[Heart disease and pregnancy--results of consequent interdisciplinary management]. / Herzerkrankung und Schwangerschaft--Ergebnisse konsequenter interdisziplinärer Betreuung.

In this paper it has been published about the interdisciplinary cooperation during the treatment of 143 pregnant women having heart diseases. In spite of a partial centralisation this number only 0.46 per cent of all deliveries in a period of 16 years. 32.1 per cent of the cases are congenital heart diseases and 46.2 per cent acquired heart diseases. In the acquired heart diseases mitral failures prevailed. Pacemakers have to be applied preventively only in 6.3 per cent. NYHA-stages did not impair during pregnancy. Vaginal operative delivery is compulsory only in two of seven cases heart diseases indicated a cesarean section. Consequent early get-up in the puerperium is important in NYHA-stages I-III. Maternal mortality was 0. Perinatal mortality was 0.7% (one child died antenatally).

[Serum uric acid as a prognostic parameter in prenatal monitoring of gestoses]. / Die Harnsäure im Serum als prognostischer Parameter bei der präpartalen Uberwachung der Gestosen.

A correlation between gestosis and increase of serum uric acid level has been known for a longtime. From the 6th month of pregnancy we found significantly increased values in all hypertensive pregnant women. In the 7th and 8th month of pregnancy there was a high significant deviation in gestoses second degree (classification of the organisation gestosis). In the two last months of pregnancy all gestoses deviated high significantly from the uric acid level in serum of the normal collective. There is a correlation between pathologically increased mean uric acid values in the 9th and 10th lunar month and increased systolic and diastolic blood pressure values. The uric acid level in pregnant women with gestosis, whose illness or its consequences led to cesarean section, is significantly higher than in patients with normal delivery. In accordance with literature we could not find a limit above the fetus dies. In our opinion determination of plasma uric acid in late pregnant hypertensive women is one additional parameter calculating both maternal prognosis and fetal risk.

[Plasma aldosterone in pregnancy, during labor and in the newborn infant]. / Untersuchungen zum Plasmaaldosteron in der Schwangerschaft, unter der Geburt und beim Neugeborenen.

Plasma aldosterone levels of mother and child during pregnancy were measured by means of radio-immuno assay without chromatography. In cases of unconspicuous pregnancy average aldosterone concentrations were found to increase from 23.2 ng/100 ml in the first trimester to 37.2 ng/100 ml in the second trimester and further to 64.0 ng/100 ml in the third.--High values were recorded from mothers (71.9 ng/100 ml) after birth and from umbilical cord blood of vaginally delivered newborns (83.4 ng/100 ml).--Aldosterone values as low as 60.9 ng/100 ml were recorded from newborns delivered by caesarean section with reduced parturitional stress. These were lower with significance than the levels recordable from newborns after spontaneous vaginal delivery (83.4 ng/100 ml). Values lower with significance were recorded from plasma of pre-eclamptic women in the third trimester (41.9 ng/100 ml).--No difference was found to exist between aldosterone concentrations in umbilico-arterial blood, on the one hand, and those in umbilico-venous blood, on the other.

Study of plasma aldosterone in normal pregnancy, in pre-eclamptic women and in cord plasma of newborns.

A radioimmunoassay without chromatography was used for the determination of plasma aldosterone in pregnancy. The mean values (+/- S.D.) of aldosterone concentration increased consistently from 23.2 +/- 5.3 ng/100 ml (n = 14) during the first trimester to 37.2 +/- 10.6 ng/100 ml (n = 17) during the second trimester and 64.0 +/- 18.8 ng/100 ml (n = 29) during the third trimester of pregnancy. The highest values were found at delivery (71.9 +/- 14.2 ng/100 ml; n = 21) and in the cord plasma of newborns (83.4 +/- 14.9 ng/100 ml; n = 21). Significantly lower plasma aldosterone values were found in the plasma of pre-eclamptic women during the third trimester of pregnancy (41.9 +/- 21.3 ng/100 ml; n = 11).