Gene/Protein Disease Symptom Drug Enzyme Compound
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Determination of the creatinine concentration of the amniotic fluid was undertaken between the 25th and 40th week of gestation in 114 patients. The normal serum creatinine level was simultaneously determined in 43 of these patients. The aim of this study was to examine whether this parameter of fetal renal function allows a conclusion to be drawn with respect to fetal maturity and the length of gestation. With increasing length of gestation a marked increase in the amniotic fluid and the maternal serum creatinine concentration was observed (p less than 0.01). The large scatter of the values made it impossible to relate any particular creatinine concentration to a certain week of gestation. However, if the concentration of creatinine in the amniotic fluid has reached a value of 2 mg% or more, a mature baby can be predicted in most cases. A tendency to raised levels of creatinine was seen in cases of EPH gestosis and latent diabetes mellitus. The determination of creatinine in the amniotic fluid can be recommended with certain reservations as an additional method to assess fetal maturity.
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PMID:[Creatinine during pregnancy (author's transl)]. 99 51

Because of premature labour, probability of fetal retardation, discrepance at term of delivery, Rh-incompatibility or EPH-gestosis 185 patients were hospitalized. 76 pregnant women received twice 1.5 ml Celestan Depot i.m. (4.5 betamethasone acetate and 6mg betamethasome dinatrium phosphate per injection) within an interval of 24 hours. It was necessary to maintain a tocolysis for at least 48 hours as a minimum after the first injection of Celestan Depot. The other 109 patients without treatment of glucocorticoids were considered as a controlgroup. We could show that antepartum application of betamethasone before the 38. week of gestation was associated with a reduction of RDS in our premature infants. Only one baby of the betamethasone-treated infants died of hyaline membrane disease during the first 7 days of life compared with 11 of the control group. In 11 patients patients amniocentesis was performed before the first injection of glucocorticoids and was repeated 2 to 7 days later. The amniotid fluid lecithin phosphorus concentration was determined. In the same period of pregnancy and the same iterval the lecithin phosphours level of amniotic fluid was analysed in 11 other patients who were not rreated with glucocorticoids. The difference between amniotic fluid lecithin phosphorus concentration in the first and second anslysis was found significant by a level of significance of alpha = 5%. There was no evidence of an influence of the therapy with Celestan Depot on this increase. The excretion of oestorgens in the urine of 24 hours was analysed in 22 gradidae before and 7 days after the treatment with betamethasone. The oestogen values of the day before application of betamethasone served as baseline figures. All patients showed a market fall in urinary oestrogens excretion, especially after the second day of therapy. After day 2 the values returned rapidly to baseline values. There were no differences between treated and control groups in Apgar scores at birth or in the incidence of icterus neonatroum (bilirubine level is greater that 10 mg% in the serum). The results of our study support the hypothesis that in humans glucocorticoid administration to the fetus accelerates lung maturation. Relatively brief intrauterine exposure of human infants to pharmacological doses of betamethasone was associated with a substantial reduction in the incidense of RDS.
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PMID:[First experiences with prenatal affection of infantile lung maturation by betamethason (author's transl)]. 115 18

Prenatal case histories and labours of 908 mothers who delivered prematurely at the University of Heidelberg, Department of Gynaecology and Obstetrics in Mannheim, between the years 1966-1971 were compared with a freely selected group of 782 mothers who delivered healthy mature infants with birth weights over 2500 g. (Premature infants -- under 2501 g; Stillborn infants -- under 2501 g and a minimum 35 cm crown-heel length). A tendency to premature delivery was observed in primipara, multipara with at least 4 previous deliveries, unmarried mothers, and in women with a preceding miscarriage or with closely spaced pregnancies less than 24 months apart. Bleeding during pregnancy, EPH-Syndrome, inadequate prenatal care, premature amnion rupture, abruptio placentae, pathological presentation and complications during labour were more frequently observed in mothers who delivered prematurely than those at full term. Histo-pathological changes of the placentas were found in 11,2% in cases of premature births as opposed to 3,6% in full term cases.
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PMID:[A comment about premature births (author's transl)]. 117 95

Analysis of 16 486 obstetric and neonatal case histories of the years 1963--1972. 30.7% of all neonates of Austrian (A) mothers showed one or more signs of placentar insufficiency. Pronounced prenatal dystrophy (p.d.) occurs in similar numbers in women with or without EPH gestosis, but has other important causes as well. In p.d. excentric umbilical cord insertion is more common than in neonates without dystrophy (56.4 : 52.4). Very young mothers often have neonates with p.d. During the ten year period p.d. increased considerably until 1967. After that it decreased slightly but not to the numbers at the start. These changes in frequency apply to all maternal age groups equally. Pronounced and highgrade p.d. in foreign workers' (f.w.) children is significantly more common than with A mothers (p 0.0001). Cushing's syndrome as a symptom of fetal disease due to diabetes has become rarer by over 50% owing to more intensive preventive measures; at the same time still-births of those weighing 4000 g or more have disappeared. The frequency of Cushing's syndrome rises according to the age of the mother from 0.8% to 3.5%. In Austrian mothers the number of previous abortions has decreased during these 10 years, just as has the number of births. The chances of actual pregnancies are the worse the higher the number of previous abortions. In f.w. mothers previous artificial abortions are far more numerous, but the outcome of pregnancy does not deteriorate with an increase in previous abortions. In A mothers the effects of previous premature or still births are the same as after abortions but much more pronounced. The percentage of normal births following premature births has fallen somewhat in A mothers during the ten year period, also after one miscarriage from 86% to 71%, probably owing to effective prevention of late abortions. Of 173 pairs of twins the first-born was heavier than the second in 71 instances. It is confirmed that the second twin is still-born almost twice as often as the first-born and this in twins of whom the second is heavier than the first. 11% of individual twins weith more than 3000 g and 28% between 2501 and 3000 g. The heavier the twins the lower the average age of the mother (from 30.8 to 26.6). The mothers whose first twin weighs more than 2500 g, the second less, appear to be younger than those with an inverse ratio (27.6 : 30.7).
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PMID:[The influence on the outcome of pregnancies of sociologic and medical changes during 1963--1972. II. Special section: prenatal dystrophy, diabetogenic fetal disease, the impact of previous miscarriages and twins (author's transl)]. 117 91

