Biomedical subjects
Publications and source records attributed to U Retzke.
Results of treatment of placental insufficiency by transcutaneous electric nerve stimulation (TNS) in 101 patients are demonstrated and compared with a treatment of a special infusion therapy. While TNS-therapy a significant rise of Fischer-Score was observed. In both groups the urinary estrogen excretion was increased.
The external version of fetus from breech into a head presentation is one of the methods to avoid maternal and fetal risk by Cesarean section and by vaginal delivery. As a supposition, we see a technique which is undangerous for mother and fetus. Our procedure corresponds in many points with a practice, which is published by B. Westin. The sober patient is positioned head down on the side of fetus small parts. Then an intravenous infusion is given over 30 min with 2 micrograms fenoterol (Partusisten)/min. The version is performed in many single and little steps. It needs time, a soft hand and the readiness of the Cesarean section. In 104 of 242 patients with breech presentation there was the indication with fulfilled suppositions for such a version. The success-rate was nearly 50%. In no case there was a complication. The rate of Cesarean section past turning was clearly reduced in contrary to breach presentation. The fetal outcome was clearly better. The version of breach presentation is recommended.
96 healthy late pregnant women with singleton pregnancies counted the fetal movements beginning with the 34th week of pregnancy. The start for this daily counting was in the morning at 9 o'clock a.m. The method used is "count till ten" according to the so-called "Cardiff-system". An other group of 76 healthy late pregnant women started the counting in the evening at 5 o'clock p.m. The time necessary to collect 10 fetal movements is in the evening hours about 2-3 hours shorter than in the morning. The modified Cardiff-system with counting in the evening with start at 5 o'clock p.m. is recommended.
It is reported on 68 Latzko-grafts in vesicovaginal fistulae. In 63 cases (92.6%) the closure was successful in the first session; 4 of the 5 failures were corrected with the same technique in the second session. The method is technically simple and little stressing for the patient. It is to be recommended particularly for the treatment of the typical posthysterectomy fistula. The shortening of the vaginal canal is insignificant also in young women.
In 21 women suffering from a severe motoric urge syndrome have been operated on with partial denervation of the urinary bladder according to Ingelman-Sundberg. The procedure was performed in 18 women unilaterally and in 3 bilaterally. Because of combined urge-stress-incontinence in 3 cases the plastic repair of pelvic floor was performed additionally with the unilateral nerve resection. With 5 recurrencies there has been a success rate of 75%. Out of 5 recurrencies 3 patients have been operated on twice, in 2 of them successively. The method founded by Ingelman-Sundberg is recommended as a ultima ratio for patients suffering from severe motoric urge syndrome which does not respond to conservative treatment.
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The literature concerning the value of the "small neuroleptanalgesia" for obstetrical pain-relieve is in dispute. Our experiences are based on the single application of 0.05 mg Fentanyl and 2.5 mg Droperidol on the presupposition of a well--proportionate labour activity with a cervix dilatation of at least 2-4 cm. Sporadically we reinject Fentanyl once more or exceptionally Droperidol, too. Among 308 primigravidae and 189 multigravidae with continuously directed application of Oxytocine the duration of the delivery was shortened distinctly compared with the control group without "small neuroleptanalgesia" but with the same tocergic treatment. After the application of the "small neuroleptanalgesia" the labour--intensity is unchanged, exceptionally a very short lessening in the immediate phase after injection. The method is innocuous for the mother, for the fetus and for the new-born. It is effective and practicable under all circumstances. The method of the "small neuroleptanalgesia" is recommended.
