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Biomedical subjects

R Boos

Publications and source records attributed to R Boos.

At least 55 records · Page 3Linked to original sources
PubMed1980

[Foetomaternal transfusions after amniocentesis in early pregnancy - evaluation of 1,000 cases (author's transl)].

The foetal haemoglobin (HbF) content was determined before and 2 hours after amniocentesis in 1,000 cases of amniocentesis conditioned by genetic indication (between the 15th and 20th pregnancy week). HbF-identification was effected according to the method of Kleinhauer and Betke. In primarily (before amniocentesis) negative HbF findings, HbF positive findings after amniocentesis were obtained in 7.2% of the patients. However, if the HbF-determinations were positive already before amniocentesis, a quantitative increase of HbF-cells in the maternal blood smear after amniocentesis was observed in 15.9% of the patients. Patients with punctures in the case of placenta of the anterior wall showed and increase in HbF values after amniocentesis in 12.2% of the cases, compared against 8.9% only in patients with posterior wall placenta, but these differences were statistically not significant. Amniocentesis under ultrasonic visual control caused a drop in the number of repeated amniocentesis trials to 20/500, aspiration of bloodstained amniotic fluid to 3.6% and HbF-cell positive blood smears after amniocentesis to 7%. (Free-hand-needle-technique: amniocentesis failures 42/500, amniotic fluid samples contaminated with blood in 9.6% of the cases and increases in HbF-values after amniocentesis in 12.6% of the cases). A total of 82 Rh-negative patients were given conventional anti-D-prophylaxis independent of the localisation of placenta. No sensitization was observed in any of the cases. No boosting was caused by early amniocentesis in cases where a positive anti-body finding had been established (3 cases to date).

Amniocentesis↗
PubMed1978

In vivo performance of the pH tissue electrode during acute acid-base changes in the dog.

The ROCHE tissue pH-electrode was tested in acute animal experiments under various metabolic conditions. In anesthetized dogs an electrode was placed in the subcutaneous tissue of the scalp, neck, and axilla. Simultaneous with the continuous measurement of tissue pH, the overall acid-base balance of the animal was measured discontinuously at 5-min intervals by means of indwelling arterial and venous catheters. Various forms of acidosis and hypoxia were produced in the experimental animal and the sensitivity of the electrodes in relation to their site was tested. A high correlation between the continuously measured tissue pH values and the corresponding arterial and venous actual blood pH values were found in the physiologic pH range. With acute changes of acid-base balance no correlation could be found in the acidotic range.

Acid-Base Imbalance↗
PubMed1978

Continuous measurement of tissue pH in the human fetus.

The ROCHE pH electrode was tested clinically in 20 fetuses and one nonviable newborn with severe malformations. The proper fixation of the electrode in the fetal scalp is difficult. In the physiologic pH range a good correlation between capillary blood pH and tissue pH exists. The situation is less clear for the acidotic range.

Capillaries↗
PubMedDate not supplied

Actions of GABAergic ligands on brisk ganglion cells in the cat retina.

Gamma-aminobutyric acid (GABA) is the major inhibitory neurotransmitter in the mammalian retina. We tested the actions of iontophoretically applied GABAergic ligands on the spontaneous and stimulus-evoked activity of retinal ganglion cells recorded extracellularly in the in vivo cat eye. GABA as well as GABAA receptor agonists inhibited all brisk ganglion cell types. This action was antagonized by bicuculline. Bicuculline on its own increased the activity of ON-ganglion cells but suppressed OFF-ganglion cells. This suppression effect was abolished during the blockade of glycinergic transmission by strychnine. The GABAB receptor agonist baclofen inhibited OFF-ganglion cells whereas the activity of ON-ganglion cells was either increased or decreased depending on the stimulus contrast. The antagonists, phaclofen and 2-hydroxy saclofen, produced opposite effects to baclofen and antagonized its action. The present study demonstrates that both GABAA and GABAB receptors modulate the activity of ON- and OFF-ganglion cells in the cat retina.

Animals↗
PubMedDate not supplied

[Effect of hypertensive pregnancy complications on neonatal outcome of growth retarded fetuses].

