Geburtsh Frauenheilk
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Geburtsh Frauenheilk · Mar 1990
Case Reports[Neurologic complication following spinal anesthesia for manual detachment of the placenta].
Long-term paralysis of the lower extremities was observed in a 31-year-old fourth-gravida patient, undergoing a curettage under spinal anaesthesia because of placenta accreta. The patient recovered within three days from her neurological signs and symptoms, consisting of complete paresis of the hip and knee flectors and severe headache. Clinical investigations including a neurological examination, spinal puncture, x-ray pictures of the lumbosacral area and haemograms revealed no evidence for an infection, abscess or haematoma. With regard to the fact, that neurological deficiency disappeared completely within three days, it seems probable, that the symptoms were caused by the longer lasting gynaecological position (Steinschnitt-position) during the period of delivery and curettage thereafter.
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A great number of patients with gynaecological malignant diseases suffer from severe pain, caused, for example, by bone metastases of breast cancer or tumour infiltration of the pelvis and the lumbar plexus in uterine cancer. Several methods of treatment are available depending upon the origin of pain. It is possible to achieve pain relief by radiotherapy or by cytostatic therapy. ⋯ If possible, the oral route should be selected. If vomiting occurs, or if patients are unable to take oral medication, morphine can be given peridurally, intrathecally or by infusion. Often, an additional treatment is necessary with different medicaments like tricyclic antidepressants and corticosteroids.
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Geburtsh Frauenheilk · Dec 1989
[Evaluating the cervix in pregnancy using vaginal sonography. Studies of cervix insufficiency].
Transvaginal ultrasound provides important detailed information, which cannot be obtained by routine manual vaginal examination. By measuring the outside-inside distance (from os externum to os internum), we can determine the actual length of the cervix. By depicting the cervical canal, we can identify early dilatation. ⋯ A total of 485 measurements of the cervix was carried out. Fifty patients with normal clinical findings between 28 and 32 weeks of pregnancy were compared to the same number of patients in the 28th to 32nd week of pregnancy, with the clinical diagnosis of an incompetent cervix. A cervical length of 46.3-39.3 mm was found in normal pregnancies, and a length of 34.0-21.4, when a clinically incompetent cervix had been diagnosed, a difference of 12.3-17.9 mm.
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Geburtsh Frauenheilk · May 1989
[Particular aspects of creation and assessment of an obstetrical data bank].
The use of computers improves data storage capacity and leads to a homogeneous documentation of data obtained. After extensive preparations documentation was started using in 1975 the 2nd Department of Obstetrics and Gynecology computer. The obstetrical-gynecological data base is used for organisational, epidemiological, scientific and mixed purposes. ⋯ Furthermore, it has to be differentiated between single and multiple pregnancy. Good cooperation between physician and medical computer expert is necessary for good quality of evaluation. The evaluated data enable one to find new aspects and connections, which may offer the impetus to perform new prospective research.
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Geburtsh Frauenheilk · Dec 1988
[Indications and results of diagnostic laparoscopy in the assessment of lower abdominal pain].
Between 1976 and 1986 laparoscopy was performed in 3,584 patients to establish the cause of acute and chronic lower abdominal pain. The most frequent indications for laparoscopy were lower abdominal pain of unknown etiology, adnexitis, and adnexal tumors. The overall level of agreement between the clinical and laparoscopic diagnoses was 56.8%. ⋯ It also proved impossible to establish any organic cause in 8% to 32% of the other cases clinically diagnosed. The principal advantage of laparoscopy is, that the diagnosis is definite, rendering medication and laparotomy unnecessary in many cases. This applies in particular, with regard to appropriate treatment for lower abdominal pain of unknown etiology with no organic findings, and the treatment of benign ovarian cysts.