[Morbidity and mortality in 1984-1985 of premature infants in breech presentation with a birth weight equal to or less than 1,500 g. A prospective study on the question of vaginal or abdominal delivery]. / Zur Morbidität und Mortalität in den Jahren 1984-1985 aus Beckenendlage geborener Prämaturer mit einem Geburtsgewicht less than or equal to 1500 g. Eine prospektive Studie zur Fragestellung vaginaler oder abdominaler Entbindungsweg.

The effect of the obstetrician's choice for delivery route on the early morbidity and mortality of very low birth weight infants in breech presentation (less than or equal to 1500 g) was studied prospectively in 22 children. Criteria of the morbidity were beside antenatal cardiotocogram, the Apgar-score at 1, 5 and 60 min., the cord venous pH-value and the duration of assisted ventilation after immediate delivery. From the first to 28th day of life we continuously analyzed the lowest oxygen pressure, the highest carbon dioxide pressure, therapy with NaHCO3 and the duration of assisted ventilation. But there were no significant differences in morbidity data and mortality between the newborn infants after vaginal and abdominal delivery. However the brief duration of assisted ventilation and brief ventilation time with a FiO2 greater than 0.3, after abdominal delivery were striking despite of a negative starting point of these children. For that reason we are of opinion that a well-timed abdominal delivery of very low birth weight infants in breech presentation shows a favourable influence on the normalization of metabolic and respirations data in the postnatal period and by this on the early morbidity.

[Oral long-term tocolysis of threatened premature labor using clenbuterol (Contraspasmin, Spiropent). A placebo-controlled double-blind method]. / Orale Langzeittokolyse der drohenden Frühgeburt mit Clenbuterol (Contraspasmin, Spiropent). Eine plazebokontrollierte Doppelblindstudie.

In quest of a efficacious oral tocolysis drug for inhibition the preterm labour we used in a randomised study the betamimeticum Clenbuterol or placebo with 1 tablet 3 times daily (3 X 0.02 mg/d Clenbuterol) in a total number of 109 patients. In result we can't see any significant distinction in gestational age and birth weight at delivery time and in duration of therapy up to delivery between the two groups. For that reason we are of the opinion, that a fundamental influence of Clenbuterol on premature birth cannot be expected.

[Effects of various anesthesia procedures used in forceps delivery on the cardiopulmonary adaptation of the newborn infant. 1. Modification of cardiac adaptation]. / Die Auswirkungen verschiedener zur Forcepsentbindung angewandter mütterlicher Anästhesieverfahren auf die kardiopulmonale Adaptation des Neugeborenen. 1. Mitteilung: Die Beeinflussung der kardialen Adaptation.

Healthy, spontaneously born infants, delivered at the calculated time shows a postnatal tachycardia combined with harrowing of oscillation. But then there is a normalisation in heart action. This phenomenon is nearly the same both in spontaneous delivery and intubation anesthesia for forceps delivery starting with propanidid. Therefore propanidid is of less risk for the neonate. But after hexobarbital anesthesia our results reveal a lingering cardial adaption of the neonate, which is statistical significant. This points to possible cardiac depressive side effects of this drug. Therefore the usage of hexobarbital anesthesia should be well considered in obstetrics.

[Effects of various anesthesia procedures used in forceps delivery on the cardiopulmonary adaptation of the newborn infant. 2. Modification of pulmonary adaptation]. / Die Auswirkungen verschiedener zur Forcepsentbindung angewandter mütterlicher Anästhesieverfahren auf die kardiopulmonale Adaptation des Neugeborenen. 2. Mitteilung: Die Beeinflussung der pulmonalen Adaptation.

Mature newborns reveal the same pulmonal adaption to extrauterine conditions after forceps delivery in general anesthesia for the mother beginning with propanidid or hexobarbital as newborns after spontaneous delivery. Intervalls of apnoe, being physiological during neonatal adaption up to the fourth life-hour, occurred in all three tested groups in the same frequency. Genuine apnoe in combination with following bradycardia and cyanosis couldn't be observed. Moreover during the whole examination time all mean values of respiration frequency were physiological. Therefore we believe that there is no fundamental deterioration of newborns respiration, i.e. a depression in nerve-centre, caused by propanidid or by hexobarbital, despite of repeatedly contrary description.

[Effect of the oral beta-mimetic drug clenbuterol (Contraspasmin, Spiropent) and orally and intravenously administered Partusisten on the rheobase]. / Der Einfluss des oralen Betamimetikum Clenbuterol (Contraspasmin, Spiropent) sowie oral und intravenös verabfolgten Partusistens auf die Rheobase.

Clenbuterol (Contraspasmin, Spiropent) was used to treat threatened delivery in a dosage of three times 0.02 mg per day because of its beta-mimetic effects and the halflife time for elimination of 34 hours. We examined the effect of Clenbuterol on the maternal rheobase as a factor to estimate the influence of this drug on neuromuscular structures of maternal organism. After the first oral application of Clenbuterol we found a significant decrease in this value and after second and third application a distinct fluctuation. This fact shows besides the positive beta-mimetic properties the side-effects on the vegetative nerve system and on neuromuscular structures of the female body.

[Use of beta mimetics in cerclage operations]. / Zur Anwendung von Betamimetika im Rahmen der Zervixverschlussoperationen.

This paper deals with the change of rheobase in connection with the cerclage of cervix uteri. For this reason special attention is paid to the starting value of rheobase before operation and its reaction after cerclage using comparable parameters like pelvic score, gestational age at the beginning of lying-in treatment and date of cerclage. Based on our results we have to state that a cerclage is justified only in genuine insufficiency of cervix uteri provided there are no contractions, and the rheobase at the starting point is above of a defined level.

[Effectiveness of clinical action in treatment of premature birth problems (author's transl)]. / Zur Wirksamkeit klinischer Massnahmen bei der Behandlung der Frühgeburtlichkeit.

The effectiveness of clinical action on a general premature birth situation was studied against the background of 21, 244 childbirths (twins and stillbirths included), in the District of Erfurt, between 1974 and 1979. Clinical attention was considerably stepped up in all cases of imminent premature birth. Steps taken included hospitalisation, sedation, medicamentous tocolysis, cerclage, maturity induction, and organisational measures. Many more people than ever before were called in for action. Yet, no significant change was achieved, neither in terms of the absolute premature birth rate nor in restricting such problems to higher age or weight groups. -- Sizable reduction of perinatal mortality in the period under review was in no way related to measures to reduce the premature birth rate, but it was rather attributable to improvement in prenatal and intranatal diagnosis and in postnatal care. -- The conclusion is that action outside hospital should be intensified.

[Uninvolved combination of hardware for objectivation of rheobase measurement (author's transl)]. / Einfache Gerätekombination zur Objektivierung der Rheobasemessung.

Reported in this paper is a combination of equipment by which muscular response in rheobase measurement can be recorded. Hence, some of the possible errors relating to the human factor in using conventional methods will be ruled out, and better comparability between different author's findings will be ensured.