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Biomedical subjects

K Philipp

Publications and source records attributed to K Philipp.

105 records · Page 6Linked to original sources
PubMed1978

[Localization of the placenta by means of nuclear medical methods].

Accurate localization of the placenta in the cavity of the uterus is indicated prior to transabdominal amniocentesis and in cases where hemorrhages occur during pregnancy. Several nucleo-medical techniques are available for this purpose. Earlier a so-called placentography was performed, a method later replaced by placental scintigraphy. Today the gamma scintillation camera is ideal for localizing the seat of the placenta. In case of a normally embedded placenta, the profile view makes it possible to determine whether the placenta is attached to the anterior or posterior wall. In case of an anterior wall placenta it is possible with a radioactively labelled marker to draw the outline of the placenta on the abdomen of the patient so that the examiner is certain to puncture in an area that does not contain the placenta. Diagnosis of placenta praevia is assured in all cases by use of the gamma scintillation camera. Short-term introduction of an emitter into the posterior fornix vaginae makes it possible to determine the position of the internal orifice of the cervix uteri. If the caudal part of the placenta extends up to this mark, a placenta praevia is likely and all obstetrical precautions indicated have to be taken.

Female↗
PubMed1978

[Conisation during pregnancy (author's transl)].

The paper reviews 15 cases undergoing conisation during pregnancy. In 2 conisation was immediately followed by radical operation for invasive squamous carcinoma. 11 patients had pre-invasive carcinoma by microscopic evidence on serial step sections, while the remaining 2 showed high-grade dysplasia of the cervix. Atypical tissue was successfully removed in toto in 6 of the 8 cases with lesions predominantly localizing at the cervical surface. Of the 5 abnormal epithelial processes which were almost entirely endocervical only 1 was completely removed. Abortion occurred in 4 of the 13 patients undergoing conisation without prophylactic cerclage. Shirodkar's operation was done at the time of conisation in 7 cases, in one after an interval of 10 weeks. This prophylactic measure failed to prevent prematurity in 2 cases, while the remaining 6 gave birth to living and mature infants between the 37th and the 40th week of gestation.

Abortion, Spontaneous↗
PubMed1978

[The influence of the continuous epidural anaesthesia on uteroplacental blood flow (author's transl)].

Continuous lumbar epidural anaesthesia causes a drop in maternal blood pressure by decreasing flow resistance in the peripheral vascular bed. By infusion of 1000 ml NaCl blood pressure can be kept constant. Our work shows, that dilatation of the peripheral vessels has a positive effect in patients with reduced uteroplacental flow, as it results in an augmentation of placental flow. In women with normal placental function such an effect could not be seen. The practical use of these results is illustraded by a case report.

Anesthesia, Epidural↗
PubMed1977

[Pregnancy after conisation for atypical epithelial processes of the uterine cervix (author's transl)].

At the First Department of Obstetrics and Gynecology, University of Vienna Medical School, 148 females aged under 35 years at the time of conisation were examined between 1963 and 1974 to determine their desire for children, their fertility status and the course of pregnancy. After conisation a total of only 42 females (28,4%) wanted children. Of 104 patients with preinvasive carcinoma, a desire for children was reported by no more than 21 (20,2%); among the cases with dysplasia, the number of women desiring children was equally 21 (47,7%). By the end of 1976, after a followup period of 1 to 13 years, 16 of 42 females wanting children failed to conceive, while the remaining 26 gave birth to 20 children. Judging from our admittedly small material, conisation thus apparently has no effect on conception. However, the course of pregnancy was found to be impaired in some cases by the incompetent cervical function. Twelve patients required a Shirodkar operation, which failed to prevent late abortion in 2 cases and premature delivery in 4. Nine women gave birth at or at best 3 weeks before term without preventive methods.

Adult↗
PubMedDate not supplied

The influence of leptin on placental and fetal volume measured by three-dimensional ultrasound in the second trimester.

For a couple of years mechanisms influencing placental and fetal growth and the functioning of leptin, the protein product of the ob/ob gene, have been subjects of intensive research. This study's aim was to investigate whether maternal serum leptin and amniotic fluid leptin have an influence on placental and fetal size measured by three-dimensional ultrasound in the second trimester. To determine this, 40 women with a singleton intrauterine pregnancy at the time of the amniocentesis were included in the study. Placental and fetal volume measurements were obtained and correlated to maternal serum leptin, amniotic fluid leptin, body mass index and gestational age. Multiple regression analysis identified amniotic fluid leptin as an independent negative predictor of placental and fetal volume (r = -2.29, p = 0.032 and r = -0.95, p = 0.011, respectively). In contrast, there was no correlation between maternal serum leptin and placental or fetal volume. The median leptin level in amniotic fluid (9.5 ng/ml) was significantly lower than in maternal blood (18.6 ng/ml). However, there was no significant correlation between maternal serum leptin and amniotic fluid leptin (r = 0.208, n.s.). Body mass index did not reveal any significant influences on placental or fetal volume. The relatively high level of amniotic fluid leptin and its inverse correlation on placental and fetal volume in the second trimester suggest that it possibly plays a role as an anti-placental growth hormone or feedback modulator of substrate supply to the fetus and placenta.

