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Biomedical subjects

P Husslein

Publications and source records attributed to P Husslein.

At least 163 records · Page 9Linked to original sources
PubMed1988

Abortion risk in chorionic villus sampling. Evaluation in elective termination of pregnancy.

100 patients were examined to evaluate the risk of abortion of chorionic villus sampling. In the 8th-10th week of pregnancy a catheter with a mandrin was introduced into the chorion frondosum under ultrasound guidance. The mandrin was then removed and trophoblast tissue obtained by aspiration. The patients agreed to postpone elective termination of pregnancy for 2 weeks. Another ultrasound was performed before suction curettage. With increasing experience, the abortion rate dropped to 4%, whereas the rate of successful biopsies and analyses rose to more than 90%. Based on these results, chorionic villi sampling was made available at the 1st Department of Obstetrics and Gynecology, University of Vienna, as an alternative method to amniocentesis. Out of 38 biopsies, 25 karyotypes were normal, two biopsies revealed pathological results (trisomy 21, 22), 11 samples showed no results (insufficient tissue or no mitoses). One patient had a spontaneous abortion (trisomy 22) and one an abortion due to infection. Chorionic villus sampling could replace amniocentesis because chromosomal anomalies may be detected already in the 1st trimester of pregnancy.

Abortion, Induced↗
PubMed1988

[The medroxyprogesterone acetate serum level following various medroxyprogesterone acetate dose schedules in gynecologic oncology].

Medroxyprogesterone acetate (MPA) is used as an adjuvant hormonal medication in patients with different kinds of carcinomas. Since adequate serum levels are thought to be essential we determined the individual, postoperative MPA levels in 36 patients with endometrial carcinoma over a period of 12 weeks. The patients received either an oral dose of 3 X 100 mg MPA or a weekly changing scheme with 2 X 10 mg Tamoxifen and 3 X 100 mg MPA. An additional small group of 4 patients with ovarian carcinoma was enrolled receiving an oral dose of 1000 mg MPA daily. The peripheral serum levels of MPA exhibit enormous inter- and intraindividuell variations and only the high dosage schemes yield levels above 90 ng/ml which are claimed necessary by some authors. The cortisol concentration measured at the same time were within the normal range and did not correlate with the MPA values.

Antineoplastic Agents↗
PubMed1988

[Sensitivity test in labor induction with prostaglandin E2 vaginal tablets].

The study was designed to evaluate whether an oxytocin sensitivity test in addition to pelvic scoring would increase the predictive value concerning successful induction in cases of elective induction by means of prostaglandin (PG) E2 vaginal tablets. Furthermore we investigated if this test could lead to a further reduction in the already low rate of protracted labour and operative deliveries. In order to establish the optimal dosage we compared the endocervical application of 1.5 ml PG E2 with 3 mg intravaginal. 160 pregnant women without any risks were included at due date; 73% decided spontaneously to have labour induced by means of PG E2 tablets. In these induction groups the delivery intervals were significantly shorter and the rate of operative deliveries was reduced. The fetal outcome, however, was the same as in those women who decided to await spontaneous onset of labour. The endocervical application did not prove any better. The oxytocin sensitivity test yielded additional information about the chances of inducing labour successfully. The results confirmed again the efficacy and acceptance of this method of labour induction.

Administration, Intravaginal↗
PubMed1987

[Differentiation of an outcome sample in elective labor induction with PGE2 by the oxytocin sensitivity test].

The goal of the present study was to evaluate whether the implementation of an oxytocin sensitivity test in addition to pelvic scoring would improve prediction of successful induction and could lead to a further reduction in the already low rate of protracted labour and operative deliveries in cases of elective induction by means of prostaglandin (PG) E2 tablets. In order to establish the optimal dosage we compared the endocervical application of 1.5 mg PG E2 with 3 mg intravaginally. Out of 158 women without risk factors examined at term 73.5% decided to have labour induced. In the induction groups given endocervical or intravaginal PG E2 the delivery intervals were significantly shorter and the rate of operative deliveries was reduced. In comparison with those women who decided to await spontaneous onset of labour, the fetal outcome was, however, the same. The endocervical application of 1.5 mg PG E2 did not prove any better than 3 mg given intravaginally. The performance of a pretherapeutic oxytocin sensitivity test yielded additional information about the chances of inducing labour successfully. The results confirmed the efficacy and acceptance of this method of inducing labour.

