Search PubMed⌕ Search

Biomedical subjects

R Obwegeser

Publications and source records attributed to R Obwegeser.

35 records · Page 2Linked to original sources
PubMed1996

Breech infants: vaginal or cesarean delivery?

BACKGROUND: This study was undertaken to determine whether planned vaginal or elective cesarean delivery is better for singleton term breech infants and their mothers. METHODS: We studied deliveries of 388 singleton term breech infants that were born in our teaching hospital in Vienna. We follow well defined criteria for vaginal delivery versus cesarean section of term breech fetuses. We thus compared 280 (72%) cases scheduled for vaginal delivery with 108 (28%) scheduled cesarean sections with regard to neonatal mortality and morbidity, including Apgar score, umbilical artery pH, and postpartum maternal morbidity. RESULTS: Vaginally delivered fetuses of primiparas had lower five-minute Apgar scores (5% < Apgar 7) and a lower umbilical artery pH (39% below 7.2). This is significantly different from the abdominally delivered primiparas (no Apgar below 7, only 11% with an artery pH below 7.2). Multiparas did not show significantly different results with regard to Apgar scores and umbilical artery pH between the different modes of delivery. Postpartum maternal morbidity was not different between the two groups. CONCLUSION: The results suggest that planned vaginal delivery of singleton breech infants of primiparas result in newborns with lower Apgar-scores, a lower umbilical artery pH and a poorer fetal outcome. On the other hand, it seems that singleton term infants of multiparas do not profit from cesarean delivery.

Adolescent↗
PubMed1995

[Ultrasound diagnosis of fetal tooth anlagen and their histologic correlates].

AIM: The present study was to examine the radiographic and histologic correlation of the respective ultrasonographic findings. METHODS: Histologic examinations were performed in 12 fetuses who had died in utero between 16 and 34 weeks of gestation. The fetuses had been examined by intrauterine sonography for tooth germs and had been subjected to additional radiographic examinations post abortum or partum. During autopsy, the tooth germs were again examined sonographically and radiographically, and non-decalcified histological sections were obtained by means of the sawing and grinding technique. RESULTS: The results obtained by histologically examining the 12 fetal jaws in the ultrasonic plane corresponded in all cases to those examined by sonography and radiology. CONCLUSION: Sonographic proof of tooth germs might gain increasing importance in future because agenesia of tooth germs is one of the principal signs of a variety of hereditary syndromes, particularly those of ectodermal origin.

Ectodermal Dysplasia↗
PubMed1994

Recurrent Dandy-Walker malformation.

This is a report of a 18 year-old woman with two consecutive fetuses suffering from a Dandy-Walker malformation (DWM). The first diagnosis of Dandy-Walker syndrome was at 24 weeks gestation. According to the parent's request, this pregnancy was terminated. Seven months after that event a new case of Dandy-walker malformation was diagnosed in the same woman. She was at 21 weeks of gestation.

Abortion, Eugenic↗
PubMed1993

The risk of malignancy with an apparently simple adnexal cyst on ultrasound.

We received data of 144 patients, who had been operated upon in the 2nd Department of Obstetrics and Gynecology in Vienna because of persisting sonographically detected "simple" adnexal cysts. Only 3 cysts were malignant (one of them borderline). All three patients were postmenopausal. The mean diameter of the malignant cysts were 7, 11 and 18 cm, respectively. 82 sonographically simple cysts were histologically benign. We found 27 cysts associated with chronic pelvic sepsis (hydrosalpinx and pseudocysts), 22 were benign cystadenomas and 10 were endometriotic.

Adult↗
PubMed1993

Fetal pulmonary cyst treated by repeated thoracocentesis.

This is a report of prenatal diagnosis and successful therapy of a septated fetal pulmonary cyst by repeated puncturing. This treatment was performed under ultrasonographic guidance for signs of fetal cardiac decompensation. This made normal development of the lungs possible.

Adult↗
PubMed1993

[Sonographic determination of the malignancy of ovarian tumors and therapeutic consequences].

