A preliminary study of fetal ductus venosus blood flow during the first stage of labor.

OBJECTIVE: The measurement of fetal ductus venosus blood flow during labor by means of color Doppler sonography. METHODS: 26 women between 37 and 41 weeks of gestation were included in the study. At various stages of cervical dilation (<2 cm, 2-4 cm, 6- 8 cm, and fully dilated) blood flow velocity waveforms of the fetal ductus venosus during and between contractions were studied in fetuses with a negative non-stress test. The Pulsatility index for veins (PIV) and the Peak velocity index for veins (PVIV), respectively were calculated off-line. The mean+/-standard deviation between and during contractions were determined for descriptive analysis. RESULTS: Waveforms were visualized during 139 contractions and 159 episodes of uterine relaxation in 24 of 26 fetuses (92.3%) in normal labor. Three and more waveforms were recorded, in 59.0% during contractions (82/139) and in 57.9% between contractions (92/159), respectively. The mean PIV and PVIV values during contractions were 1.68+/-1.02 and 1.46+/-0.72, respectively. Between contractions the values were 0.49+/-0.21 for the PIV and 0.44+/-0.18 for the PVIV, respectively. CONCLUSION: Ductus venosus blood flow can be visualized in labor. Further studies are needed to establish normal values.

Normal values of fetal ductus venosus blood flow waveforms during the first stage of labor.

OBJECTIVE: To present normal values of fetal ductus venosus blood flow waveforms during the first stage of labor during and between contractions. MATERIALS AND METHODS: Seventy-eight women between the 37th and 41st weeks of gestation were included in the study. At distinct stages of cervical dilation, blood flow velocity waveforms of the fetal ductus venosus during and between contractions were visualized in fetuses with a normal non-stress test. The pulsatility index for veins, peak velocity index for veins and fetal heart rate were calculated off-line. The means +/- standard deviations (SD) during and between contractions were compared using the Wilcoxon test. RESULTS: Ductus venosus blood flow velocity waveforms were visualized during 331 contractions and 375 episodes of uterine quiescence in 74 of 78 fetuses (95%) during normal labor. The mean +/- standard deviation values of pulsatility and peak velocity indices for veins during contractions were 1.66 +/- 0.85 (median: 1.56, range: 0.29-4.69) and 1.46 +/- 0.65 (median: 1.34, range: 0.26-3.13), respectively. Between contractions the values were 0.48 +/- 0.19 (median: 0.46, range: 0.14-1.00) for the pulsatility index and 0.44 +/- 0.18 (median: 0.42, range: 0.14-1.00) for the peak velocity index for veins. These differences during and between contractions were highly significant (P-value < 0.0001), whereas the fetal heart rate showed no significant differences. CONCLUSION: There are significant differences in fetal ductus venosus blood flow waveforms during and between labor contractions. Further studies should evaluate whether these normal values of the fetal ductus venosus are beneficial for risk evaluation in fetuses with an abnormal non-stress test and/or intrauterine growth restriction.

[The career course of women and men psychiatrists]. / Zu Karriereverlüfen von Psychiaterinnen und Psychiatern.

Data from a survey distributed to all directors of psychiatric hospitals in Germany (n = 286) were used to examine sex differences in rank attainment among psychiatrists. Furthermore the directors were asked to assess differences between male and female psychiatrists concerning their professional activities. A total of 207 directors responded, 10 of them were female. In the rank of assistant doctors male psychiatrists predominated only at the university departments (61%). The position of a registrar was held mainly by male doctors in all types of hospitals: 78% at the university departments, 64% at psychiatric hospitals and 56% at psychiatric departments at general hospitals. 43.9% of the responders assessed women less interested in a professional career than men, 46.5% thought that women are more interested in treatment than in research activities, 43.5% admitted that in case of female applicants their private situation (family, children) is more important for the decision to give a job than in case of male ones. 87% of the directors found that a higher number of women within their teams is very important for a good work climate.