[Osteology and history--radiological aspects].
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Biomedical subjects
Publications and source records attributed to L Diener.
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The causality between late abortion respectively premature birth and cervical insufficiency is proven. The prophylactic and therapeutic cerclage can be a contribution to a reduction of the frequency of premature births. A sound knowledge of the physiological state of the cervix uteri during pregnancy is necessary for a well-timed indication. This problem was confirmed by a study with 258 longitudinal examinations (134 nulliparae, 124 parae). There was no significant difference between the two groups of patients. The change of the cervix uteri is described in 45 cases of cervical insufficiency without labour. In most of the cases the disease developed from a physiological initial or intermediate stage within a short time. Short-term controls are necessary in case of divergency from the physiological state.
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In this paper the results of special monitoring of pregnancies with risks are reported and compared with a collective of not specially monitored pregnancies with risks. It is possible to reduce the total rate of low birth weights and the rate of premature infants significantly by special care with consequent use of a schedule of monitoring. The rate of premature infants was 3.7 per cent in the specially monitored collective as far as the women were accessible to a prolongation of gestation. In the cases of birth weights up to 2500 g a significant removal towards higher and more favourable birth weights can be achieved by special monitoring. The causalities in the premature infants are demonstrated. The prolongation of gestation by cerclage is to be considered as a partial success.
The rate of pregnancies with risks is about 50 per cent in our area. A retrospective examination of 906 pregnancies with risks and 185 analysed cases of low birthweight infants of the years 1974 to 1976 shows, that 79 per cent of the low birth-weight infants can be predicted by the use of the catalogue mentioned in the first part. The comparison of the percentage of risk factors in the two collectives indicates, that the group of pregnancies with risks is representative. In connection with the results reported in part 1 a special monitoring of all pregnancies with risks is considered to be justified. The causes for success are pointed out. If there is no possibility to organize special monitoring, the consequent use of the schedule of monitoring by trained specialists is recommended.
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The fate of the newborn child decisively depends on its antenatal condition. The surveillance of pregnancies gets an increasing importance. In this report 113 women with risk pregnancies are compared with 453 women with normal pregnancies. The two collectives had underlain the same conditions of leading and monitoring of delivery. They are compared as to perinatal morbidity and mortality. The problem of prematurity and dysmaturity is especially considered. It is possible to reduce the rate of premature infants by adequate care. Conclusions are mentioned for a graduated system of surveillance of pregnancies.
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Fifty-one patients were investigated concerning thromboembolic complications in the operated leg after elective surgery of the hip. Suspicion of clinical deep venous thrombosis (DVT) arose in 11 patients, i.e. 21 per cent. Thirty-five patients were investigated with phlebography. The incidence of DVT among those patients was 15 cases, i.e. 43 per cent. It is concluded that acetylsalicylic acid, a drug which inhibits the platelet release reaction and thereby blocks the platelet aggregation, given orally in a dose of 2 gram per day from the first postoperative day, is not effective in diminishing the incidence of postoperative deep venous thrombosis.