Geburtsh Frauenheilk
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Various parameters associated with fibrinolysis were examined in plasma and placenta tissue extract in 18 patients with HELLP syndrome (haemolysis, elevated liver enzymes, and low platelet count). A significant increase in plasma concentrations of tPA and PAl-1 was observed in the HELLP patients in comparison to 18 pregnant women of the control group (equal duration of pregnancy). In contrast, there was no difference in plasma concentrations of uPA, uPA-receptor and D-dimer. ⋯ Our findings indicate, that endothelial damage with release of tPA may be involved in the pathophysiological pathway of HELLP syndrome. Increased plasma levels of PAl-1 may reflect deficient fibrinolysis resulting in impairment in microcirculation. Clinical relevance of tPA and PAl-1 plasma concentration as possible predictor of hypertensive pregnancy complications will have to be studied further.
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Geburtsh Frauenheilk · Apr 1994
Review Case Reports[Unilateral, sensorimotor femoral nerve paralysis following abdominal gynecological operation].
Unilateral or bilateral femoral nerve functional deficiency deficit occurs as a rare iatrogenic complication of gynaecological abdominal or vaginal surgery. Self-retaining abdominal retractors, that exert a constant pressure on the femoral nerve during the operation, are the most frequent cause. ⋯ The favourable prognosis of the femoral nerve sensory and motor deficiencies can be complicated by damage to the knee joint resulting from leg muscle paresis. A personal observation and a literary review on sensomotor paresis after gynaecological abdominal surgery are discussed.
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Geburtsh Frauenheilk · Mar 1994
Case Reports[Uterine rupture in the 22nd week of pregnancy in placenta percreta].
The placenta percreta is a rare event in pregnancy. A case of spontaneous rupture of the uterus in the 22nd week caused by placenta percreta (verified by histological examination) is described. Causal facts and therapeutic aspects are discussed.