[Diagnostic microlaparoscopies with 2 mm optics]. / Diagnostische Mikrolaparoskopien mit 2-mm-Optiken.

Within a period of 5 months a serious of 42 small diameter laparoscopies (2 mm) (SDL) were performed with a modified technical approach. 28 (SDL). Procedures were done under general anaesthesia and the findings were controlled by concurrent conventional laparoscopy. In 26 out of 28 patients we could confirm the SDL diagnosis. 14 patients had SDL in analgosedation. Optical information gained by SDL was sufficient and, as experience in handling the system increased, also competitive. The procedures performed in analgosedation were tolerated and highly appreciated (reduced incisional pains, reduced complaints due to pneumoperitoneum). SDL procedures seem to have possible indications in gynaecology.

[Specific antibodies to herpes simplex virus, cytomegalovirus and rubella virus: distribution in amniotic fluid and blood]. / Spezifische Antikörper gegen Herpes-simplex-Virus, Zytomegalie-Virus und Röteln-Virus: Verteilung in Fruchtwasser und Blut.

Fifty-nine unselected pregnant women were included in the study at the time of delivery. Immediately post partum maternal blood was obtained by venous puncture, and fetal blood from the umbilical cord. Amniotic fluid was obtained by amniocentesis during labor prior to rupture of the amniotic sac. Virus-specific rubella, herpes simplex and cytomegalo virus antibodies were determined with a commercial enzyme immune test. The virus-specific antibody titers are higher by a factor of 1.3 to 1.5 in the fetal than in the maternal serum. In contrast, the concentration of the corresponding antibodies in the amniotic fluid is approximately 5 titer levels (log 2) lower than in the maternal serum - regardless of the maternal antibody titer level. In view of its low concentration of antibodies the amniotic fluid can hardly be regarded as an "immunological barrier" if it serves as a "transport or distribution medium" in some virus infections. However, passive intra-amniotic immunization could be useful for combating certain virus infections during pregnancy, especially just before term.

[Is there a relation between an increase in IgM in the newborn infant and the course of pregnancy and labor?]. / Besteht zwischen einer IgM-Erhöhung des Neugeborenen und dem Verlauf von Schwangerschaft und Geburt ein Zusammenhang?

In order to check the significance of the serum IgM concentration in newborns the IgM levels in the placental blood of 263 randomly selected neonates were determined; in 105 of these children the IgM concentration was again determined on the 6th day of life. The maternal IgM concentrations were also determined for the purpose of comparison. All of the newborns were allocated to infection risk categories on the basis of history and clinical data. The findings were evaluated on the basis of the mean values with simple standard deviation, single-case analysis and arrangement of the medium values in sequence. Significantly elevated IgM concentrations were found in newborns with the risk factor asphyxia on the 6th day of life. There was a certain tendency to elevated IgM concentrations - established on the basis of the mean values and the median value grouping - in the groups with maternal infection, premature rupture, frequent vaginal examination, and post-term birth of the child. The investigation shows that the majority of elevated IgM concentrations in neonates in whom no infection can be found are not closely correlated to a certain risk factor. An elevated IgM concentration in a newborn appears to be a factor of low specificity with regard to infection. However, in the diagnosis of neonatal infections it provides additional information in the overall context of the clinical examination.

[Manifest chickenpox reinfection in pregnancy with low varicella antibody titer?]. / Manifeste Windpocken Reinfektion während der Schwangerschaft bei niedrigem Varizellen-Antikörper-Titer?

The report concerns a case of an obvious varicella reinfection during pregnancy and the course of varicella-IgG and -IgM titers, respectively. By means of early diagnosis with an enzyme-linked immunosorbent assay (Elisa) and immediate application of a high - titered commercial varicella-zoster immunoglobuline, an infection of the foetus was probably prevented.