Any Ultrasound investigation cannot reveal a histological diagnosis. There is a close correlation between sonographic characterisation of ovarian tumours and malignancy. Facts as size and structure of tumours, as well as papillarities on septae or walls of the cysts have much influence on the risk of malignancy. In cases with presence of papillarities in ovarian tumours a malignancy rate of 90% has to be expected. Contrary, simple, completely anechogenic ovarian cysts are benign with a probability of 98%. To improve the accuracy of prediction, we have to consider all other clinical aspects (age, anamnesis, tumour marker, etc.) We have to differentiate three steps concerning the risk of malignancy of ovarian tumours with subsequent different therapeutic management: the so called "simple Cyst", the "benign adnexal tumour" and the "malignant ovarian masses".

Biomarkers, Tumor↗
PubMed1993

[Echographic evaluation of the integrity of adnexa tumors].

The preoperative diagnosis of pelvic tumours is getting more and more important. This has special relevance to the increasing possibilities of conservative management of adnexal tumours and cysts (puncturing or operating by laparoscopy). We reviewed sonographical and histological data of 514 patients, who were operated on in the 2nd Department of Obstetrics and Gynaecology in Vienna because of pelvic masses. We correlated sonographical parameters like size of tumour, distinctness of margins, different kinds of internal echo pattern, papillary vegetation on the cystic wall or septa, with the defined histopathological diagnosis. A close relationship between size of tumour and tumour status could be found. The size of benign tumours was 7.1 cm. Malignant tumours had a size of 10.7 cm. The size of the high-echogenic area within the tumour, as well as its homogeneity, seemed to be of great importance. Such tumours with high-echogenic areas within, and especially those who had nonhomogeneous structures of these areas, proved to be malignant in 81% of the cases. Similarly, we found a close correlation of papillary vegetation either on cystic walls or on septa with the confirmed diagnosis of malignancy. Septa without papillarities or changing of their thickness were less important. By means of using our criteria a less experienced sonographic examiner could reach as good results as an experienced one in predicting malignancy.

Adenocarcinoma↗
PubMed1992

[Effect of high performance sports on female menstrual cycle exemplified by windsurfing].

Questionnaires were sent to all female members (n = 60) of the Austrian Funboard Association (funboard = the most athletic windsurfing class). They included questions about the menstrual cycle, physical capacity, libido and performance dependent on the particular cycle phase. There was no significant libido or capacity peak, neither for the windsurfers nor for a normal collective (n = 100); on the other hand there was an evident low during menstruation. A mean length of the menstrual cycle of 26.5 +/- 2.8 days and a bleeding time of 4.4 +/- 1.2 days were found, while metrorrhaghia and dysmenorrhea were less frequent than in the normal collective. One reason for these findings could be that physical activity reduces dysmenorrhea.

Adult↗
PubMedDate not supplied

Homocysteine--a pathophysiological cornerstone in obstetrical and gynaecological disorders?

Homocysteine, a product of the methionine cycle, is known to play an important role in cardiovascular diseases, neurological disorders and embryology, and in very important, fast growing fields concerning obstetrics and gynaecology. Therefore, we attempted an actual overview on possible obstetrical and gynaecological disorders as a consequence of an impaired methionine cycle. We tried to evaluate all mechanisms concerning homocysteine metabolism in order to look for hypothetical possibilities of therapeutic interventions. Using MEDLINE starting in January 1966, a search was conducted for articles published in which homocysteine was included as a subject heading or a text word. This search was also specified in combination with other key words such as obstetrics, pregnancy, gynaecology and cancer. Additional sources were identified through cross-referencing. All sources found were examined with regard to providing substantial information on our topic. The information obtained was divided into articles dealing with homocysteine and the methionine cycle itself, homocysteine and pregnancy, and homocysteine and hormones, including menopause, hormone replacement therapy and oral contraceptives. Another group was concerned with other special gynaecological aspects of the methionine cycle. We suggest that elevated concentrations of homocysteine could be a marker and perhaps a cause of, or contributive to, a wide range of obstetrical and gynaecological disorders.

Animals↗
PubMedDate not supplied

[Increased rate of spontaneous version in breech presentation by Indian bridge? A prospective, randomized study].

