[Surgical microscopy in various stages of vaginal hysterectomy]. / Operationsmikroskop für einige Phasen der vaginalen Hysterektomie.

This article reports on a new application for operating microscopes to reduce risks when performing a vaginal hysterectomy. Magnification helps to perform the following steps: dividing the vesicocervical ligament, mobilizing the rectum, opening the plica vesicouterine and opening the pouch of douglas.

[Intramural pregnancy with vague symptoms]. / Symptomarme intramurale Gravidität.

The clinical course of an intramural pregnancy in a 28-year-old nullipara is reported. Clinical and sonographic symptoms were not specific. The diagnosis was suspected on laparoscopy. At laparotomy, evidence of incipient rupture of the uterus was found, but no intraperitoneal hemorrhage. The gestational sac was removed without opening the uterine cavum, and the localization within the myometrium was confirmed histologically. Intramural pregnancy is a rare event whose pathogenesis is not clear. Surgical treatment with conservation of the uterus is possible in some cases.

[Occult uterine perforation caused by an intrauterine device]. / Okkulte Uterusperforation durch Intrauterinpessar.

This article reports on a patient who had an asymptomatic perforation of the uterus by an intrauterine contraceptive device. Six and eight years later, the woman had normal pregnancies and deliveries. Ten years later an exploratory laparotomy was performed because of abdominal pain of unknown origin. The intrauterine device was surgically removed from Douglas' pouch. We summarize and discuss the complications due to a perforation of the uterus by an intrauterine contraceptive device and appropriate diagnostic procedures.

[Pregnancy and childbirth in a mother with active histiocytosis]. / Schwangerschaft und Geburt bei einer Mutter mit aktiver Histiozytosis.

The course of pregnancy is described in a 20-year-old patient who had had active histiocytosis X since infancy. After an acute onset during the first year of life, a disseminated chronic state developed at 18 months of age which persisted until the pregnancy. Long-term therapy with 6-mercaptopurine was instituted at diagnosis and was not discontinued until the 17th week of pregnancy. The course of pregnancy, delivery and puerperium was normal except for elevated LDH, altered protein electrophoresis and anemia. The newborn showed no abnormality.

[A simple water bag system for mammosonography]. / Einfaches System mit Wasservorlauf "water bag" für die Mammasonographie.

A simple system for ultrasonic mammasonography in the suspended position is reported. The breast is immersed in a polyethylene bag filled with water at 38 degrees C. The scan is made using a hand-guided real-time probe. The quality of the image is equal to that obtained using more expensive systems.

[Low-carat gold intrauterine device for contraception 44 years in the uterus]. / Niedrigkarätiges Goldintrauterinpessar zur Antikonzeption 44 Jahre im Uterus.

We report on a patient who retained a low-carat gold IUD in her uterus for 44 years. The IUD, which may have been hand-made, has one long and one short arm. The long arm lays within the uterine cavity and the short arm protruded from the cervical canal. The intrauterine device was inserted prior to the second World War. Since she tolerated it well, the patient did not seek regular medical check-ups. At 80 years of age, she complained of lower abdominal pain and the IUD was removed. The patient is suspected to have an ovarian tumor.

[Pregnancy and labor in a mother with Silver-Russel syndrome]. / Schwangerschaft und Geburt bei einer Mutter mit Silver-Russel-Syndrom.

A 23-year-old primigravida admitted to the labor room one week prior to term because of bleeding was known to have a congenital asymmetry, but a heart defect, which decisively affected the course of delivery, had been undiagnosed up to that time. Secondary caesarean section was necessary for fetal and maternal indications. In women with congenital hemihypertrophy or hemihypotrophy (Silver-Russel syndrome), any associated malformations should be ruled out prior to pregnancy.

[Recurring, histologically confirmed Moschcowitz syndrome during pregnancy]. / Rezidivierendes, histologisch gesichertes Moschcowitz-Syndrom während der Schwangerschaft.

A report is presented on a young woman who survived two episodes of thrombotic thrombocytopenic purpura, 5 years apart, in the 31st week of a twin and a singleton pregnancy respectively. The rare clinical picture of Moschcowitz syndrome during pregnancy is described with reference to this unique case report, and the diagnosis, etiology, therapy and clinical course are discussed.