[Compliance in gynecologic screening and causes for delayed tumor diagnosis in East Thüringen]. / Compliance für gynäkologische Vorsorgeuntersuchungen und Ursachen von Tumorverschleppung in Ostthüringen.

The public health service of the former GDR paid special attention to early recognition and the registration of malignancies. Due to this efforts the staging of cervical cancer moved to more low-staged tumours admitted to our hospital from the eastthuringian region. In spite of this around 35% of our patients with malignant diseases had stage II or higher staged tumours ad admission. The causes for delayed perception were analysed. Campaign-like preventive actions formerly supported by factories and public health service will not take place again. The responsibility for secondary prevention has to be taken over by practicing gynaecologist in cooperation with the general practitioner. A pilot study revealed that only 11% of the women followed a written invitation for a preventive gynaecological examination. But a general practitioner concerning the patients individuality persuaded 75% of his patients letting perform such a check up. The family doctors direct advice to consult a gynaecologist is the most effective way to get the patients compliance for a preventive examination. The epidemiology and results of therapy will become evident by duty of notification and central registration of malignancies. Relatively centralized therapy and obligatory follow up under the responsibility of the treatment center for about five years enhance the therapeutic results. The positive experience of gynaecological oncology of the eastern part of the Federal Republic of Germany ought to be maintained and should be developed.

[Side effects of intrauterine pessaries--a retrospective study]. / Nebenwirkungen bei Intrauterinpessaren--eine retrospektive Studie.

Based upon a retrospective evaluation of 27,519 cycles in 932 patients, we determined the type and rate of incidence of side effects. In 57.2% of the patients, the course was without any complaints. Approximately 80% of all complications, induced by IUD, occur already during the first 3 months after insertion, with the exception of pelvic inflammation and pregnancy. 62.5% of the adnexitides and/or endometritides were observed during the 4-year observation period during the first 12 months without time cumulation; this applies likewise to the pregnancies occurring with IUD. The largest proportion of side effects were haemorrhagic disorders (33.2%), followed by recurrent pain in the lower abdomen (9.9%).

[Fetal movement and acceleration behavior in hypertension in pregnancy]. / Fetales Bewegungs- und Akzelerationsverhalten bei Schwangerschaftshypertonie.

Under standardized conditions, 26 pregnant women with pregnancy-related hypertension of different degrees were submitted to cardiogram-synchronous recording of fetal body and respiratory movements. The gestational age was between the completed 34th and 38th weeks. Of the 26 fetuses of the risk group, 20 were normotrophic and 6 hypotrophic. 40 normotrophic unimpaired fetuses of the same gestational age served as a control group. The average duration of the examination period was 70 minutes. The fetal movement and acceleration behaviours did not differ between the normotrophic fetuses of the risk group and those of the control group. The hypotrophic fetuses from the risk group, however, had significantly lower fetal body and respiratory activities than the normotrophic fetuses from this group. The same holds true for the degrees of heart rate activity. It can be concluded that pregnancy-related hypertension as the only pregnancy complication does not have a measurable influence on fetal movement and acceleration behaviours. This is true for both treated and untreated pregnancy-related hypertensions. The severity of pregnancy-related hypertension is not primarily reflected in changes of fetal movement and acceleration behaviours, either. This means that the parameters presented are not suited to prognosticate the effects of pregnancy-related hypertension on the fetus a priori. The situation becomes quite different if in addition to pregnancy-related hypertension some intrauterine fetal growth retardation develops. In this case, the fetus indicates its impairment by increasingly impaired movement and heart rate activities as a consequence of chronic oxygen deficiency.

[Anal manometric studies following 3d degree perineal tear]. / Analmanometrische Untersuchungen nach Dammriss III. Grades.

This study shows clinical and manometric data of fecal continence following third degree tears in correlation to anamnestic findings. The results are discussed with reference to the literature.

[Results of therapy of endometrial carcinoma and analysis of risk factors in comparison with a control group]. / Therapieergebnisse beim Endometriumkarzinom und Risikofaktorenanalyse im Vergleich mit einer Kontrollgruppe.

Overall 1,021 patients with endometrial carcinoma were treated between 1965 and 1982 at the Department of Obstetrics and Gynecology and the Department of Radiology, Friedrich-Schiller-University, Jena. The 5-year-survival rate of all patients amounted to 63%. The 5-year-survival probability with primary surgery was 76.1%, with primary irradiation 34.4%. The frequency of risk factors in the patient group was compared with an age adjusted group of patients who underwent a D & C due to irregular bleeding of benign causes. Overweight and infertility were evaluated as significantly more frequent risk factors in cancer patients. There was no significant difference between the two groups concerning the factors hypertension, diabetes, heart-diseases, irregular bleeding and history of carcinoma in the family.

[Results of treatment of ovarian cancer patients at the Jena University Gynecological Clinic 1974-1983]. / Behandlungsergebnisse bei Ovarialkarzinom-Patientinnen an der Universitäts-Frauenklinik Jena in den Jahren 1974-1983.