BACKGROUND: The effectiveness of Indian version to convert fetuses from breech to vertex presentation was evaluated. METHODS: One hundred and nine pregnant women presenting between 30 and 32 weeks of gestation with singleton breech infants were included in our prospective randomized open study making an interim analysis recruitment to estimate the sample sizes after one year. The spontaneous version rate of fetuses in breech presentation was compared with the version rate in women performing Indian version. Indian version is a maternal positioning exercise that consists of raising the pelvis, abduction of the thighs, and relaxed abdominal breathing. Clinical parameters that could influence the result were assessed. RESULTS: In primiparous women, the version rate was 70% in the Indian version group and 63% in the comparison group. In multiparous women, 89% Indian versions and 87% spontaneous versions were observed. Parity was the only clinical parameter found to be related to outcome. CONCLUSION: Indian version does not significantly improve the rate of spontaneous version of breech to vertex presentation.

Adult↗
PubMedDate not supplied

[Effectiveness and tolerance of tramadol with or without an antiemetic and pethidine in obstetric analgesia].

The aim of this prospective, randomised, blind study was to investigate the analgesic potency and tolerance of intramuscular Tramadol compared to a standard obstetric analgesia with Pethidine. Triflupromazine was administrated in combination with the two tested analgesics in order to study its efficacy in alleviating the emetic side effects of the tested analgesics. 66 parturients were randomly assigned to three groups: group A: 100 mg Tramadol (Tramal), group B: 100 mg Tramadol (Tramal) and 10 mg Triflupromazine (Psyquil), group C: 50 mg Pethidine (Alodan) and 10 mg Triflupromazine (Psyquil). No significant differences concerning duration of labour, FHR-alterations, umbilical cord blood gases, respiration pattern and Apgar Scores of the neonate occurred. In all three groups the analgesic effect was equally good. Combination of the analgesic with the antiemetic showed no reduction of the incidence and severity of side effects.

Adult↗
PubMedDate not supplied

[Discrepancy between Apgar score and umbilical artery pH value in the newborn infant. (Correlation to mode of delivery and fetal outcome?)].

In a retrospective study data from more than 9000 live births were analyzed. Our aim was to compare the significance of Apgar-Score and umbilical artery pH in predicting the condition and development of the newborn. We were particularly interested in three groups of patients: "Group A" included patients with a 5 minute Apgar-Score < or = 7 and a normal pH > 7,2. In "Group P" the pH was < 7,10 combined with a normal Apgar-Score (8 to 10). Both groups were compared with a "normal group" (pH > 7,20 and Apgar-Score between 8 and 10). There was a higher percentage of operative deliveries in group A (38%) and group P (20%) compared to the normal group (15%). The only predictor of a low Apgar-Score was meconium stained amniotic fluid (Group A 16%). A poor condition of the newborn correlated much better with a low Apgar-Score than with a low umbilical artery pH. In group A the rate of newborns transferred to the neonatology unit was 43% and the perinatal mortality rate was 50%. The poor correlation of a low umbilical artery pH and the fetal outcome is partly explainable by the standard cut off level of 7,20 for acidosis, which seems to be too high.

Acid-Base Equilibrium↗
PubMedDate not supplied

[Obstetric management of patients with HELLP syndrome].

The syndrome of haemolysis, elevated liver enzymes and low platelet count (HELLP-Syndrome) is a severe form of preeclampsia and eclampsia. The clinical course is characterized by right upper quadrant and epigastric pain, hypertension, proteinuria and edema. Maternal and neonatal morbidity are high. The underlying cause for this pregnancy-related syndrome is still unclear. As soon as a reliable diagnosis is established handling of patients suffering from HELLP-Syndrome is ambivalent: Immediate termination of pregnancy, however, poses a problem at early gestational age. Therefore some authors have advocated a conservative management. At our department active management and delivery by Caesarean section as soon as possible has gained acceptance in the past 5 years. We report our experience with 23 patients over a 12 year period, and with 4 patients from the intensive care unit (N = 27). Mean gestational age was 33.5 weeks (+/- 4.8) and the mean birthweight was 1922.5 g (+/- 971.5). 19 patients were delivered by Caesarean section. Most complications were based on a delayed delivery and subsequent deterioration of maternal condition. Reduction of the time interval between establishment of diagnosis and termination of pregnancy (1980-1985-3 days; 1986-1992-12 hours) resulted in a better outcome. We recommend intensive laboratory screening and exact clinical examination since missed or delayed diagnosis as well as delayed delivery are life threatening for mother and child. Only prompt delivery yields an improvement of prognosis.

Adult↗