Geburtsh Frauenheilk
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Geburtsh Frauenheilk · Mar 1980
[Maternal complications following conduction anaesthesia during a delivery (author's transl)].
The danger of maternal complications during local and conduction anaesthesia during delivery is important for the indication for the choice of the method and for informed consent from the patient prior to delivery. Data on maternal complications since 1960 in the use of the pudendal block, the paracervical block, spinal anaesthesia for vaginal deliveries and Caesarean sections, single shot lumbar epidural anaesthesia and continous catheter lumbar epidural anaesthesias and caudal anaesthesias are presented. The respective anaesthetic risk apparent from this data are discussed.
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Geburtsh Frauenheilk · Dec 1979
[The bacterial contamination of epidural catheters with areobe and anaerobe germs in obstetrics (author's transl)].
Following anaesthesia the tips of 105 epidural catheters were investigated for aerobe and anaerobe bacteria. In one case aerobe germs (staphycoccus epidermidis) and in three cases anaerobe germs (propioni-bacteria were isolated. ⋯ Even in the face of a clinically uncomplicated course the presence of bacteria on the catheter tip is considered to be a potential risk for infection. As a preventive measure the skin disinfection procedure was changed and the disinfectant is left for sic minutes instead of three minutes.
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The advantages of caudal anaesthesia in obstetrics far outweigh the few disadvantages. The perinatal mortality of premature infants is reduced under caudal anaesthesia. ⋯ It is possible to carry out all vaginal and abdominal procedures with this anaesthesia. The elimination of pain during labor and delivery permits a more intensive experience of labor and delivery for the mother under caudal anaesthesia.
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Geburtsh Frauenheilk · Nov 1978
[Pathomechanisms, signs, symptoms and management of amniotic fluid embolism (author's transl)].
The rare, acute and dramatic event of amniotic fluid embolism is increasing in relative importance as a cause of maternal mortality. Recent findings based on the estimation and characterization of circulating fibrin, fibrinogen content and fibrin-fibrinogen degradation products indicate that the coagulation disorder is caused by intravascular coagulation and extensive fibrinolysis and fibrinogenolysis. ⋯ Intensive therapy of shock and rapid restoration of blood volume with blood transfusion (fresh whole blood) and infusion of other fluids. 3. Treatment of the coagulation disorder with fibrinogen, antifibrinolytic agents (aprotinin--Trasylol), platelet transfusion and fresh frozen plasma.
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Geburtsh Frauenheilk · Nov 1978
Comparative Study[Comparison between intra and para cervical anaesthesia in therapeutic abortion (author's transl)].
Therapeutic abortion during the first trimester of pregnancy was carried out as an out-patient procedure under local anaesthesia in 40 women. The intracervical injection of 1% mepivacaine resulted in satisfactory freedom from pain just as the paracervical injection. ⋯ The dilatation of the cervical canal was the determining factor for pain during the procedure. The intracervical and the paracervical local block are equally suitable for out-patient therapeutic abortion in our series.