[Evaluation of the effects of active rubella vaccination. Comparative studies of the evaluation of seroconversion using the ELISA technic and the hemagglutination inhibition test]. / Zur Beurteilung des Impferfolgs nach aktiver Röteln-Impfung. Vergleichende Untersuchung zur Bewertung der Serokonversion mittels ELISA-Technik und Hämagglutinationshemmtest.

31 women were vaccinated with attenuated rubella-virus (RV) strains. According to the prevaccinal antibody status they were grouped as follows: I: HIT 1: less than 10, RV-specific IgG 1: less than 20; II: HIT 1: less than 10, RV-specific IgG 1: greater than 20; III: HIT 1: greater than or equal to 10, RV-specific IgG 1: greater than 30. The postvaccinal geometric mean titers for RV-ELISA-IgG were somewhat higher in group II compared to group I, eventually because of a weak booster effect based on low level prevaccinal RV-antibody titers--but the difference is not significant for 5%. The difference between RV-ELISA-IgG in group II and group I is significant. Within group II there is a low titer rise upon vaccination although elevated prevaccinal titers were already present. The quotient "RV-ELISA-IgG-titer: HIT-titer" is in the range of greater than or equal to 23:1 for the postvaccinal period (8-10 weeks after vaccination) compared to about 8:1 resp. in stationary sera of reconvalescent individuals. These quotients could be helpful for interpretation of suspicious elevated titers during pregnancy.

Should blood glucose monitoring be done in overweight and/or giant infants of non-diabetic mothers?

Monitoring of serum glucose levels in 60 asymptomatic overweight (4.000-4.499 g) and giant (greater than 4.500 g) newborns of non-diabetic mothers during the first 72 hours of life did not reveal pathological values. The mean result of giant infants was lower than that of the group less than 4.500 g. In mothers of overweight infants diabetes mellitus should always be kept in mind. However, the diagnosis may be difficult particularly in its latent form due to metabolic alterations caused by pregnancy. For this reason it is necessary to monitor blood glucose levels for hypoglycemia in these newborns just as in infants of mothers having a manifest diabetes mellitus.

Studies of the uptake and distribution of inulin and alpha-aminoisobutyric acid after intraamniotic injection in the guinea pig.

Pregnant guinea pigs were given intraamniotic injection of 14C-alpha-aminoisobutyric acid and 3H-inulin. Both substances were taken up by the fetus in different concentrations. High levels of alpha-amino-isobutyric acid were found in the placenta, liver, and serum. Inulin on the other hand, being a macro-molecule distributed by diffusion in the extracellular space, was found in high concentrations in the small intestine and in the placenta. Thus the main pathway for transferring nutrient substances from the amniotic fluid to the fetus would seem to be the gastro-intestinal tract. Thus supplementary nutrition of the fetus by the intraamniotic injection of nutrients is a possibility.

The transcutaneous PO2 measurement as an additional evaluation index to the physiological and pathological conditions under delivery.

Transcutaneous PO2 was continuously recorded from 17 newborns sub partu by normal deliveries and four cases with umbilical cord complications. These data were correlated with the corresponding fetal heart rate alterations and the maximum of contraction directly and 30 s thereafter. During the course of delivery three stages are differentiated: first stage of labor, full cervix dilatation, second stage of labor. The statistical evaluation succeeded in the X2-test (P less than 0.01). Deriving from this result the tcPO2 measurement is an additional aiding procedure beside the cardiotocographic control for subpartal supervision.

[Determination of cytomegalo-, herpes simplex- and rubellavirus-antibodies resp. during perinatal period by Elisa-technique (author's transl)]. / Bestimmung der Zytomegalie-, Herpes- und Rötelnvirus-Antikörper mit der Elisa-Technik in der Perinatalperiode.