In a retrospective analysis 228 patients suffering from ovarian carcinoma were investigated. They had been treated at the Dept. of Gynecology of Jena from 1974 up to 1983. We determined remission rate, remission time, and 5-year survival. Conclusions of our analysis are the following: The incidence and 5-year survival of patients suffering from ovarian cancer are nearly constant during the time interval obtained in this study. Survival will be determined by 38%. Early stages (I and II) were treated only by operation while patients suffering from higher stages (III and IV) were undergone chemotherapy and/or radiotherapy. We obtained value of the remission rate and the 5-year survival rate, comparable to these reported in literature.

[Acute urine retention in a large myoma of the perivesical connective tissue]. / Akute Harnverhaltung bei grossem Myom des perivesikalen Bindegewebes.

In this paper we present the base history of a 49 years old patient suffering from acute bladder outlet obstruction caused by a large leiomyofibroma of the perivesical connective tissue. We discuss our experiences with the results reported by literature. We conclude that the team work of urologists and gynecologists was very important to cure this women.

[Experiences in the diagnosis and evaluation of recto-anal incontinence disorders]. / Erfahrungen bei der Diagnostik und Bewertung rektoanaler Inkontinenzbeschwerden.

Report on diagnostic procedure to clear complaints about anorectal incontinence objectively. Special hint on the importance of electromanometry of the continence organ.

[Therapy and treatment results of cervical cancer in the Medical School of the Friedrich Schiller University of Jena from 1965 to 1976 (report on 1453 cases)]. / Therapie und Behandlungsergebnisse beim Zervixkarzinom am Bereich Medizin der Friedrich-Schiller-Universität Jena in den Jahren 1965 bis 1976 (Bericht über 1453 Fälle).

In this paper, therapeutic results of 1,453 cervical cancer patients stage T1-T4 who have been treated at the Gynaecological Hospital and the Radiological Hospital of Jena University are reported. The overall Five-Year Survival Rate amounted to 68.4 per cent. Surgical and radiological therapeutic measures are demonstrated with regard to their development and to side effects between 1965 and 1983. As a consequence of the results obtained the necessity for treating cervical cancer patients in a cancer center has to be stressed.

[Results of the treatment of cervical cancer at the Department of Medicine of the Friedrich Schiller University in Jena 1965-1976. I. Surgical therapy only]. / Ergebnisse der Behandlung des Zervixmalignoms im Bereich Medizin der Friedrich-Schiller-Universität Jena in den Jahren 1965-1976. I. Mitteilung: Alleinige operative Therapie.

The early stages of the cervical carcinoma require a different treatment after special diagnostic measures to prevent therapeutic lesions or overtreatment. In this paper therapeutic results are reported obtained from 269 patients with cervical carcinoma category T1 which were operated on without any other therapeutic measures from 1965 to 1976. - Five-year survival rates were 97 per cent. The results show that the new trend for malignant diseases: as conservative as possible and as radical as necessary, didn't increase the risk of recurrence. The change from vaginal radical hysterectomy to hysterectomy in stage Ia or abdominal radical hysterectomy in stage Ib improved the results of treatment.

[Genital carcinoma in pregnancy]. / Zum Genitalkarzinom in der Schwangerschaft

From 1949 to 1974 there had been found and treated 131 malignant genital tumours during pregnancy post partum and post abortum at the Clinic of Obstetrics and Gynaecology of the University of Jena. The 5-year rate of surival of cervical carcinomas was 59,6%. That is no difference to cases discovered outside of pregnancy. It is discussed the possible influence of pregnancy on the growth of cervical cancer.

[The significance of meconium-containing amniotic fluid at the onset of labor following a normal pregnancy]. / Bedeutung von mekoniumhaltigem Fruchtwasser zu Beburtsbeginn nach normalem Schwangerschaftsverlauf

The delivery process of 218 gravids admitted after a normal course of pregnancy with meconium containing amniotic fluid are analysed. The higher operative frequency (25,2%) in comparison with the test group (10,9%) and the fact that in 4 fetuses the pH value on admission was under 7,20 confirm the recommendation to make obligatory the admission amnioscopy of all gravids at the beginning of birth. This practice involves continuous medical shift work. The perinatal mortality of the analysed deliveries was 0,46%.

[Correlation of antenatal cardiotocogram and amnioscopy in the management of pregnant women with prolonged pregnancy]. / Korrelation von antenatalem Kardiotokogramm und Amnioskopie bei der Uberwachung von Schwangeren nach Uberschreitung des errechneten Geburtstermins

In 125 women whose pregnancy continued for more than the calculated date of delivery 171 CTG were written and the parameters were analysed quantitatively. The lead of the CTG involved an amnioscopy in each case. The findings were compared with each other and with the condition of the newborn. The results show: 1. The normal value for the density of fluctuation-types (given by Rüttgers [15]) exceed in our cases. 2. A significant increase of density for the silent fluctuation-type was demonstrated well overdue of the calculated date. 3. There is no close correlation between the findings of the amniotic fluid and the characteristerics of CTG in excess of the fixed birthdate, even if the newborns show symptoms of overmaturity. The combined application of amnioscopy and prenatal CTG are considered as valuable methods to recognise the fetal risk early in post-term birth.