Administration, Intravaginal↗
PubMed1987

[Comparison between prostaglandin E2 gel and oxytocin in medically indicated labor induction].

The use of prostaglandins (PG) increasingly replaces the "classical" method of induction of labour by means of oxytocin and amniotomy, the last-named method being associated, especially in women with an unripe cervix, with side effects like prolonged labour and a higher rate of obstetric surgery. In this study the point of interest was whether prostaglandins offer any advantages over the classical method in respect of efficacy and maternal and foetal tolerance. 99 patients subdivided into primiparae and multiparae were randomly assigned to group A or B. In group A labour was induced with 1 mg resp. 2 mg PGE2 intravaginally at an interval of 6 hours. In group B the method of induction consisted of intravenous oxytocin and amniotomy. The success rate of induction was almost equal in both groups. However, in those patients where PGE2 induction did not succeed and who could not be delivered within 12 hours the cervical score was significantly improved in comparison to the oxytocin group. Based on the experience reported in the literature, one might speculate that an increased dosage could still improve the results of vaginally administered PGE2 gel.

Administration, Intravaginal↗
PubMed1986

[Experiences in 2,149 labor inductions using 3 mg prostaglandin E2 vaginal tablets. A retrospective analysis].

This study is a retrospective analysis of induction of labour by means of PGE2 tablets, one group being electively, the other group medically indicated; in all, 2149 primi- and multiparae during a period of 5 years. Application of the vaginal tablets containing 3 mg PGE2 was effected every 6 hours. Low-risk women stayed mobile up to the amniocentesis performed at about 4-5 cm. Patients with specific risks or spontaneous ruptures of the membranes were supervised correspondingly. About 80% of the primiparae, respectively 90% of the multiparae of the elective induction group delivered within 24 hours after the first application of a vaginal tablet. The rate of Caesarian sections was extremely low. As expected in patients in whom induction of labour was necessary usually before term, the percentage of successful inductions was lower and the rate of Caesarian sections higher. The foetal outcome in both groups in respect of Apgar scores, and the blood gases of the umbilical cord as well as length and weight ranged within the normal limits. The cleared perinatal mortality was 0% (1 congenital defect with death). This study shows that the good results of prospective studies with a smaller number of cases can be confirmed by a retrospective analysis of an extensive group of patients, demonstrating the increasing acceptance of induction of labour by means of PGE2 tablets in elective as well as in medical indications.

Administration, Intravaginal↗
PubMed1986

[Labor induction with 3 mg of prostaglandin E2 vaginal tablets. A renaissance of programmed labor? Results of a prospective randomized study].

Vaginal application of tablets containing prostaglandin at term in pregnant women with a favorable cervical score is a very efficacious method of induction of labour. Due to the motility of the women they consider this method of induction as almost natural. We, therefore, aimed at discussing the optimal procedure in low-risk pregnancies at due date, by means of a prospective randomised trial. In 345 women with a favourable cervical score, labour was either induced by means of intravaginal application of tablets containing PGE2 according to a precise plan, or spontaneous onset of labour was awaited while CTG-controls were performed on an outpatient basis every second day until the 42nd week of pregnancy was completed. 80 per cent of the nulliparas and 96.3 per cent of the multiparas of the induction group delivered within 24 hours of the first tablet application. All pertinent delivery intervals were significantly shorter in this group compared to those women where spontaneous onset of labour was awaited. The incidence of prolonged labour was low in both groups and not significantly different. Only 4.2 per cent of the women in the group where spontaneous labour was awaited, reached the completed 42nd week of pregnancy. Only one woman had to be induced because of a suspicious CTG. The rate of operative deliveries was lower in the induction group (1.1% versus 3.8% Caesarean sections). With the exception of one foetal death due to a cord complication three days after the due date the foetal outcome was excellent in both groups. The acceptance of the procedure was tested by means of a questionnaire during the post partum period.(ABSTRACT TRUNCATED AT 250 WORDS)

Cesarean Section↗
PubMed1985

[Defects in the prostaglandin system. IV. Inborn, nonfamilial plasma factor deficiency].