Cytomegalovirus (CMV)-infections attract increased attention among viral infections in the pre- und perinatal period resp. The decreasing cell mediated immunity by the end of pregnancy may favour conditions for primary infections or reactivations with CMV. With the Elisa-technique we looked for CMV-specific antibody status in the perinatal period with special respect to striking titers. The same serum samples were screened for antibody status to Herpes simplex virus (HSV) type 1 specific IgG and rubellavirus specific IgG resp. 67% were positive for CMV-IgG, 90% for HSV-type 1-IgG and 93.5% for rubellavirus IgG. CMV-specific IgM antibodies were found in 3.6% but only 1.5% were suspicious for recent CMV-infections according to higher CMV specific IgM titers.

[Therapy of the malnourished fetus. Organ distribution of intraamniotic alpha-amino-isobutyric acid]. / Therapie des mangelversorgten Feten. Organverteilung nach intraamnialer Injektion von alpha-amino-Isobuttersäure.

After intraamniotic injection alpha-amino-isobutteracid is resorbed rapidly by the fetus. High concentrations can be found in liver, lungs, placenta and serum. Main organs of resorption are the intestine but also placenta and lungs. Resorption and distribution of substances occur more rapidly in younger fetus than in later stages of pregnancy. In spite of different haemodynamic and function of some fetal organs there are a lot parallels in the fetal preterm and newborn infant physiology. Because of the capacity of the fetal intestinal mucosa to resorb high molecular substances without hydrolysis, there appears a possibility of a compensatory paraplacental nutrition in certain cases. This is especially important as this way of nutrition is of significance physiologically in certain early stages of pregnancy.

[Animal experiments with ligation of intestinal segments to study absorption of alpha-amino-iso-butyric acid by intestinal mucosa of foetus (author's transl)]. / Tierexperimentelle Untersuchungen mit abgebundenen Darmsegmenten zur Frage der Resorption von alpha-Aminoisobuttersäure durch die fetale Darmschleimhaut.

The authors developed an animal model with ligation of intestinal segments of guinea pig foetuses. Evidence was found to the effect that amino acids were absorbed in high concentrations by foetal jejunum. A peculiar aspect, additionally detected, was relating to the capability of foetal intestinal mucosa to absorb large-molecular substances, such as inulin.

[Rubella vaccination during puerperium? Effect of rubella vaccination during puerperium on the titer of HAH]. / Röteln-Impfung im Wochenbett? Einbluss der Röteln-Impfung im Wochenbett auf vorbesthende HAH-Titer.

The rubella-HI-titer of 142 women vaccinated against rubella during childbed and 126 women not vaccinated during childbed were tested at the time of delivery and again 10-12 weeks later. The results show booster effects if prevaccinal titer were low. In the case of higher prevaccinal titer a titer reduction due to vaccination results.

[Surgical refertilization by means of laser technic. Animal experimental study]. / Zur operativen Refertilisierung durch Laser-Technik. Tierexperimentelle Untersuchungen.

Animal experiments on rabbits with a CO2 laser concerning end-to-end-anastomosis of cornua uteri are reported. The rate of success of this laser technique by a before investigated optimal energy density of 64 Watt sec/cm2 (8 Watt,0,2 sec) was about 70% deliveries without any complication. This method could be an alternative to the presently used microsurgical methods of refertilisation in human tubar sterility.

[Animal experiment studies on the question of damage to the fetal kidney by gentamycin]. / Tierexperimentelle Untersuchungen zur Frage einer Schädigung der fetalen Niere durch Gentamyzin.

It is reported about animal experiments of pregnant guinea pig. We found a special affinity of gentamyzin to maternal and fetal kidney-tissue. The application of this aminoglycosid seems therefore problematic in pregnancy.

[Influence of different obstetric-manipulations on the continuous measured pO2-tension upon the fetus sub partu (author's transl)]. / Einfluss unterschiedlicher geburtshilflicher Massnahmen auf die kontinuierlich gemessene pO2-Spannung des Feten sub partu.

The influence of different obstetric-manipulations and medicamental applications was investigated in regard of the continuous measured fetal intrauterine pO2-tension sub partu. By demonstrating some original registrations it was intended to point out the efficiency of these obstetric-manipulations.