the first case of quadruplets after IVF born in Austria and try to illustrate the perinatal, social and ethical problems. The 34 year old woman was treated in our sterility outpatient clinic because of secondary sterility. In 1988 finally she underwent IVF procedure. Four oocytes were retrieved by means of vaginal follicle puncture. 4 embryos were transferred, and after 3 weeks 4 viable embryos were seen at an ultrasound investigation. Due to placental insufficiency a cesarean section had to be performed in the 31st week of gestation. The weights of the premature infants were 1280 g, 1340 g, 1260 g and 1250 g. Two years after birth two infants show neurologic defects and need permanent care.

Adult↗
PubMed1990

Assessment of female urinary incontinence by introital sonography.

By the use of a vaginal sector scanner, placed to the vaginal introitus (introital sonography), we studied the static and dynamic function of the urethrovesical region in patients with genuine stress incontinence and detrusor instability. Patients with genuine stress incontinence (n = 25) revealed either an increase of the retrovesical angle or the angle of inclination associated with a descent of the bladder neck during coughing. Opening of the bladder neck during cystometry, showing an increase of the detrusor pressure, was observed in patients with motor urge incontinence (n = 10). Application of the technique is recommended in patients with stress incontinence undergoing surgery for objective intraoperative assessment of successful reformation of the urethrovesical junction, irrespective of the surgical procedure. Compared with radiologic techniques, introital sonography has many advantages with no radiation exposure and with minimal inconvenience to the patient.

Female↗
PubMed1990

In vitro fertilization with spermatozoa from alloplastic spermatocele.

This case report describes successful IVF of oocytes of a 22-year-old female with epididymal spermatozoa aspirated from alloplastic spermatocele of the husband presenting with bilateral congenital absence of the vas deferens. Motile spermatozoa were aspirated from the reservoir 3 months after implantation. Abortion occurred 22 days after embryo replacement.

Abortion, Spontaneous↗
PubMed1990

Plasminogen activators, plasminogen activator inhibitor, and fibronectin in human granulosa cells and follicular fluid related to oocyte maturation and intrafollicular gonadotropin levels.

We determined the relative distribution of tissue plasminogen activator (TPA) antigen, urokinase-type PA antigen, PA inhibitor activity, and fibronectin levels in lysates of human granulosa cells (GC) and the respective follicular fluid (FF) in relationship to oocyte-corona-cumulus complex morphology. In addition, FF gonadotropins were measured to investigate a possible relationship of gonadotropins to PA activity. A significant increase of TPA antigen in GC lysates of intermediate and mature oocyte-corona-cumulus complex was found when compared with immature oocyte-corona-cumulus complex. Urokinase-type plasminogen activator levels and PA inhibitor levels did not reveal any significant differences between the different groups. In FF the concentrations of PA and PA inhibitor were significantly lower than in GC lysates and showed no significant difference between the oocyte-corona-cumulus complex groups. The concentration of fibronectin was significantly elevated in GC lysates of mature follicles. The marked increase of TPA in human GC during oocyte maturation showed a positive correlation with the increase of FF follicle-stimulating hormone and beta-human chorionic gonadotropin in the group of mature oocyte-corona-cumulus complex. The data obtained suggest that in man TPA is the predominant PA involved in the process leading to follicular rupture.

Adult↗
PubMed1990

[Breast feeding following breast reduction-plasty and mastopexy?].

A certain amount of breast tissue remains connected with the nipple after aesthetic breast surgery, except in cases of free nipple grafting. Breast feeding is therefore possible. The obstetrician or the midwife are often with the question, whether breast feeding can be recommended. In this study we have investigated, whether lactation is adversely affected by breast surgery. 105 patients who had been operated for unilateral or bilateral mammahyperplasia or mammoptosis, were examined and questioned about breast feeding after operation. The operative techniques of McKissock, Pitanguy and Strömbeck had been used. Breast feeding attitude of our patients was compared with a corresponding collective without breast surgery from the 2nd University Clinic, Gynaecological Department. Five of 14 patients breastfed their babies. The remaining patients did not breastfeed, either after having been counselled not to breastfeed or because of admission of the newborn to a neonatal care unit. Only in two patients no lactation was observed. In our opinion, patients should be informed and encouraged, that breastfeeding is possible after aesthetic breast surgery.

Adult↗
PubMed1990

[Prenatal diagnosis of placental tumor using Doppler sonography].

Chorioangiomas are relatively frequent, benign and highly vasculated tumours of the placenta. In a few rare cases they show an excessive growth. Placental necrosis, preterm delivery and foetal asphyxia are well-known complications. Another severe complication is maternal thrombocytopenia, leading to serious thrombopathia. In cases with unfavourable examination conditions, it may be difficult to distinguish ultrasonographically between a chorioangioma and foetal elements. In our case, final diagnosis of a 10 by 9 cm chorioangioma became possible by the use of Doppler ultrasound. Arterial and venous signals were seen all over the tumour. During the following period of observation, the tumour did not grow and pregnancy was uneventful. Diagnosis of chorioangiomas should be made as early as possible to enable the obstetrician to adjust the management of pregnancy to complications that can be expected.

Adult↗
PubMed1989

Platelet specific proteins (beta-thromboglobulin and platelet factor 4) in normal pregnancy and in pregnancy complicated by preeclampsia.

Pregnancy is accompanied by significant alterations of platelet function. Platelet activity can be determined by measurement of plasma levels of secreted platelet proteins. In this study we determined plasma levels of beta-Thromboglobulin (beta-TG) and Platelet Factor 4 (PF4) simultaneously in 35 women with uncomplicated pregnancy and in 15 patients with preeclampsia in third trimester of gestation. Additionally, PF4 plasma levels were measured using a commercially available Radio Immunoassay (RIA) and an Enzyme Immunoassay (EIA) simultaneously and values obtained were compared. Platelet count and creatinine were in the normal range in both groups; however, significantly higher levels of beta-TG (P less than 0.0005) and PF4 (P less than 0.0001) were found in case of preeclampsia. High levels of platelet proteins emphasize the active role of the platelets in the alterations of hemostasis in cases of preeclampsia.

Female↗