[Clinical aspects and problems of cytomegalovirus infections in newborn and premature infants]. / Klinische Erscheinungsbilder und Problematik der Zytomegalieinfektion beim Neu- und Frühgeborenen.

Describing the course of illness of six newborn infants suffering from connatal respectively postnatal acquired cytomegalovirus infection most important problems of this disease during neonatal period are discussed. There are reviewed: questions according diagnostic specificity of CMV-infection in the newborn; neurologic and sensorineural sequelae; the influence of prematurity and immune deficiency on the severity of the disease; possibility of chemotherapy against CMV and; the morbidity of preterm infants following postnatal, especially transfusion-associated CMV-infection.

[Studies on manifestations of Rh-related hemolytic disease of the newborn in the years 1974-1989 in the Erfurt district]. / Untersuchungen über das Auftreten des Rh-bedingten Morbus hämolyticus neonatorum in den Jahren 1974-1989 im Bezirk Erfurt.

In the course of 13 years (1977-1989) 223 of 223,121 liveborn infants in the district of Erfurt suffered from haemolytic disease due to Rh-isoimmunization, 0.1 per cent died. An initial drop of morbidity from 1.6 to 0.6 of 1000 newborns was followed by stagnation and further increase during the last years. More than 50% of the affected babies were delivered by women who had to be protected from sensibilization by immune prophylaxis. The cause for the immunization were deliveries (75%), miscarriages and interruptions (23%). The most important reason for the insufficient decrease of the Rh-morbidity is the failure of immune prophylaxis in the case of ABO-incongruence between mother and child. Our results support the demands for a general immune prophylaxis without taking into consideration the main blood groups and the number and result of the pregnancy. The quantity of severe erythroblastosis (7 stillborn and 5 hydropic liveborn) demonstrates the necessity to improve the prenatal management of these babies.

[Serum concentration of gentamicin in newborn infants]. / Untersuchungen zur Serumkonzentration von Gentamicin bei Frühgeborenen.

Serum levels of gentamicin were determined in 15 premature infants (birth weight 1,120-2,250 g, gestational age 27-36 weeks) by agar immunoassay. The intramuscular applied doses was 6 mg/kg/day, the doses interval 12 hours. We found an increase of the gentamicin serum level during the first 72 hours after the beginning of therapy. At the second day of treatment the serum levels in 46.5% of all patients were determined below the therapeutic concentration, but a toxic level was found in more than 60% of all cases during the period of steady state. The serum levels were higher in preterm newborns of less than 1,500 g birth weight, then in more mature infants. We recommend: 1. To double the first doses of gentamicin 2. To modify the gentamicin level by expanded intervals of therapy and/or reduced doses under monitoring, especially during the first week of life.

[Treatment of post-hemorrhagic hydrocephalus in premature infants]. / Zur Problematik der Behandlung des posthämorrhagischen Hydrozephalus Frühgeborener.

Our experiences in the course of illness of very low birth weight infants suffered from posthemorrhagic hydrocephalus are described. Clinical proceedings for performing of the hydrocephalus are explained, advantages and disadvantages of treatment by serial lumbal punctures, influences of drugs on the dilatation of the ventricles and the insertion of ventriculo-peritoneal shunts are discussed. The outcome was unfavourable in hydrocephalus following Grad III ore IV hemorrhage. Therefore the prevention of severe hydrocephalus must be the common sense of obstetricians and neonatologists.