[Smoking and gestosis: comparative results of clinical and histomorphometric studies]. / Rauchen und Gestose: Vergleichsergebnisse klinischer und histomorphometrischer Untersuchungen.

Altogether 85 term placentae (20 from gestosis patients, 44 from patients who smoke and 21 normal term placentae) were examined macroscopically, microscopically and autoradiographically. The results and clinical data were analysed: strong smokers were compared with severe gestosis patients. A direct relation between reduced birthweight and placental insufficiency in gestosis patients and smokers could be established. In gestosis patients we found a "negative"--hypotrophic structural change of the placenta as a result of haemodynamic disturbance. In patients who smoke we found a "positive"--hypertrophic structural change of the placenta as an adaptation and compensation to the hypoxic stimulus of nicotine.

[Graduated ruler for making a transverse suprapubic incision]. / Règle graduée pour incision transversale suprapubienne.

The transverse suprapubic incision is the most usual approach to laparotomy in obstetrics and gynaecology. It has many advantages both from the aesthetic as well as the functional points of view. The low transverse scar is hidden in the region of the pubis. Post-operative breakdowns (such as hernia and eventertion) that occur with longitudinal incisions have almost disappeared. The site, the length and the height of the incision vary according to the surgeon's ideas and his experience. The result cosmetically therefore varies and the optimum benefit is not always achieved. We describe a graduated ruler specially designed for the transverse suprapubic incision. It was worked out in 1984. It makes it easier to standardise the technique of suprapubic incision, but one that can be changed according to variations in body contours. The ruler can be sterilised. It is available in two models: one, a flexible one which is ideal for caesarean sections and laparotomies in fat women or where the abdominal wall is distorted by tumours under it; the second model is rigid and should be able to be used on the normal flat abdomen. One and a half years experience shows that the ruler can be used to standardise the technique of transverse suprapubic incision. It also helps to teach this method of laparotomy; and the cosmetic results have become better.

Urinary protein patterns and preeclampsia.

A retrospective study of urinary protein patterns, as determined by SDS-PAA-disc-electrophoresis was performed in 107 patients in third trimester of pregnancy because of preeclampsia. The aim was to determine whether the protein patterns allow a differentiation between nephropathies associated with genuine toxaemia of pregnancy and those in which toxaemia was superimposed on preexisting renal glomerular or tubular disease. The magnitude and type of proteinuria was related to the mean arterial pressure (MAP). 47% of all patients showed a mixed protein pattern independent of the MAP-severity. This form of proteinuria is probably associated with a genuine toxaemia of pregnancy. It was not possible to determine if pure glomerulopathies whose frequency rose with MAP, had already been present before pregnancy. In a third of the 22 patients followed-up post-partum pathological protein patterns or increased protein excretion was detected. This implies that 35% of the nephropathies were present before pregnancy. However, differentiation between preexisting and toxaemia associated nephropathy was not always possible. SDS-PAA-analysis of urinary protein should be carried out in earlier stages of pregnancy in cases of increasing MAP and proteinuria.