[Total cervix occlusion--an efficient measure in prolapsed amniotic membranes in extreme prematurity?]. / Der totale Muttermundsverschluss--eine effiziente Massnahme bei prolabierender Fruchtblase im Bereich der extremen Frühgeburtlichkeit?

BACKGROUND: We analysed retrospectively whether the total cervix occlusion implicates efficient the prolongation of pregnancy in patients with bulging fetal membranes during extreme prematurity. PATIENTS AND METHODS: Between 1993 and 1999 nineteen pregnant women (17 singleton and 2 twin pregnancies) with cervical incompetence and bulging membranes at 20 to 27 weeks' gestation (mean 24 weeks) underwent total cervix occlusion (TCO) at the Department of Obstetrics at the Technische Universität of Munich after taking cervical cultures, prophylactic antibiotic treatment, tocolysis and induction of fetal lung maturity (after 33 weeks of gestational age). RESULTS: Eleven of nineteen pregnancies were carried beyond 32 weeks' gestation. 6 of 21 fetuses, included 2 twin pregnancies died. Considering the perinatal mortality the mean prolongation of pregnancy was 9.4 weeks after total cervix occlusion. 9 of 19 pregnant women were delivered beyond 37 weeks of gestational age. CONCLUSION: Taking the small number and the lack of a randomized trial into consideration, these results implicate the total cervix occlusion as an efficient method in cases of bulging membranes during extreme prematurity. Nevertheless a thorough postoperative control and screening of infectious complications are required.

[Initial experiences with primiparous women using a new kind of Epi-no labor trainer]. / Erste klinische Erfahrungen bei Erstgebärenden mit einem neuartigen Geburtstrainer Epi-no.

PURPOSE: The effectiveness of a vaginal dilatator (Epi-no) in avoiding episiotomies and improving the fetal outcome was examined. DATA SOURCES AND METHODS: Fifty pregnant women were included in our prospective study and took part in the prepartal birth training program with Epi-no. Matched-pairs were compared for the rate of episiotomy and perineal tears, neonatal APGAR score, average time of training, duration of labour and analgesia during delivery. RESULTS: We found a significant reduction in the rate of episiotomies in the group of women who participated in the birth training program with Epi-no (EG: 49%) compared to women who did not take part in our training program (NEG: 82%). Also the rate of perineal tears was twice as high in the latter (4% vs. 2%). Moreover, children of women of the EG showed better one-minute-APGAR-scores. In addition to this we found a significant reduction in the average duration of the second stage of labour in the EG (29 min) if compared with the NEG (54 min). Women in the EG had a lower rate of PDA (16% vs. 36%) and needed less analgesics than those in the NEG. Women of the EG who delivered without episiotomy had trained on average two days longer than women who had had an episiotomy. CONCLUSION: Birth training with Epi-no decreases the rate of episiotomies in primiparous significantly.

A standard large wound of the corneal epithelium in the rabbit.

A method of iodine vapor cautery was applied to rabbit eyes. The cautery produces an approximately circular area denuded of epithelium of uniform size. The eye is not inflamed, and the very rapid mean healing rate of 1.42 mm2hr-1 was observed.