Zentralblatt für Gynäkologie
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Biography Historical Article
[Our gynecologic heritage. Robert von Olshausen (1835-1915), pioneer in surgical gynecology. 5th contribution on the history of the Berlin Society of Obstetrics and Gynecology].
Robert von Olshausen was an outstanding German gynecologist at the turn of the century and a pioneer of operative gynaecology. His fields of excellency were ovarotomy, the problems of asepsis, carcinoma therapy and the development of obstetrics in general. ⋯ For many years Olshausen was the chairman of the Berlin Society of Obstetrics and Gynecology, since 1894 as honorary chairman. The present paper is a biography of Robert von Olshausen, showing his importance for the development of the modern gynaecology in Berlin and Germany.
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The HELLP-syndrome is the most severe form of pre-eclampsia. Fetal and maternal life is threatened because of missing prodromi and sudden onset of complications. This case report describes the development of HELLP-syndrome in a 26 y/o G1P0 in the 26th week of gestation. ⋯ No hypertension was stated. The pregnancy was terminated by cesarean section resulting in a viable 900 g female newborn, who was transferred to the neonatal intensive care unit. The patient's condition stabilized quickly after the delivery, symptoms decreased within 4 days.
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We retrospectively analyzed 468 deliveries in 1989, 935 deliveries in 1990, and 1020 deliveries in 1991 from cephalic presentation. Oxytocin was given for reason of not sufficient labor (cervical dilatation < 1 cm/hr) after spontaneous or artificial rupture of membranes. ⋯ Prolonging the interval of increasing oxytocin did not adversely influence the condition of the neonates and was not associated with a significant change in the cesarean section rate. The average duration of oxytocin administration was prolonged slightly, but the maximum dose and therefore the average total dose administered were decreased.
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At the Clinic Obstetrics and Gynecology, Allgemeines Krankenhaus Celle, two cases of amniotic fluid embolism were observed. The first case showed the two characteristic phases of the disease (cardiopulmonary shock followed by severe disseminated intravascular coagulopathy). During the onset of the cardiorespiratory symptoms, the patient underwent cesarean section and a healthy infant was born. ⋯ Cesarean section was carried out immediately. At first, the infant was heavily depressed, but further development was normal. Inspite of great advances in intensive care amniotic fluid embolism still is considered to be a very dangerous event with 86% maternal mortality.
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Comparative Study
[Control of labor with prostaglandins after previous cesarean section].
The authors studied the possibilities of vaginal labour management by induction after previous caesarean section. They compared the effectiveness of oxytocin and prostaglandins in uterus action. ⋯ Compared were also both the incidence of complications during labour and the effect of the uterotonic used on the fetus. It follows from the results that local application of prostaglandins is more advantageous than overall application and carries practically no risk for the patient in labour.