EPH gestosis and placental insufficiency sui generis are cause of fetal hazards. Clinical symptomatology and anamnesis indicate different tests to detect pathological conditions for the fetus. HPL, HCG, urinary estriol, measuring the placental flow-rate, ultrasonic diagnosis as all other usual examinations during pregnancy were carried out. In EPH gestosis a reduction of all placental functions was found like as for thrombocytes and fibrinogen. Placental insufficiency showed an even greater reduction of placental function, only thrombocytes and fibrinogen remained constant. Weight and length of the newborn were according the pathological placental function reduced. Morphology of the placenta could proof the results of the previous done tests.
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PMID:[Optimal monitoring in EPH gestosis and idiopathic placentar insufficiency (author's transl)]. 118 12

An information about the experience with DILATOL-treatment of 11 patients suffering from EPH-gestosis with hypertonia as the main symptom, is given. In all cases it was possible to reduce the systolic and diastolic blood-pressure. In long-time treatment an increasing resistance to therapy was noticed. In any case the treatment has to be combined with a frequent medical control of the gravidity with respect to the foetus and the placenta, to determine the right moment of the premature finishing of the gravidity, which is often necessary. Although no child of our 11 patients, died, it wasn't possible to prove the fact, that the perinatal mortality in the case of heavy EPH-gestosis after treating with beta-adrenergic substances is reduced. There weren't noticed any detrimental consequences to mother and child after treating with DILATOL within a space of time up to 4 weeks up to a total amount of 500 mg.
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PMID:[Clinical experience with Dilatol therapy in EPH-gestoses]. 118 72

After a detailed presentation of the new nomenclature and classification of EPH gestosis defined by the gestosis organization, this paper analyzes the gestosis index according to Goecke. The significance of the latter as a part of the symptomatic classification is determined and critically studied. The investigation is based in 934 cases of EPH gestosis comprising 40 perinatal deceased for which a correlation can be established between the cause of death and the gestosis of the mother. The investigations confirm the relevance of the gestosis index for the assessment of perinatal mortality risk. Repetitive determinations of the gestosis index can be of essential importance for controlling the development of EPH gestosis and assessing the fetal prognosis.
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PMID:[Gestosis index and perinatal mortality]. 118 94

On the base of the fundamental knowledge on immunological reactions in the normal pregnancy the disease of the EPH-gestosis is described from the immunological viewpoint. The following facts may be significant: 1. The increased occurence of specific and nonspecific crossreacting antibodies against liver, kidney and placental tissue in the blood of pregnant women and puerperas. 2. The increased occurence of placental infarctions and throphoblastic defects as well as fibrinoid deposits in the placenta, the arteriols and in the kidney. 3. Changes in the protein composition of blood. 4. The changed maternal cell-mediated immunity.
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PMID:[Immunological aspects in EPH gestosis]. 119 18

75 breech- and 71 cephalic deliveries between the years 1965-1970 at the University Clinic, Mannheim, were later examined in their 3 rd. to 7 th. years of life with respect to intelligence and motor developments. Mean intelligence quotient (IQ) of breech deliveries was 109, cephalic deliveries 110. The IQ was correlated with following other criteria: lie, age and parity of the mother, EPH-Gestose, methods of delivery, course and duration of labor, first Apgar score, weight of infant, bilirubin concentration, suspect cerebral damage and morbidity between discharge and recall for examinations. No significant differences in intelligence or motor development were found between the two groups of children.
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PMID:[A comparative follow up study about intellectual and motoric development of breech presentations (author's transl)]. 122 Mar 54

127 specimens, obtained by different methods from the myometrium and the placental bed after parturition, are investigated histologically. This material includes normal pregnancies as well as cases of maternal diabetes with and without hypertension and cases of hypertension in EPH-gestosis. The different parts of the arterial system (spiral arteries, basal arteries, radial arteries) are separately investigated. Physiologically, the pregnancy induces changes in the wall of the decidual arteries and possibly in the distal part of the radial arteries. The fibromuscular layer including the elastic fibers were destructed and replaced by fibrin and connective tissue. For this reason, in these parts of arteries it is very difficult to separate pathological from physiological changes.
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PMID:[Morphology of myometrial and decidual arteries in normal pregnancy, in toxemia of pregnancy, and in maternal diabetes (author's transl)]. 122 14


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