Zentralblatt für Gynäkologie
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Comparative chemical tests, under laboratory conditions, of 20 newborns with normal pH and 20 children with acidotic pH values in blood obtained from the umbilical artery have shown that in newborns medium acidosis resulted frequently is disseminated intravascular coagulation, whereas advanced acidosis led to the same situation with regularity. The thrombocytes, coagulation factors II and V, of the authors' acidotic newborns were clearly exposed to consumption. ⋯ Systematic efforts to detect disseminated intravascular coagulation should be made in all cases in which the postnatal umbilical artery pH of newborns in 7.09 and below. Determination of haematocrit, thrombocyte count, and fibrinogen degradation products may be sufficient as an immediate-action minimum programme in such cases.
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Experience obtained from 115 childbirths with catheterisation for epidural analgesia is reported in this paper. Reduction of labour pain was optimum with all patients.--The rate of CTG alterations and acidosis of foetal blood was not beyond that recordable from normal deliveries. The rate of vaginal surgery was increased to 14.8 per cent due to one patient in whom expulsion was delayed and the expulsion period thus prolonged.
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Reported in this paper is a combination of "single shot" peridural analgesia with termed delivery, in the context of 100 patients. The analgesic method was applied individually to any of the women involved, depending on aggravating nociperception, all under compulsory cardiotocographic control. The results are given with reference to both objective parameters and interviews with the patients. The authors' own modification seems to be suitable for large-scale routine use.
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A retrospective evaluation was made of the blood pressures of 131 patients with hypertensive late gestosis who had undergone caesarean section for maternal or foetal indications, between 1971 and 1977. Rauwolfia preparations should be avoided in both long-term and acute hypotensive treatment of late gestosis patients not only for their unfavourable impact upon circulation at large, but also for their cumulative effects in terms of drastic depression of blood pressure in case of anaesthesia necessary for whatever reason. ⋯ Anaesthesia should be induced, using the base anesthetic propanidid which worked extremely well in terms of circulatory stabilisation. It is obviously superior to barbiturates in that particular respect.
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The authors report on the modern trends and the pro and contra in treatment of pre-eclampsia and eclampsia. Ambulatory therapy is only allowed in mild preeclampsia by rest, high-protein lowcaloric diet and mild sedation. Also during the stationary therapy diuretics should be commonly avoided. ⋯ For the treatment of eclampsia well tried standardized methods with few drugs as magnesium sulfate and when necessary barbiturates and hydralazine are mentioned, furthermore, the combination with new therapeutic managements as the osmo onco-therapy and the modern anaesthetic technics. There is agreement that in severe preeclampsia induction of labor should be performed before term. The indication for that is facilitated by the modern perinatal diagnostics.