[The determination of surface tension in amniotic fluid as a simple method for the diagnosis of fetal lung maturity (author's transl)]. / Die Messung der Oberflächenspannung im Fruchtwasser als einfache Methode zur Bestimmung der fetalen Lungenreife

For the past several years it is possible to determine the maturity of the fetal lung from the amniotic fluid. Towards the end of the pregnancy the content of surface active substances for instance Lecithine, increases in the amniotic fluid. It is therefore possible to determine the maturity of the fetal lung directly by measurements of the surface tension in the amniotic fluid. In 265 patients from 17 to 42 weeks gestation a total of 340 determinations of the surface tension in the amniotic fluid were carried out. A simple commercial interfacial tensiometer was used. The clinical value of the measurements was determined by the occurrance of a respiratory distress syndrome which was objectively evaluated by the so called Hobel Score. The determination of the surface tension for the amniotic fluid is valuable as a screening test prior to the determination of the relatively expensive L/S ration. The test was compared with the Clements Test which is also a screening procedure.

[Feto-maternal microtranfusion after amniocentesis in the 2nd trimenon (author's transl)]. / Fetomaternaler Erythrozytenübertritt nach Amniozentese im zweiten Trimenon

120 healthy patients 16 to 34 years of age were studied. All patients were admitted to the clinic for legal abortion and were admitted to the clinic for legal abortion and were between 16 and 20 weeks pregnant. Amniocentesis were performed for intraamniotic application of prostaglandins. The incidence of microtransfusion of fetal red blood cells in these patients were studied. Blood samples were taken before and one hour after amniocentesis. 104 patients (86.7 p.c.) did not show any fetal erythrocytes in the peripheral blood neither before nore after amniocentesis. In ten patients (8.4 p.c.) less than 0.055 ml transfused fetal blood were determined as well before as after the puncture of the amniotic sac without any increasing tendency. In six patients (4.9 p.c.) signs of an induced fetal-maternal-microtransfusion could be proved. All six patients had no fetal cells in the circulation before treatment. Four of these had a microtransfusion of less than 0.05 ml, two patients between 0.05 and 0.10 ml. The localisation of the placenta by ultrasonic technic as an absolutely demand before amniocentesis is strongly recommended, especially in cases of prenatal diagnostic purpose.

[Pre- and postnatal treatment of severe Rh-erythroblastosis (author's transl)]. / Pränatale und postnatale Behandlung der schweren Rh-Erythroblastose

162 children with severe Rh-erythroblastosis were treated with 326 prenatal blood transfusions. 89 (55%) survived. The indication and technique for this treatment and the postnatal intensive care of the newborn are reported. Prenatal diagnosis is extended by the author's immunofluorescence technique assessing the fetal Rh factor D even as minute contamination amongst other cells, in order to privente unnecessary treatment of Rh negative children. Checking the effectiveness of prenatal blood-transfusion this technique can demonstrate differences in the counts of HbF- and D-cells. Success of treatment appears to be, in part, determined by dexamethasone just before delivery and by immediate postnatal substitution of erythrocyte concentrates and following exchange transfusion. With increasing experience the percentage of successful treatment rose. Of 40 children treated during the last 2 years with 95 prenatal transfusions, 67,5% survived. 41 fetuses had ascites already at the first prenatal transfusion. 9 of them (22%) survived. The data of the children treated, earliest in the 21st week of pregnancy, are given: Bilirubin level in amniotic fluid, number of prenatal transfusions, gestational week at delivery, hematocrit, HbF cells, number of postnatal exchange transfusions and later transfusions. Postnatal development of successfully treated children corresponds to that of other premature children without erythroblastosis.

The scope of prenatal therapy in severe rhesus hemolytic disease.

Prenatal blood transfusion of a fetus established anemia due to rhesus hemolytic disease can be life saving. In Hamburg-Eppendorf 252 transfusions in 130 babies have so far been carried out. The success rate was 51%. Out of 39 babies who had ascites at the time of the first transfusion, 13 survived. The amount of ascites aspirated at the first transfusion correlates with the prognosis: The chance of producing a living and healthy child is greater when the amount of ascites is under 5 mls than when it is over 5 mls. Babies with amniotic fluid bilirubin values from 0.4 to 0.6 still have a good chance of survival, whereas the prospects of success with values over 0.6 are very small. The technical risk of prenatal transfusion before the 27th week amounts, according to our observations, to about 6%.

[Fetal placental antigens in the serum of tumor patients]. / Fetale Plazentaantigene im Serum von Tumorpatienten

With the anti-placente rabbit serum three different placente antigens could be demonstrated in the serum of pregnant women and new borns, in ascites hydropic new borns and in liquor ammin. These fetal antigens could be also demonstrated in the serum of women with malignant and benign tumors. There was no identity with alpha1-fetal protein or C-reactive protein. It is discussed either the tumor cells synthesize fetal proteins directly or they produce substances which stimulate the organism for production of these antigens.

[Placenta antigens in serum of pregnant women]. / Nachweis spezifischer Placenta-antigene im Serum Schwangerer.

PIP: Antiplacenta serum was produced in rabbits using placenta extract; 3 different placenta antigens were demonstrated in placenta extract by means of the rabbit serum. These placenta antigens were found in the serum of pregnant women with normal and pathological pregnancies,in the urine of pregnant women, in the amniotic fluid, umbilical cord blood, and in the ascites of dropsical infants. The immunological characterization of the placental antigens is described in detail.^ieng