[Studies of obstetric and socioeconomic factors in the origins of prematurity]. / Untersuchung geburtshilflicher und sozio-ökonomischer Faktoren in der Genese der Frühgeburt.

Data of 400 term deliveries and 100 preterm deliveries were analyzed to determine the effect of the socio-economic situation, prior abortion, premature birth and other complications on current pregnancy outcome. Of special interest was the question if pregnancy complications in an antecedent pregnancy would lead to intensified care in a following pregnancy. A prior premature birth increases the risk for prematurity significantly. In contrast to earlier studies illegitimacy has no influence on rate and outcome of preterm birth. It is the most striking result of this study that a high risk factor as previous abortion, stillbirth or prematurity gives no cause for improved or intensified prenatal care.

[Value of laboratory parameters in androgenization in the female with special reference to the "free androgen index"]. / Die Wertigkeit von Laborparametern bei Androgenisierungserscheinungen der Frau unter besonderer Berücksichtigung des "freien Androgen-Index".

The degree of androgynism (A) in women can be assessed via clinical data and by determining the levels of testosterone (T), dehydroepiandrosterone sulfate (DHEA-S) and testosterone binding globulin (TBG) in the blood. The determination of the "free androgen index" (FAI), the ratio of total T and TBG, helpful in estimating the level of free T in serum, conveys valuable additional information: in case of FAI below 1, a mild kind of A without elevation of free testosterone can be assumed. However, severe A with elevation of free testosterone and absolute hyperandrogynism is associated with FAI values above 1. In 63 women with signs of A the parameters mentioned above and the FAI were used to determine the degree of severity of A. These data were compared with the corresponding data of a control group. It could be shown that in women whose A was due to idiopathic hirsutism the increased level of bonded T played a causal role. The mean FAI in this group was 0.41. In contrast, in women with POC syndrome and androgynous cycle disturbances, the absolute hyperandrogynism with elevation of free T levels predominated. In these groups the mean FAI was above 1. However, women with male pattern bolding as single sign of A did not exhibit any significant difference in comparison to the control group. In this disease, the increased response of androgen receptors in the skin despite normal androgen levels seems to play a causal role. Two cases of androgen producing ovarial tumours and one case of adrenogenital syndrome were analysed separately.

[Prognostic significance of biochemical and sonographic findings in hemorrhage in early pregnancy]. / Prognostische Bedeutung der biochemischen und sonographischen Befunde bei Blutungen in der Frühgravidität.

In order to classify events of bleeding in early pregnancy (7th-16th week of pregnancy), an ultrasonic examination was carried out on 72 pregnant women, as well as tests establishing the HCG-secretion in the early morning urine and the progesterone level in the serum before commencing hormone therapy. The collected medical evidence was compared with standard curves. In order to test its prognostic validity, it was related to the termination of the pregnancy. In cases of miscarriage, the placenta was examined histologically and the progesterone level decrease registered over 48 hours. In 34 women, the pregnancy ended with a birth; in 26 (76.5%) of these cases the progesterone values were with the normal area. The HCG-secretion was normal in 25 (74.3%) patients. The sonographic classification indicated an intact pregnancy in every case. In 38 cases the pregnancy was disturbed. In this group of patients, the progesterone level in 36 cases (94.8%) and the HCG values in 27 patients (71.1%) were below the normal. Signs of life were absent in 37 pregnancies (97.4%) in the ultrasonic examination. By virtue of the statistical evaluation of this data, a high reliability can be attributed to the sonographic evidence with regard to the correct prognosis for bleeding in early pregnancy.

[The pulsatile administration of releasing hormone (GnRH) for the treatment of hypothalamic amenorrhea]. / Die pulsatile Releasinghormon-(GnRh-)Gabe zur Behandlung der hypothalamischen Amenorrhö.

12 women with hypothalamic amenorrhoea (degrees II to IIIb) were given pulsatile releasing hormone in 14 treatment cycles. The minipump "Zyklomat" (Ferring Ges.m.b.H., Kiel) with a treatment set giving 0.8 mg LH-RH was used in all cases. In 86% (12 out of 14) of the treated cycles ovulation was recorded. 3 out of 8 women who desired a baby became pregnant. 1 of these pregnancies followed directly on a treatment cycle whilst the other 2 pregnancies resulted from spontaneous biphasic cycles following the treatment cycle. In 4 women pulsatile releasing hormone was used to examine the functional reaction of the pituitary gland and the ovary. In this group 1 spontaneous biphasic cycle was seen following the induced ovulatory cycle.

[Hypergonadotropic amenorrhea following laparoscopic tubal sterilization]. / Hypergonadotrope Amenorrhö nach laparoskopischer Tubensterilisation.

A case is reported of secondary hypergonadotropic amenorrhoea following laparoscopic tubal sterilization with unipolar high-frequency current. Before the operation there had been no indication of hormonal disturbance in the 28 year-old woman. Endocrinological investigation of the patient and histological examination of the ovaries confirmed the clinical diagnosis of premature menopause. It is assumed that the ovaries had been irreversibly damaged by the coagulation procedure.

[Treatment results after a single local application of 500 mg of clotrimazole in vaginal mycoses during pregnancy]. / Behandlungsergebnisse nach einmaliger lokaler Applikation von Clotrimazol 500 mg bei Vaginalmykosen in der Schwangerschaft.

Antimycotic effect and compatibility of a single-dose treatment with Clotrimazole 500 mg were studied in 47 pregnant women with proven vaginal mycosis seen at the University Clinic of Obstetrics and Gynecology in Graz. Clinical and mycological controls were carried out one and five weeks after treatment was commenced. The following results were obtained after a total of 50 single-dose treatments (3 patients had a second course of 500 mg Clotrimazole 3 months after the first dose): In 39 patients (78%) complete recovery from infection was achieved, in 3 patients asymptomatic contamination was found and in 4 patients therapy was unsatisfactory. In 4 cases a recurrency was found after 5 weeks. Neither in the patients nor in their infants any side-effects of the drug could be observed.

[Pregnancies following tubal diagnostic procedures]. / Schwangerschaften nach tubendiagnostischen Massnahmen.

During the years 1976 to 1980, 178 laparoscopies with hydropertubations and 113 hysterosalpingographies as well as 24 combined tests were carried out at the University Clinic of Obstetrics and Gynecology Graz. Of these, 263 cases could be evaluated. On the basis of the diagnosis made by above mentioned examinations, a pregnancy was practically impossible for 102 women. Of the remaining 161 cases, 38 (23,6%) conceived within the first six cycles subsequent to "invasive diagnosis". It is assumed that these patient's pregnancies can be attributed directly to the diagnostic measures. It is presumed that the reason for this therapeutic effect lies in the removal of a mechanical or psychic disturbance.

[Androgenetic amenorrhea]. / Die androgenetische Amenorrhoe.

Virilism in females is often associated with menstrual disorders. There is an evident correlation between the severity of virilism, the level of androgens and the degree of menstrual disorder. A study was carried out between January 1978 and December 1980 on 75 women with various degrees of virilism. The majority of women with severe hirsutism and male-type alopecia were found in the group with amenorrhoea. Furthermore, the four cases with the full-blown picture of severe virilism were found exclusively in this group. Clarification of the virilizing manifestations on the basis of a determination of the basic hormonal status (including the steroid fractions), the dexamethasone suppression test (including the HCG stimulation test) and the oestrogen-gestagen suppression test, diagnostic laparoscopy and phlebography of the adrenal gland is discussed and the methods evaluated.