In 830 healthy pregnant women with delivery after the 37th week and parturation of a new-born normal for date (NFD) the Symphysis-Fundus-Measurement (SFM) was established and a standard curve was constructed. The curve is a nearly identic one with that given by the Swedish author Westin. There are significant deviations from the standard curve in patients with large for dates fetuses (LFD) and in those with small for dates fetuses (SFD). For LFD the difference is to make ensure statistically in the 24th and for SFD in the 31th week of pregnancy. Both parameters leave the +/- 1s--Standard-deviation in the 33th week of pregnancy. The +/- 2 s--Standard-deviation is not to be passed over. In twin-pregnancies the +/- 2 s--Standard-deviation is crossed after the 18th week of pregnancy. In obese pregnant women the SFM is to be seen significantly over that of pregnancies with normal body-weight. In conclusion we believe, that by consideration of the +/- 1 s--Standard-deviation and of the values for obese women in the curve of the SFM the distinctive sensitivity for detection of SFD-pregnancies is to be improved. By assessment of the registered dates of 308 Nulligravidae and 260 Multigravidae showing an undisturbed progress of pregnancy and a term--delivery the Westin--Score of the cervix uteri and its underlying single parameters have been ascertained and graphically recorded. The values concerning the Multiparae are a bit higher positioned than those of the Nulliparae. The inclination of both curves are otherwise similar.(ABSTRACT TRUNCATED AT 250 WORDS)
The outpatient department for pregnant women at the district hospital, womens department of Suhl/GDR uses the so-called "gravidogram" according to Westin. To assess the predictive value of the cervix score (modus Westin) all patients had been examined vaginally on the occasion of each consultation. In 969 singleton-pregnancies the rate of premature deliveries was 6.5% and so within the limits of international statistics. There was a remarkable tendency to newborns weighting more than 2000 g and a duration of pregnancy longer than 35 weeks. The shift involves more chances of a undisturbed development of the newborns. Repeated assessment of the cervix score in the course of pregnancy is recommended.
Presentation of a set of generators for the transcutaneous electric nerve stimulation serving the treatment of placental insufficiency. First experiences confirm the proper practibility of the method in the variant of our generator set.
First report about therapeutic experiences with Mictonorm (Propiverinhydrochlorid) in the field of urogynaecology. Mictonorm is a new preparation and acts as a parasympathicolytic (anticholinergic) agent and also as a direct musculotropic relaxans. In 25 patients suffering from urge- or combined urge-stress incontinence a significant increase in the capacity of the urinary bladder, a significant decrease of the intravesical pressure and a distinct reduction of the complaints has been registered. Mictonorm is recommended for the treatment of urge-incontinence and other diseases with urge-symptoms (urgency, pollacisuria, enuresis etc.) and also as a adjuvant in the treatment of acute or chronic cystitis.
The influence of ethinylestradiolsulfonate on the cytological image of the urethra was examined on 11 women who underwent the salpingo-oophorectomia bilateralis. The criterion of the proliferative effect was the Dynamic-Estrogenicity-Index (DEI). After a 6 to 8 weeks treatment at a dosage of one milligram weekly a DEI of 7,27 (+/- 0,74) was attainable. From this point of view we can also summarize a very good urethrotrophic effectiveness. Ethinylestradiolsulfonate is recommended for the treatment of affection on the urethra, especially of those in which an estrogen deficit is the genuine reason or a favoured factor by women after hysterectomia and salpingo-oophorectomia bilateralis for substitution with hormones.
Demonstration of a new tocograph which is portable and easy to operate. In more than 3500 examinations it registered excellent tocograms. It's wide use could improve the diagnostic and well-timed therapy of premature labour.
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Terbutalin, a beta-mimetic drug, appears to have a favorable beta 2:beta 1 ratio. It is suitable for uterine relaxation. Ten normotensive pregnant women with imminent premature labor were studied during intravenous infusion of terbutalin with the non-invasive method of quantitative sphygmometry. Cardiac output increased and total peripheral resistance decreased. As there was only slight variation in the arterial blood pressure, terbutalin is indicated especially in cases with hypotension.
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In hypertension pregnancy a hypoperfusion syndrome of the peripheral tissues, caused by disturbances of the microcirculation, first of all endangers the fetus in utero. The aim of treatment is to correct the hypertension in such a way that perfusion of the uteroplacental unit, as one important part of the total peripheral resistance, increases. We investigated the cardiovascular effects of intravenous infusions of 10% mannitol, 40% sorbitol, 10% low molecular dextran, 10% low molecular dextran with an admixture of 10% mannitol, as well as of the successive application of 40% sorbitol and 10% low molecular dextran in hypertensive late pregnant patients. The specific effects of osmotherapy, oncotherapy, and osmo-oncotherapy are described in detail. In severe cases requiring acute treatment, the osmo-oncotherapy is the most advantageous because it combines raising cardiac output, decreasing total peripheral resistance, and edema-mobilizing and diuresis-inducing effects.