Adult↗
PubMedDate not supplied

Correlation of first trimester placental volume and second trimester uterine artery Doppler flow.

Uterine artery Doppler examination can identify impaired trophoblast invasion in the second trimester of pregnancy. High resistance and an early diastolic 'notch' show insufficient physiological conversion of the spiral arteries. Uterine artery Doppler is routinely performed between 22-24 weeks which is relatively late for treatment. In this study we wanted to find out whether women with increased uterine blood flow resistance at 22 weeks already have reduced placental volumes in the first trimester measured with 3D sonography.A total of 1060 women with singleton pregnancies had three dimensional (3D) volume measurements of their placentae between 11-13 weeks and uterine Doppler scans between 21-22 weeks. Stepwise logistic and linear regression analyses were used to show a correlation between placental volume (PV) and a CRL dependent placental quotient (PQ) with uterine perfusion parameters. Uterine perfusion at 21-22 weeks depends significantly on PV or PQ at 11-13 weeks (P< 0.0001 for both) and smoking behaviour (P=0.006). The occurrence of a notch also depends significantly on PV and PQ (P< 0.0001 for both) and also on gravidity (P< 0.0001) and age (P=0.0007) as well as on smoking behaviour (P=0.0094). PV and PQ did not show any dependency on age, gravidity, BMI or smoking habits. Placentae of women with high resistance uterine perfusion in the second trimester are already remarkably small in the first trimester. Placental volumetry is probably an efficient method for early and simple identification of impaired trophoblast invasion.

Age Factors↗
PubMedDate not supplied

[Ultrasound and endoscopic image of exencephaly (acrania) in the 12th week of pregnancy].

BACKGROUND: Acrania is a rare congenital anomaly of unknown pathogenesis, in which the flat bones of the cranial vault are absent and the facial bones are normally present. MATERIALS AND METHODS: We present a case of a 4th gravida, who had already born 2 children with acrania and came for an ultrasound examination in the 12th week of gestation. RESULTS: By transvaginal ultrasonography it was possible to diagnose fetal acrania already in the 12th week. By hysteroscopy at the same time we could see, that the brain was covered by a thin membrane, the facial bone and the shape of the cranium were normal. CONCLUSIONS: By hysteroscopy it was possible to confirm the diagnosis and to detect additional malformations. This fetus showed a small omphalocele, hexadactylism on both sides and clubfeet on both sides. DISCUSSION: By hysteroscopy in this early week of pregnancy we could demonstrate, that acrania is an independent anomaly and not the first stage of an anencephaly as reported by other authors. Hysteroscopy also offers the advantage of viewing the intact fetus before pregnancy termination.

Abnormalities, Multiple↗
PubMedDate not supplied

[Combined test in the first trimester of pregnancy in 3,316 unselected pregnant patients for diagnosing Down syndrome].

UNLABELLED: The high detection rate (DR) for Down syndrome pregnancies which can be achieved by measuring fetal nuchal translucency (NT) early in pregnancy can be improved by combining it with placental hormones (PAPP-A, f beta hCG) and maternal age ("combined test"). In this study we wanted to assess the DR using the "combined test" in an unselected population of self-referred pregnant women at a false positive rate (FPR) of about 5%. MATERIALS AND METHODS: NT, PAPP-A, f beta hCG and maternal age were measured in all women with singleton pregnancies who booked for delivery in our hospital from 1.12.97 to 31.12.99 and who were between 10 and 13 completed weeks of gestation (crown-rump-length 35-70 mm). Calculation of the specific Down risk was done with the computer program Alpha, Version 5aa (Logical medical systems, London). RESULTS: A total of 3316 women were tested. Out of 10 Down pregnancies, which occurred in this period of time 9 could be detected with the test. 137 women had a positive test result but a non-Down pregnancy (FPR 4.1%). CONCLUSIONS: The combined test is an excellent test for the detection of Down syndrome pregnancies in a low-risk population. DISCUSSION: The constant increase in maternal age at the time of delivery can also lead to an improved DR if a simple age dependant protocol for Down-detection is used, but only at the price of a much higher number of amniocenteses and subsequent abortions. The DR for Down syndrome can be increased much more markedly using the "combined test" at a much lower FPR (approximately 5%).

Abortion, Eugenic↗
PubMedDate not supplied

[Associations between birth weight and placental volume in the first trimester].

