[Echocardiography during pregnancy--longitudinal studies in primigravidae]. / Echokardiographie während der Schwangerschaft--Verlaufsuntersuchungen bei Primigravidae.

As a result of hormonal changes processes of adaptation of the cardio-vascular system occur during pregnancy. These regulative changes are the basis for the present echo-cardiographic study which was made under standardized conditions with healthy primigravidae (n = 20) compared to nulligravidae (n = 24). Besides blood pressure and heart frequency dimension and volume sizes of the left ventricle (LV) as well as the LV-weight of muscle and the peripheral vascular resistance were analysed. As result significant increases from the 15th to the 35th week of pregnancy (SSW) could be found for the following parameters: heart frequency, arterial blood pressure, endosystolic volume of the left ventricle, cardiac output, left ventricular weight of muscle (p less than 0.01) endosystolic diameter of the left ventricle, enddiastolic volume of the left ventricle and heart index (p less than 0.05). The peripheral resistance was continuously decreased in the course of pregnancy (p less than 0.01). Compared to non-pregnant women the following parameters showed significantly higher values: heart frequency, cardiac output and heart index (p less than 0.01). The peripheral resistance was significantly lower in pregnant women compared to non-pregnant women (p less than 0.01). From the results the conclusion can be drawn that with statistic certainty echocardiography records adaptive processes of the circulation regulation relative to pregnancy and enables a separation in the groups of pregnant and non-pregnant women.

[Significance of initial weight and weight development for the course and outcome of pregnancy]. / Untersuchung zur Bedeutung von Ausgangsgewicht und Gewichtsentwicklung für den Verlauf und das Ergebnis einer Schwangerschaft.

In a retrospective analysis the connection between pregravide weight and development of weight of the pregnant woman with regard to the duration of pregnancy and the birth weight of the child have been investigated, by means of the three-dimensional contingence-table-procedure. The rise in weight up to the 28th week of pregnancy as well as up to the end of pregnancy influence the characteristics of the child (duration of pregnancy and birth weight) in a significant measure. A rise in weight of more than 6 kg till the 28th week of pregnancy indicates with a high degree of probability a further normal progress of pregnancy. In the second part of the study tables showing normal values for the rise in weight during pregnancy are prepared on the basis of the tables showing optimal values according to Moehr.

[Physical fitness during pregnancy]. / Untersuchungen zur körperlichen Leistungsfähigkeit im Verlauf der Schwangerschaft.

In a study of longitudinal section 25 primigravidae were examined during pregnancy on the bicycle ergometer. A group of 10 non-pregnant women in their postmenstrual phase was used as controls. Blood glucose, cholesterol, triglyceride and lactic acid were analysed parameters in addition to cardiorespiratory. The reaction of the cardiovascular system to submaximal load in healthy pregnant women is economic. The metabolic system reacts with an intensified availability of energy via fat-metabolism and a diminished utilisation of glucose. Pregnancy is a physical stimulus for the female organism.

[Cardiovascular action of dipyridamole in advanced pregnancy (author's transl)]. / Kardiovaskuläre Wirkung von Dipyridamol in der Spätschwangerschaft.

Quantitative sphygmometry was used to check the cardiovascular action of an intravenous injection of 30 mg of dipyridamole in ten women, between the 31st and 38th weeks of pregnancy. Circulation was intact in all of them, but there was suspicion of intra-uterine foetal retardation. Moderate decline in arterial mean blood pressure was paralleled over a short period of time by increase in heart rate, stroke volume, and cardiac output. Overall peripheral resistance dropped with significance and caused, with some probability, increase in uterine perfusion. Hence, dipyridamole proved suitable for intra-uterine reanimation.

[The cardiovascular effect of diisopropylaminhydrochloride (Disotat) in non-pregnant hypertensive women]. / Die kardiovaskuläre Wirksamkeit von Diisopropylaminhydrochlorid (Disotat) bei nichtschwangeren Hypertonikerinnen.

With the help of the quantitative sphygmometry and the unbloody graphic registration of the arterial pressure the hemodynamic effect of diisopropylamine hydrochloride (disotat) was investigated in 10 non-pregnant hypertensive patients. After a rapid intravenous application of 100 mg diisopropylamine hydrochloride (DIIPA) within 10 minutes after injection a statistically significant decrease of the systolic pressure by 15%, of the diastolic pressure by 9% and of the arterial medium pressure by 15% developed. Thus the blood pressure amplitude was restricted by 25%. Connected with the decrease of the pressure was a significant decrease of the stroke volume by 22% and of the cardiac output by 19%. The total peripheral resistance increased statistically uncharacteristically by 13% in comparison to the initial value. The courses of the curves show that in all parameters during the 45-minute observation duration the initial values are striven for, however, without reaching them in every case. Thus the decrease of pressure induced by bolus injection of DIIPA independent on the existence of pregnancy is always accompanied by a decrease of the output volumes of the heart and the increase of the total peripheral resistance.

