[Method of terminating labor in eclampsia].
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Continuous lumbar epidural anaesthesia causes a drop in maternal blood pressure by decreasing flow resistance in the peripheral vascular bed. By infusion of 1000 ml NaCl blood pressure can be kept constant. Our work shows, that dilatation of the peripheral vessels has a positive effect in patients with reduced uteroplacental flow, as it results in an augmentation of placental flow. In women with normal placental function such an effect could not be seen. The practical use of these results is illustraded by a case report.
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The fraction of complement C3, the total complement activity and the levels of IgG, IgA and IgM immunoglobulins have been estimated in the third trimester of pregnancy in 70 control pregnant women and in 38 hypertensive pregnant women who presented either with "pure toxaemia" or with "superimposed toxaemia". The level of IgG is definitely but not significantly lowered in cases of "pure toxaemia". The other parameters that were studied showed no notable changes in comparison with control pregnant women.
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The authors discuss some etiologic and clinical aspects of M. Sheehan II based on 2 histologically proven cases. They point out the consecutive connection between the preeclampsia, DIG and the development of the syndrom. The role as starters of some medicaments beside other factors is suggested. The paramount importance of an immediate diagnosis and adequate and correct therapeutic measures, which include a prompt interruption of pregnancy and treatment of the acid-base dysbalance, the renal and haematologic failure is stressed, as well as the prophylactic measures.
Serum, cord blood and amniotic fluid beta2-microglobulin contents were measured from normal pregnancies complicated by EPH gestosis, Rh immunisation and pathological serum levels of HPL and alpha1-fetoprotein. We found no changes in high risk pregnancies from normal serum levels. beta2-microglobulin seems to be no parameter in managing complicated pregnancies and fetal growth retardation.
A cross sectional retrospective study of 400 cases of amniocentesis was performed to evaluate the reliability of using fetal fat staining cells as a method for assessment of fetal age and maturity. A sharp rise in the percentage of these cells in amniotic fluid occurred after 37 weeks of gestation and a level of 20 per cent or more indicated fetal age of 38 weeks or more, corresponding to maturity by our definition. The false positive and negative rates were 3.5 per cent and 14 per cent respectively. The pre-eclamptics, diabetics and Rh sensitized groups fell within the distribution of the normal population. The dysmature group, however, showed an earlier rise (20% at 36 weeks). The origin of the fetal fat staining cells and the reasons for the early rise in dysmaturity are discussed. Estimation of fetal fat staining cells in the amniotic fluids using the 20 per cent level is a reliable test for maturity in normal and some abnormal pregnancies, excluding dysmaturity.
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