On routine screening of 143 newborn infants, complete plasma factor deficiency was discovered in 4 cases. All the relatives, however, exhibited normal plasma factor activity. Up to now all 4 babies are healthy. Long-term follow up should clarify whether an inborn plasma factor deficiency might predispose to diseases accompanied by haemostatic imbalance.

Biological Assay↗
PubMed1985

[Resorption of prostaglandin E2 following various methods of local administration for ripening of the cervix and end the induction of labor].

PGEM concentration was determined radioimmunologically in a non-pregnant woman in whom PGE2 was infused intravenously at increasing dosage and in women in whom labour was induced by various methods for local application of PGE2. There was excellent correlation between the amount of PGE2 infused intravenously and the levels of PGEM determined in the peripheral plasma. The following methods of local application of PGE2 were included in the study: 0.4 mg PGE2 gel placed retroamnially by means of a balloon catheter; 0.4 and 0.5 mg PGE2 gel applied endocervically; 1.5 mg PGE2 given pericervically through a portio adapter and 3 mg PGE2 placed intravaginally in form of a single vaginal tablet; also included was a control group where only vaginal examination was performed. Blood was withdrawn before, and then 30 minutes, 1, 2 and 3 hours after PGE2 administration. Mean levels of PGEM in the maternal peripheral plasma showed no change within or between the various groups, with the exception of one patient in the portio adapter group where hyperstimulation occurred. After removal of the adapter PGEM levels dropped to baseline values. It is concluded from the present study that local application of doses currently used to soften the cervix and/or induce labour at term does not give rise to PGEM concentrations in the maternal blood of the same magnitude as achieved by intravenous PGE2 administration.

Abortion, Induced↗
PubMed1985

Is prostaglandin E2 really of therapeutic value for postoperative urinary retention? Results of a prospectively randomized double-blind study.

In a prospectively randomized double-blind study 28 patients with urinary retention after anterior colporrhaphy were administered either placebo or prostaglandin E2 in different doses (0.75 mg, 1.5 mg, or 2.25 mg) intravesically on postoperative days 6 and 7. Urodynamic assessment was performed before and after treatment. A moderate but not significant decrease of maximum bladder capacity, bladder compliance, and maximum urethral closure pressure was found in patients treated with 2.25 mg of prostaglandin E2. These urodynamic changes did not correspond to the clinical outcome: Residual urine decreased and effective bladder capacity increased significantly in all four groups uninfluenced by the type of therapy. The rate of success (defined by the amounts of residual urine after therapy) was similar in the four groups. A long-term effect of prostaglandin E2 could also be excluded, since the mean time interval from operation to the first day without residual urine was similar in the four groups. Therefore the therapeutic value of intravesically administered prostaglandin E2 in doses from 0.75 to 2.25 mg must be seriously questioned.

Clinical Trials as Topic↗
PubMed1985

Prostacyclin does not influence placental blood pool in vivo.

In 20 healthy pregnant women placental blood pool was estimated by means of placental scintigrams before, during and after infusion of either prostacyclin (PGI2) or placebo for 10 min to study the effect of PGI2 on the local regulation of uterine blood flow. There was no difference in the mean number of counts between the PGI2- and the placebo-treated group. Therefore no effect of PGI2 on uteroplacental blood pool could be detected in healthy gravidae.

Adult↗
PubMed1984

Oxytocin receptors in the human uterus during pregnancy and parturition.