INTRODUCTION: Associations between the size of the placenta and birth weight have been described before. This connection has also been found in (sonographically estimated) second trimester placental size. The aim of this study was to find out if there are any differences in first trimester placental volume between various birth weight groups. METHODS: Placental volume was obtained from non-smoking women at the end of the first trimester during a period of eight months. After birth, the newborns were divided into four groups: below the 10th, 10th to 50th 50th to 90th and above the 90th centile. As is known from previous research, placenta size changes in proportion to crown-rump-length. Therefore, the medians of the "placenta quotients" (placental volume/CRL) of each group were compared in order to correct for differences in gestational age. RESULTS: Data from 1476 pregnancies could be evaluated. The overall median of the placenta quotient was 0.98. It was 0.85 in the group below the 10th, 0.92 between 10th and 50th, 1.02 between 50th and 90th and 1.10 above the 90th centile (p < 0.0001, median test). DISCUSSION: The finding of associations between early pregnancy placental size and birth weight at term gives hope for the development of new diagnostic methods for the recognition of placenta-associated problems. Further research is required to estimate the clinical possibilities for the detection of pregnancies at risk of severe growth retardation and other conditions.

Austria↗
PubMedDate not supplied

[Uterine activity in induction of labor by vaginal administration of prostaglandin E2 tablets].

Induction of labor with intravaginal application of PGE2-tablets has become more popular recently. Delivery intervals have been reported to be reduced. Therefore we investigated intrauterine pressure profiles in a group of 25 women in which labor was induced electively by means of vaginal applications of 3 mg PGE2-tablets and compared them to a control group of 27 women with spontaneous onset of labor. In the first hours after amniotomy the frequency of contractions was higher in nulliparous whereas baseline and amplitude were increased in multiparous women. Overall uterine activity (hourly contraction area) however, was not statistical different in both groups. We concluded that shortened delivery intervals in the PGE2 induction group is based on an increased uterine activity in the first stage of labor. At the usual dosage no pathological pressure increases could be observed which lead to fetal compromise.

Administration, Intravaginal↗
PubMedDate not supplied

[Attempt to diagnose a "small" placenta by HPL determination before the 18th week of pregnancy].

In a prospective study covering 175 gravidae it was investigated whether the risk of a "small" placenta could be detected by determining HPL or serum estriol once during the first 18 weeks of pregnancy. The results show that neither the HPL value nor the serum estriol value correlate with the weight of the placenta or the child. Therefore, the problem of early detection of a "small" placenta cannot be resolved with these hormone parameters.

Estriol↗
PubMedDate not supplied

Immunolymphscintigraphy of axillary lymph node metastases in breast cancer patients using monoclonal antibodies: first clinical findings.

The results of preliminary investigations into the immunolymphscintigraphic (ILS) detection of axillary lymph node metastases in nine breast cancer patients by means of the 3C6F9 monoclonal antibody (MAs) are presented. The IgG2a monoclonal antibody detects a 37 KD antigen, consistently found on the surface of primary and metastatic breast tumors. Each patient received 1 mCi of I-123 (specific activity, 2 mCi per mg of antibody) as a subcutaneous injection between the 2nd and the 3rd finger of both hands, i.e., the healthy side serving as a control for the affected side. Clear images of lymph node metastases were visible 4 to 8 hours after injection of the antibody. Seven of the nine patients studied were positive by scanning and six showed positive lymph node involvement by histopathology (6/7; true positive = 86%). Two patients did not show any iodine uptake in the axilla and were subsequently found to be free of metastases (2/2; true negative = 100%). These data give an overall accuracy of ILS of 89% and demonstrate that 3C6F9 localizes preferentially in affected axillary lymph nodes compared to normal lymph nodes.

Antibodies, Monoclonal↗
PubMedDate not supplied

[Measurement of uteroplacental circulation in antihypertensive therapy with clonidine].

40 Gravidae with hypertension were treated with clonidine . Placental blood flow measurements were performed to study the effect of clonidine on uteroplacental blood flow. The results show a significant decrease of the gestosis-index and a significant improvement of placental perfusion type during medication. Therefore, clonidine is suitable for treatment of hypertension in pregnancy and has no negative effect on uteroplacental blood flow.

Adolescent↗
PubMedDate not supplied

[The influence of smoking on uteroplacental blood flow and maternal carboxyhemoglobin levels].

The effect of nicotine consumption on uteroplacental blood flow and on the carboxyhemoglobin concentration in maternal serum was examined in 20 pregnant women. It was found that poor uteroplacental circulation is more frequent in women who smoke than in those in whom placental insufficiency is suspected. Normal circulation of Type I was only recorded in gravidae smoking not more than 10 cigarettes a day. Determination of the carboxyhemoglobin concentration in the maternal serum as an indicator of the overall level of contamination by tobacco smoke revealed a significant correlation of the morning value with the placental blood flow type. The average birthweight of the newborns of smokers was 300 g lower than might have been expected. In isolated cases chronic nicotine abuse led to intra-uterine growth retardation, with no other apparent causes of placental insufficiency.

Adult↗