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[Analysis of gestationally conditioned morbidity in the German Democratic Republic].

During the last years the analysis of the perinatal mortality with its casuistic and statistical aspect has gained importance as an instrument in organizing the health protection services for females. For further achievements in the ante-, intra- and postnatal care according to the social and scientific progress and to the needs of the people a sound knowledge of the morbidity structure is of great value. Relating to these points available data sources are analysed regarding their information contents and significance. Under the aspect of their prevalence the most important diseases during pregnancy are presented.

Female↗

[Carbohydrate- and lipid-metabolism changes in monosynaptic H-gestosis].

The parameter of carbohydrate and fat metabolism (FFA, glyzerin and blood sugar) was tested among forty pregnant women with a monosymptomatic H-gestosis in the thirty-eighth and forty-second week of pregnancy. With a clear rise of all tested metabolic parameters in the single control group and the current significance of an excessive increase in the values of women in late pregnancy further correlations could be statistically proved in respect to the combination group of late pregnancy and second degree hypertonus. A definitive statement on the EPH-gestosis would necessitate further experimental tests.

Blood Glucose↗

[Cytophotometric determination of DNA concentration in the nuclei of the human placental trophoblast in late toxemias of pregnancy].

The distribution of trophoblast nuclei of the human placenta by their ploidy was studied in normal pregnancy and in late pregnancy toxemias by the monowave emthod of cytophotometry in visible light. In the plasmodiotrophoblast a pronounced increase in the amount of nuclei in the S-phase (up to 40%) was noted in late toxemias which suggests a considerable activation of the DNA synthesis. The placenta cytotrophoblast in late toxemias is substantially different from that in normality. The Langhans cells disappear almost completely while in normality they are present in young terminal villi till the very end of pregnancy. The amount of the island cytotrophoblasts is much greater, the distribution of nuclei according t the DNA content being of absolutely different character than in normality. A great amount of hypodiploid nuclei (up to 36%) was observed which are absent in normal conditions as well as much greater fluctuations in the amount of diploid nuclei (from 4% to 37%) as compared with the normal amount (25.9%). These data show a high amitotic activity in the island cytotrophoblast in late toxemias. The above changes in the plasmodiotrophoblast and cytotrophoblast might be considered as a compensatory reaction of the placenta to a considerably increased vacuolization and deep atrophic processes in degenerating villi.

DNA↗

[Human placental morphology as an index of features of maternal-fetal relationships].

Principle possibilities of the complex evaluation of the mother-fetus exchange were studied by means of morphological investigations of the human placenta in normality, in vesicular mole, late toxicoses, hemolytic disease of newborns and malformations of the fetus. The investigation of the ratio of the villi of different size, deposition of fibrinoid on their surface, the change of the amount of cytotrophoblastic elements, cells of Kaschenko-Hofbauer and the polymerity of the basic substance are of diagnostic value. The authors propose the basal lamina of the placenta to be included into the scheme of the examination of placenta.

Congenital Abnormalities↗

[Morphofunctional specialization of tissue components of the mammalian placenta and adaptational value in changes in the rate of their differentiation (evolutionary and clinical aspects)].

It has been shown that in the ontogenesis of human placenta there occur regular changes in the percentage of the villi of various calibre having different interrelationships between the trophoblast, the connective tissue stroma and the fetal vessel. The changes of the number of chorial villi affected by fibrinoid and containing blood vessels under the trophoblast in late toxicoses of women and the anemic syndrom are analyzed (treated and not treated groups of women suffering from different forms of toxicosis were compared). An increased amount of chorial villi having blood vessels under the trophoblast is noted which is a morphofunctional feature of compensatory-adaptational alterations. Possible ecologo-evolutionary approaches to clearing the biological significance of adaptational changes of morphogenesis of the human placenta in pathological pregnancy are shown by the example of the analysis of morphological peculiarities of the placenta of the dolphin.

Adaptation, Physiological↗

[Obese patients in obstetrics].

The results of two studies about the course of pregnancy and delivery in adipose women in our hospital are combined and discussed. We found a higher rate of EPH-gestosis in overweight patients. The frequency of Cesarean section was increased. Belated uterine involution post partum is more frequent in adipose women, also the occurrence of urinary tract infections. There is a significant increase in perinatal mortality, mainly due to an increase in still-born. Pneumonia due to aspiration and birth traumata occur more frequently as well and endanger the children.

Female↗