We have determined the concentration and distribution of oxytocin receptors in myometrial and decidual tissues obtained at cesarean section or hysterectomy during pregnancy. Myometrial receptor concentration was low at 13 to 17 weeks but had risen about twelvefold by 37 to 41 weeks. After the onset of labor, either preterm or term, the receptor levels were maximal and significantly higher than before the onset of labor. In cases of failed induction of labor with oxytocin and in postterm pregnancies (43 to 46 weeks), the receptor concentration was significantly lower than in spontaneous labor. Myometrial receptor concentrations in the fundus and the corpus were similar and significantly higher than in the lower part of the uterine segment, and the cervix had the lowest concentration. The parietal decidua had oxytocin receptor concentrations of the same magnitude as the myometrium. These results are consistent with a functional role of endogenous oxytocin in the activation of the human uterus during pregnancy and parturition.

Binding, Competitive↗
PubMed1984

Radiosensitizing effect of medroxyprogesterone acetate on endometrial cancer cells in vitro.

From clinical experience it is known that medroxyprogesterone acetate (MPA) can increase the radiosensitivity of adenocarcinomas of the corpus uteri. This study investigates this phenomenon in vitro. Primary explants of highly differentiated adenocarcinomas were irradiated with or without pretreatment with MPA and compared with an untreated control group and to a group treated with MPA only. Cell culture itself was performed on an agarose medium in order to prevent overgrowth by fibroblasts. Untreated samples formed 43 +/- 5 clones, explants treated with MPA only produced 39 +/- 5 clones, a difference which was not statistically different; samples irradiated without pretreatment produced 16 +/- 8 and samples after combined treatment 9 +/- 3 clones (all values means +/- SD). This numeric reduction of cell growth through preirradiation treatment with MPA was statistically significant. The effect of MPA as a radiosensitizer may be due to its potential to prolong the radiosensitive G2 phase of the cell cycle. This effect of MPA may be useful also in other hormone-dependent tumors.

Adenocarcinoma↗
PubMed1984

Plasma concentration of 13,14-dihydro-15-keto-PGE2 (PGEM) after various ways of cervix ripening with PGE2.

PGEM concentration was determined radioimmunologically in a non-pregnant woman, in whom PGE2 was infused intravenously at increasing rates and in women, in whom labor was induced by various methods for local application of PGE2. There was excellent correlation between the amount of PGE2 infused intravenously and the levels of PGEM determined in the peripheral plasma. The following methods of local application of PGE2 were included in the study: 0.4 mg PGE2 gel placed retroamnially by means of a balloon catheter, 0.4 and 0.5 mg PGE2 applied endocervically and 3 mg PGE2 placed intravaginally in form of a single vaginal tablet; also included was a control-group, where only vaginal examination was performed. Bloods were drawn before, 30 minutes, 1, 2 and 3 hours after PGE2 administration. Mean levels of PGEM in the maternal peripheral plasma did not change neither within nor between the various groups. It is concluded from the present study, that local application of doses currently used to soften the cervix and/or induce labor at term do not lead to the same PGEM-concentration in the maternal blood as after intravenous infusion of PGE2 in doses normally used to induce labor.

Cervix Uteri↗
PubMed1984

[Premature membrane rupture: effect of intracervical PGE2 gel administration on plasma oxytocin, PGFM and PGEM levels in mother and child].

Premature rupture (= PR) of the amnion is a serious complication even for the mature child if it occurs earlier than 24 hours before birth. To keep the interval as short as possible, the authors induce labour from week 35/0 in case of PR, provided the Bishop score is greater than 7. If the bishop score is lower, they conduct intracervical priming of the cervix with 0.4 mg PGE2 gel before induction of labour. This has proved clinically superior to intravenous procedures. In the study presented here, the authors attempted to find out whether intracervical administration of PGE2 gel would result in changes in the maternal and foetal plasma concentrations of oxytocin, PGFM, or PGEM when comparing conditions in case of ruptured amnion with those if the amnion remained intact. If the amnion is intact and the cervix immature (less than 2 cm), intracervical administration of 0.4 mg PGE2 gel produces a significant OT increase within 30 minutes. From a cervical width of 2 cm onwards, the OT levels are already primarily enhanced and will hardly change even after PGE2 gel administration. Similar conditions obtain in PR. PGFM plasma levels will rise only slightly within an hour after intracervical PGE2 gel administration, independent of whether there has been a rupture or not, or whether the cervix is dilated less than 2 cm or 2 cm and more.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Topical↗