[Experience obtained from use of endoprotheses in treatment of ureterostenosis (author's transl)]. / Erfahrungen mit der Endoprothesenbehandlung bei Ureterstenosenk.

Reported in this paper is the authors' own experience obtained from treatment of 25 cases of severe ureterostenosis, using plastic endoprotheses (splints), according to a technique proposed by Schmitz and Hegemann, 1966. Ascending infection did not occur at all. The disputed method may be used in exceptional situations to get to grips with postsurgical or postradiological ureterostenosis, a condition not fully avoidable yet. Such exceptions may be claimed for patients to whom uretero-surgery would be an intolerable stress or for those on whom pharmacotherapy, using glucocorticoids and antibiotics, has failed.

[Behaviour of cardiovascular system during obstetric neuroleptanalgesia, using droperidol/fentanyl (author's transl)]. / Das Verhalten des Herz-Kreislaufsystems während der geburtshilflichen ("kleinen") Neuroleptanalgesie mit Droperidol/Fentanyl.

Intravenous injection of 2.5 mg of droperidol and 0,05 mg of fentanyl to ten women with clinically intact cardiovascular system in advanced pregnancy and the cardiovascular effects of such injection were studied by means of quantitative sphygmometry. - Mean arterial blood pressure was found to drop slightly but with significance, while the blood pressure amplitude went up. Heart rates remained largely constant. Significant increase in cardiac output, consequently, resulted solely from increase in stroke volume. Total peripheral resistance was reduced with significance. Medication, using the above combination of drugs, may be recommended for obstetric analgesisa, because of its favourable impact in terms of hemodynamics.

[Circulatory effects of xanthinol nicotinate in advanced pregnancy (author's transl)]. / Kreislaufwirkungen von Xanthinolnikotinat in der Spätchwangerschaft.

Xanthinolnicotinate is a vasostimulant substance which is recommended to improve blood flow in the treatment of placental insufficiency. Quantitative sphygmometry with non-invasive graphic recording of arterial blood pressure was used in an attempt to study the effects of intravenous infusion of 300 mg of xanthinolnicotinate (Jupal) on the cardiovascular systems of ten women in advanced pregnancy with suspicion of intra-uterine foetal retardation. Their circulation remained basically unaffected, except for transient initial rise in pulse rate and cardiac output as well as decline of total peripheral resistance. However, additional blood supply to the skin and resulting shift in blood volumes may well provide a possibility of uteroplacental hypoperfusion, at least in cases in which perfusion had been restricted before. Administration of xanthinolnicotinate during pregnancy, therefore, cannot be recommended against the background of present knowledge.

[The haemodynamic principle of action of diazoxide (hypertonalum) in the treatment of acute hypertensive crises in late pregnant women (author's transl)]. / Das hämodynamische Wirkungsprinzip von Diazoxid (Hypertonalum) bei der Behandlung akuter Hochdruckkrisen in graviditate.

In ten hypertensive late pregnant women with passing crises of hypertension cardiovascular analysis with the method of quantitative sphygmometry, the unbloody recording of the blood pressure and the direct electronic measuring of the pulse wave velocity were made before and after the intravenous injection of 300 mg Diazoxid (Hypertonalum). This drug is recommended to the treatment of severe preeclampsia and eclampsia because of lessening the arterial blood pressure and the total peripheral resistance, increasing the heart rate, stroke volume and cardiac output.

[The value of magnesium sulfate in intensive care of severe toxemias of pregnancy (author's transl)]. / Die Stellung von Magnesium sulfuricum in der Intensivtherapie schwerer Gestosen.

A view on the employment of magnesium sulfate in pregnancy is given and the statement of the cardiovascular changes before, during and after the intravenous infusion of 4,0 g magnesium sulfate in ten hypertensive late pregnant women. The drug induces a mild decrease of arterial blood pressure with a distinct increase of stroke volume, cardiac output, heart rate, heart work and the heart's power. The pathologically increased total peripheral resistance is reduced. These hemodynamic effects are very favourable concerning intensive care of severe toxemias of pregnancy.

[Antenatal ethanol-fructose infusion for prophylaxis of dyspnoea (author's transl)]. / Antenatale Athanol-Fruktose-Infusion zur Prophylaxe des Atemnotsyndroms.

The incidence of dyspnoea among immature newborns, delivered after pregancy periods between 28 and 32 weeks, was reduced with statistically secured significance by antepartal intravenous administration of fructose-ethanol infusions to the mother.

[Dilatol for hypertension therapy in pregnancy (author's transl)]. / Hochdrucktherapie in der Schwangerschaft mit Dilatol.

Dilatol (Nylidrin), a betamimetic used for tocolysis, was applied to ten hypertensive women in advanced pregnancy and produced in them characteristic effects with favourable impact upon oxygen supply to the foetuses, such as significant lowering of diastolic pressure, decrease in total peripheral resistance which reflected increase in uteroplacental blood flow, as well as rises in heart rate, stroke volume, and cardiac output. Nylidrin, therefore, may be recommended as a hypotensive drug in the treatment of arterial hypertension in pregnancy.