OBJECTIVE: To determine the effect of hypertensive disorders in pregnancy on the neonatal outcome of growth restricted fetuses. There is conflicting data on the effect of hypertension during pregnancy on the incidence of neonatal respiratory distress syndrome (RDS) and intraventricular hemorrhage. Some studies report a lower incidence of RDS and intraventricular hemorrhage in infants of hypertensive mothers, whereas other studies report a similar or higher incidence in infants born to hypertensive mothers. STUDY DESIGN: We performed a retrospective analysis of 220 growth restricted fetuses born between January 1, 1996 to July 1, 1997 at the Department of Obstetrics and Gynecology of the University-Hospital at Homburg/Saar. Data were obtained by review of the medical records. Growth restricted infants born to preeclamptic women or women with HELLP syndrome were compared to growth restricted fetuses born to mothers without hypertensive disorders. RESULTS: Growth restricted fetuses born to hypertensive mothers had a significant lower birth weight (p < 0.05). The incidence of RDS in children born to hypertensive mothers was significantly higher (p < 0.05, p < 0.01) and they stayed significantly longer in the neonatal intensive care unit (p < 0.01). In contrast to infants born to mothers with HELLP syndrome (n = 7) there was no difference in the incidence of intraventricular hemorrhage, infection, sepsis, necrotizing enterocolitis or cardiac complications (arrhythmia, insufficiency) in case of preeclampsia (n = 68). The perinatal mortality of infants born to hypertensive mothers was significantly higher (p < 0.05, p < 0.01). CONCLUSION: This study does not support the contention that hypertensive disorders in pregnancy have a beneficial effect on the postnatal course of IUGR infants.

Adult↗
PubMedDate not supplied

[Intrauterine growth retardation--perinatal mortality and postnatal morbidity in a perinatal center].

OBJECTIVES: The intrauterine growth retardation (IUGR) contributes specially to perinatal mortality and morbidity. An effective treatment is not yet available. The purpose of this study is to analyse the perinatal data of a cohort with IUGR-infants including mortality and morbidity and to describe prematurity and IUGR as a combination of high risk. STUDY DESIGN: We have analysed the perinatal data of a cohort of 220 patients with IUGR-infants including mortality and morbidity. Regularly we examined fetal ultrasonographic growth, doppler measurements of fetal and maternal vessels and CTG, as well as indicated amniocentesis, placentesis and cordocentesis. Entry criteria were: normal menstrual period before pregnancy, clear gestational age, complete history of pregnancy. RESULTS: At the Department of Gynaecology & Obstetrics, University Hospital, Homburg/Saar, the incidence of IUGR (< 10th Percentile) in premature babies and newborns was 13.1% over five years (1993-1997). The percentage of premature babies with IUGR was 18.6%. The overall mortality was 4.1%, the perinatal mortality was 3.6% and the neonatal mortality was 2.7%. In 1.4% intrauterine foetal death was observed, all associated with a birthweight below the 3th percentile. The average duration of pregnancy was 34 + 4 weeks. A high perinatal mortality of 13.1% and an overall mortality of 14.7% was observed. 11.4% of the premature babies with IUGR showed deformities and about 2% presented chromosome aberrations. 46.4% of children have been transferred to the Neonatal Intensive Care Unit. 57.1% of the postnatal complications have been related to the lungs, 26.5% to the cardiovascular system and 14.3% to the cerebrum. Maternal complications were referred to: SIH/EPH-gestosis (65.4%), HELLP-syndrome (5.8%), nicotine abuse (31.4%), pregnancy anaemia (17.3%) and gestational diabetes with insuline therapy (7.7%). On the placental site the most noticeable conditions have been placental insufficiency (40.6%) and placental infarction (28.7%). CONCLUSION: Children with IUGR are exposed to high perinatal mortality and postnatal morbidity. Premature babies in association with an IUGR are at high risk. The surveillance of the pregnant women and the new-born children should be performed in a perinatal centre.

Birth Weight↗
PubMedDate not supplied

[Mediastinal cystic lymphangioma as a cause of hydrops fetalis].

This report is upon a case with fetal hydrops on the base of a paracardiac cystic lymphangioma in the mediastinum. The newborn which had hypoplastic lungs and multiple pneumatothoraces died because of a pulmonary insufficiency. An overview is given about the most common causes of the nonimmune fetal hydrops, and the pathomechanisms are discussed.

