Geburtsh Frauenheilk
-
Geburtsh Frauenheilk · Sep 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Addition of ethanol to the distension medium in surgical hysteroscopy as screening to prevent "fluid overload". A prospective randomized comparative study of ablative versus non-ablative surgical hysteroscopy and different ethanol concentration].
For answering the question at which hysteroscopical procedures an intraoperative screening method is necessary to avoid a fluid overload and whether a beginning fluid absorption can be diagnosed early by adding ethanol to the distension medium, a prospectively randomised comparative study of ablative versus non-ablative operative hysteroscopy with differing ethanol concentrations was performed (n = 120). Purisole (a mannit/sorbit solution) was used a distension medium. The measuring parameters (breath alcohol, amount of absorbed fluid, haematocrit and haemoglobin values, central venous pressure, heart frequency) were intraoperatively determined at 5-minute intervals. ⋯ With hysteroscopical procedures such as resection of myoma, endometrium ablation and septum resection, however, an addition of ethanol of 2% to the distension medium has proved useful, because with this method absorption amounts of 400 ml and more can be detected by positive values of breath alcohol. As the result of a further absorption of fluid, delayed in time compared to the first positive value of breath alcohol, there is an increase in central venous pressure and hyponatraemia. Intraoperative ethanol monitoring is a non-invasive procedure which can be performed during ablative-operative hysteroscopies and has no negative influence on the course of the intervention and the general condition of the patients.
-
Geburtsh Frauenheilk · Aug 1996
[Emergency cesarean section--organization and decision-delivery time].
The German Society of Gynaecology and Obstetrics has published standards for obstetrical services concerning equipment, personnel and organisation. All obstetrical services must be able to perform an emergency Caesarean section with a 20 minutes interval from decision to delivery (D-D time). This study represents an analysis of the 75 emergency Caesarean sections performed at the University hospital Grosshadern of Munich during the interval from 1987 to 1994. ⋯ In conclusion, an efficient emergency Caesarean delivery requires a coordinated team effort with excellent cooperation between obstetrics, anaesthesia and neonatology. Our study demonstrates that even in this optimal setting a decision to delivery time within the 20-minute interval can not always be achieved. Based upon our results and other studies, we recommend a D-D time of 30 minutes.
-
Geburtsh Frauenheilk · Jun 1996
Case Reports[Paroxysmal supraventricular tachycardia in pregnancy. Value of adenosine and other anti-arrhythmia agents].
Adenosine versus Verapamil and other Antiarrhythmic Drugs: Paroxysmal supraventricular tachycardia is the most common sustained arrhythmia during pregnancy. Verapamil has been the most commonly used agent for the treatment of PSVT with a narrow QRS complex. ⋯ Indeed, she suffered from paroxysmal supraventricular tachycardia, which was successfully terminated by intravenous adenosine. Because of its known rapid onset, high effectivity, low incidence and brevity of side effects in the mother and comparative safety in the fetus, adenosine seems to be the drug of choice for treating PSVT during pregnancy.
-
Geburtsh Frauenheilk · May 1996
Comparative Study[Premature termination of pregnancy in the 2nd and 3rd trimester. Serial administration of 1 mg gemeprost vaginal suppositories versus intravenous sulproston].
Comparison of 1 mg Gemeprost-Vaginal Suppositories Serial Application versus Sulproston i.v.: Three different regimens for the termination of second and third trimester pregnancies by the use of prostaglandins (PG) were compared in a retrospective analysis. In group A (n = 16) terminations were attempted by continuous i.v. Infusion of Sulproston 9 hours after administration of a 3 mg-PGE2-vaginal tablet overnight. ⋯ Women of parity > or = 1 showed significantly shorter intervals than nulliparae in groups A and C. Only one woman (in group A) failed to expel after induction, in four other cases (in groups A and B) complications (local thrombophlebitis, bronchospasm) were noted. The serial administration of 1 mg Gemeprost-vaginal suppositories at 5-hourly intervals showed fewer side effects and seems to be as efficient as sulproston i.v. after cervical ripening.