[Bilateral renal agenesis in insulin-dependent maternal diabetes mellitus (IDDM)--a case report]. / Bilaterale Nierenagenesie bei insulinabhängigem mütterlichen Diabetes mellitus (IDDM)--ein Fallbericht.

We report a fetal bilateral renal agenesis in a woman suffering from insulin-dependent diabetes mellitus. Early diagnosis of this lethal congenital anomaly allows well-timed termination of pregnancy. Transvaginal sonography in combination with color flow mapping render possible an accurate diagnosis of bilateral renal agenesis. Sonographic and color flow mapping features of the above described malformation as well as invasive diagnostic possibilities and causes of renal agenesis in maternal IDDM are discussed.

[Diagnosis of biophysical status in pregnancy]. / Biophysikalische Zustandsdiagnostik in der Schwangerschaft.

Based on 6,490 cardiotocographic examinations and numerous following diagnostic investigations a combined cardiotocographic and sonographic management during pregnancy care is recommended. The management starts with a non-stress-test (NST). Two acceleration (greater than 15 seconds, greater than 15 bpm) recorded within 10 or more minutes are a sign of fetal well-being. In order to differentiate between physiological- and pathologically suspicious heart frequency patterns a mechanical or acoustic provocation test is recommended. The dorsal transcutaneous electrical nerve stimulation (20 mA) is an effective continuous stimulus to wake up the fetus. The nipple stimulation test is the best physiological contraction stress test. The oxytocin challenge test may be replaced by the nipple stimulation. The following sonographic parameters of fetal condition are summarized to the fetal biophysical profile (FBP): body movements, breath movements, tonus and amniotic fluid volume. All these, together with the result of non-stress-testing, give the FBP-score. The predictive value of combined cardiotocographic and sonographic examination is much higher than the NST alone. An FBP-score less than or equal to 6 is an indication for the hospitalization. A score less than 4 with verified signs of maturity is an indication for the induction of labor.

[Telemetric labor monitoring using the fetal monitor BMT 941-1]. / Telemetrische Geburtsüberwachung unter Verwendung des Fetalmonitors BMT 914-1.

Recommendation of a telemetric system for the direct fetal monitoring using the monitor BMT 914-1 (Zwönitz). The free movement of parturients during labor is more comfortable and involves an increasing uterine activity, a labor progress and a decrease of oxytocic infusion rate.

[The geriatric patient in surgical gynecology. Results of the treatment of geriatric patients--a postoperative quality control]. / Die geriatrische Patientin in der operativen Gynäkologie. Behandlungsergebnisse geriatrischer Patientinnen--eine postoperative Qualitätskontrolle.

This paper presents results of a retrospective study covering 506 older women (age range: 60 years and older), who were treated by major gynecologic operations in a twenty-years-period between 1962 and 1981 at the Department of Gynecology and Obstetrics at the District Hospital of Stralsund. The total number of patients operated on during these twenty years was 6,246, the frequency of the operated older women 10.11 per cent. In two control periods (1967-1971 and 1977-1981) there was a slight increased of these patients in the last period from 8.22 per cent to 13.29 per cent. Comparing postoperative outcome and complication rate of the geriatric patients group there is no statistically significant difference to another group of patients (age range: 30-40 years) undergoing gynecologic surgery in 1981. Indications for gynecologic surgery showed age-dependent differences in the two groups. Our conclusions are that retrospective studies concerning clinical assuring of professional quality of medical care are not sufficient enough. As a result of this study we present our concept for medical data processing (documentation) regarding quality-assessment of gynecologic surgical care.

[Progress of labor and cardiotocographic parameters in mobilization during labor]. / Geburtsfortschritt und kardiotokographische Parameter bei Mobilisation unter der Geburt.

Report about 156 intrapartum ambulations who failed progress of labor. Internal fetal monitoring was used in all patients. Labor progress with cervical dilatation was stated in 92,1% in first stage and in 68,7% in second stage of labor. An average increase of 10 mmHg in baseline tonus and an increase in amplitude and contraction frequency were found. No significant changes in either FHR baseline, variability or floating line were observed during ambulation. The lack of any demonstrable ill effects with ambulation in labor and the improved tolerance to pain and comfort are remarkable. Intrapartum ambulation with internal fetal monitoring has a great efficacy for progress of labor and is safe for both mother and fetus.