Female↗
PubMedDate not supplied

[Doppler sonography--effect of fetal position, site of the placenta and measurement site of the fetal aorta].

The influence of fetal position, the site of placenta and the site of measurement in the fetal aorta on doppler-flow parameters was investigated in patients with uncomplicated pregnancies. In 20 cases the S/D-ratio was obtained in three different regions of the descending aorta. Measurements superior the renal vessels showed comparable values (4.1-4.3). No differences were found between signals obtained cranial or caudal of the diaphragma. Measurements at the aortal bifurcation showed significantly increased median values (6.6, p less than 0.05). No differences could be obtained concerning the influence of fetal position or site of placenta on S/D-ratio. All median values of a total of 197 patients were in the range of 4.8. Therefore it may be concluded that the above mentioned parameters do not have significant influence on doppler flow parameters in fetal vessels. However, a proximal site of measurement in the descending aorta fetalis should be reassured.

Aorta↗
PubMedDate not supplied

[Twin pregnancies with fetofetal transfusion syndrome].

During an observation period of 10 years 30 cases (11%) of twin transfusion syndrome were observed in a collective of 286 twin pregnancies at the University Women's Clinic Heidelberg. Typical symptoms of a twin transfusion syndrome as polyhydramnios, hydrops fetalis, polyserositis, disparity in fetal growth of the twins and pathological CTGs were examined for their diagnostic and prognostic values. A difference in birth weight of more than 25% was noted in only 28% of cases (range 2-58). A polyhydramnios was diagnosed in 63% of cases, an acute form in 30%. Eight of the nine pregnancies with an acute hydramnios ended in an abortion or intrauterine death up to 28 weeks of gestation. Amniocentesis for reduction of the excessive amount of amniotic fluid had no positive therapeutic effect. Eight of the pregnancies, in which a hydramnios had been detected, were further complicated by a hydrops fetalis (23%). Typical sinusoidal CTGs were registered in only 3 cases. Intrauterine fetal mortality respectively abortion up to 28 weeks of gestation was noted in 6 patients (12/60; 20%). Fetal mortality after 28 weeks of gestation occurred in 9/60 cases (15%). Four infants died more than 7 days post partum (7%). The fetal malformation rate was determined in our collective with 7% (4/60 fetuses). No chromosomal abnormalities were observed. The data collected show the prognostic relevance of the parameters analysed and reveal the cases in which a therapy might be effective. Ultrasonographic scanning of fetal activity or doppler flow measurements are further diagnostic procedures that can be employed in surveillance of risk pregnancies with twin transfusion syndrome. Also umbilical cord puncturing under direct ultrasonographic monitoring is of certain diagnostic and therapeutic value.

Cardiotocography↗
PubMedDate not supplied

[Prune belly syndrome. Prenatal diagnosis and obstetric procedure].

With an incidence of between 1 in 30,000 and 1 in 50,000 births, prune-belly syndrome (PBS) is a rare malformation syndrome. The phenotypical and pathoanatomic changes range from discrete expression to very severe malformation complexes with extremely poor prognosis. Malformations of the kidneys and the efferent urinary tract are common. In such cases, oligohydramnios often develops early in such fetuses, followed by Potter's sequence. This syndrome can generally be diagnosed by timely ultrasound investigations, i.e., before the end of the first half of pregnancy. Striking features in the fetus are often oligohydramnios and a greatly dilated urinary bladder, more rarely multicystic-dysplastic kidneys and other malformations of the urogenital tract. Diagnostic possibilities and obstetric procedure are described on the basis of ten cases seen between January 1984 and July 1987 at Heidelberg University Gynecological Clinic.

Abdominal Muscles↗
PubMedDate not supplied

[Prenatal diagnosis of thanatophoric dwarfism with cloverleaf skull].

Thanatophoric dwarfism is a rare condition occurring in 1 in 100,000 births. To date, only 2 cases have been reported on in which this condition was diagnosed prenatally before the 24th week of pregnancy post menstruationem. The majority of cases reported so far were born by cesarean section. This condition can be diagnosed early by measurement of the fetal diaphyseal bones and accompanying specific diagnostic measures to establish the possible presence of malformations. The pregnancy can then be terminated if need be, and unnecessary interventions thus avoided.

Abortion, Eugenic↗