[Effect on the cardiovascular system of a 3.5% gelatin infusion solution Gelafusal in hypertensive women in late pregnancy]. / Herz-Kreislaufwirkungen der 3,5% igen Gelatineinfusionslösung Gelafusal bei hypertensiven Sätschwangeren.

Using the method of quantitative sphygmometry with bloodless graphic recording of the arterial blood pressure and direct electronic timing of the pulse wave velocity the behaviour of the cardiovascular system in 10 hypertensive late pregnant women was examined before, during and after the intravenous infusion of 500 ml of a 3,5% gelatinous infusion solution (Gelafusal) given within 30 minutes. There is a mild and transient expansion of the plasma volume. Arterial blood pressure, stroke volume, cardiac output and total peripheral resistance remain constant nearly. Consequently the employment of Gelafusal in hypertensive late pregnant women is possible without making worse the arterial hypertension.

[Suitability of mephentermine for the management of arterial hypotension in pregnancy]. / Die eignung von Mephentermin zur Behandlung der arteriellen Hypotonie in der Schwangerschaft.

10 late pregnant women with hypotension were examined before and after the intravenous injection of 30 mg mephentermin with the method of quantitative sphygmometry, the bloodless graphic registration of the arterial blood pressure and direct electronic timing of pulse wave velocity. Systolic and diastolic blood pressure increase significantly. The cause of this rise in arterial blood pressure is the increase of stroke volume exclusively. Heart rate and total peripheral resistance remain constant. This hemodynamic mode of action is a favourable one in regard to protection of uteroplacental blood flow. Therefore mephentermin is suitable for treatment of hypotension in pregnancy.

[Cardiovascular changes during ethanol-tocolysis]. / Herz-Kreislauf-Veränderungen während der Athanol-Tokolyse.

The cardiovascular effects of an intravenous infusion of a 5% ethanol-10% fructose-solution was examined in 10 healthy late pregnant women with the method of quantitative sphygmometry. There are insignificant changes of the arterial pressure, but increase of stroke volume, cardiac output, work and power and a decrease of total peripheral resistance. In spite of these favourable hemodynamic alterations, particularly the constant heart rate, ethanol should be used only for a short-time-tocolysis.

[Influence of long-term beta adrenergic therapy on the HPL blood level and the total excretion of estrogens]. / Einfluss der Beta-Adrenergika-Langzeittherapie auf den HPL-Blutspiegel und die Gesamt-Ostrogenausscheidung.

Pregnant women with imminent miscarriage were treated with Partusisten and/or Dilatol for tocolysis beginning in the 29. week of pregnancy. During treatment the mean urinary excretion of total oestrogens (n = 35; p less than 0,01 in 36th week of pregnancy and later) and the mean plasma level of HPL increased (n = 8; p less than 0,01 in 33., 34. and 35. week of pregnancy). These changes have to be concidered in judging the fetoplacental unit or the function of placenta.

[Influence of ethinyl estradiol sulfonate on the decreased urinary bladder tonus in the menopause]. / Einfluss von Athinylöstradiolsulfonat auf den verminderten Harnblasentonus in der Postmenopause

In 40 women with hypotonic urinary bladder the influence of 17alpha-Athinyl-3-isopropyl-sulfonyloxy-Ostradiol (Athinylöstradiol) (3 X 15 mug/die without weekend) was examined concerning the intravesical pressure; The cystotonometry has been done just before as well in intervalls of 2 months during half year's period of treatment. The authors used the fill-up-cystotonometry of Hartl. The intra-vesical pressure rose significantly by the influence of Athinylöstradiolsulfonat after 2 months treatment already. In comparison to the hypotonic value before treatment there was an average normotonic urinary bladder after application of Athinylöstradiolsulfonat past 4 and 6 months. Incidence on clinical relevance of these results.

PIP: 17alpha-ethinyl-3-isopropyl-sulfonyloxy-estradiol (15 mcg 3 x daily except weekends) was administered to 40 women (average age 53.8 years) with hypotonic urinary bladder to examine the effect on intravesical pressure. Cystotonometries (Hartl's fill-up method) were preformed before treatment and then every 2 months during the 6-month therapy. After 2 months of ethinyl estradiol sulfonate treatment,the intravesical pressure rose significantly (p less than .05). After 4 months average normatonic bladder function was achieved, and this stabilized during the last 2 months of therapy. The positive and statistically significant results of the therapy are stressed, and VEB Jenapharm's oral synthetic Depotoestrogen Aethinyloestradiolsulfonat for the treatment of hormonally caused hypotonic urinary bladder is recommended.

[Ehlers-Danlos syndrome and pregnancy]. / Ehlers-Danlos-Syndrom und Schwangerschaft]

The clinical aspects of pregnancy, parturition and childbed in a young primigravida, who had the Ehlers-Danlos syndrome, are reported. The whole course was without complications, contrary to other bibliographies. A survey of the family gave no evidence, that the characteristic was familial. Possibilities of danger are showed.