[Is there a gestosis weather? Correlation of EPH gestosis with meteorologic conditions]

A historical survey on the subject of weather and eclampsy is given in the introduction, at the beginning of which the names Smellie (1752), Boutteilloux (1816), Lachapelle (1925) and Zangemeister (1900) are mentioned. In the ten-year report the gestosis indices according to Goecke (n = 56,461) in the grouping 0/I-III/ = greater than IV are correlated with six general weather situations in each of the four seasons. From the chi 2 component test according to Krauth a relevant chi 2 limit of 8,95 is established. Only the following four out of altogether (6 x 4 =) 24 weather situations prove to be associated with lower (I-III) and higher (= greater than 4) indices of gestosis. 1. Anticyclonic situations with central high in winter with indices of gestosis I-III; 2. cyclonic flow-patterns in autumn with indices of gestosis I-III; 3. situations with central low in summer with indices of gestosis = greater than IV; 4. low gradient cyclonic situations in summer with fewer indices of gestosis. In spring the indices groups do not reach or exceed the limit of significance in any of the six weather situations. The four weather situations connected with gestosis are demonstrated by means of typical examples of infrared and visual satellite photos. Summing up, the different valence of scientific evidence and clinic relevance of the results is indicated.

[Sex offenses on minor girls. Pediatric gynecologic management]

This report on 24 cases of sex offences on girls under 14 years of age examined and treated at the 2nd University Department of Obstetrics and Gynaecology in Vienna covers the period between 1984 and 1987. Experience gained in these cases led to the development of a specially devised mode of management which ranges from guidelines on supplementary history taking to special examinations and deals in particular with the after care of these young girls, which is a largely neglected area. The responsibility of the examining gynaecologist towards the victim as well as towards the person suspected of a sex offence is stressed. An obvious change in the accompanying circumstances and their possible causes are discussed.

Successful outcome of a complicated pregnancy in a renal transplant recipient taking cyclosporine A

The successful outcome of a pregnancy complicated by reversible renal failure secondary to total ureteral obstruction caused by a pregnant uterus and treated temporarily with nephrostomy is reported. The cyclosporine A (CsA) and prednisone treated female recipient of a cadaveric renal allograft gave birth to a male child, which at 2080 grams was small for gestational age (35 weeks of pregnancy). The child presented neither signs of congenital anomalies or chromosome aberrations nor nephrotoxicity, hepatotoxicity or anemia. Simultaneous measurement of trough CsA blood levels (CsA RIA, Sandoz) displayed reduced values in the child's blood (mother 864 ng/ml-4 hours after oral CsA intake; son 312 ng/ml). Beside postrenal failure the patient's pregnancy was complicated by 7 rejection episodes treated with high doses of methylprednisone (total dose 5 g) with reversible damage of the transplant function, two episodes of a urinary tract infection and increasing anemia necessitating blood transfusions. The HIV negative patient had developed a Kaposi's sarcoma 6 weeks after grafting. The progression of infiltrating skin lesions during pregnancy was not seen.

[Pregnancy and labor following kidney transplantation with cyclosporin A. Case report and review of the literature]

We report on a 22-year old patient who received a cadaveric renal transplant following haemodialysis treatment for five months due to endstage chronic glomerulonephritis. 14 months after successful transplantation while on stable renal function (serum-creatinine 1.0-1.4 mg%) the patient became pregnant. As an immunosuppressive therapy the patient got cyclosporine A and cortisone. The monitoring of the immunosuppressive therapy (Cyclosporine A) was performed by daily measurement of serum concentration by radioimmunoassay. Drug administration was adjusted to maintain serum levels of 250-550 ng/ml. Increased dosages were required from 25th week until delivery. Until the 25th week of gestation the pregnancy was uncomplicated from both the nephrological and obstetrical points of view. At the 25th week of gestation the patient became anuric. This was caused by a postrenal failure due to the compression of the transplantar ureter by the pregnant uterus. Nephrostomy was installed and was used until the end of pregnancy. In the third trimester the foetus showed growth retardation. For this reason a Caesarean section was necessary at the 36th week of gestation. A healthy boy was delivered weighing 2080 g and measuring 45 cm. No congenital malformations were observed, the chromosomal analysis showed no aberrations. After the delivery cyclosporine concentrations in the blood of the mother and the newborn were simultaneously measured. A remarkable difference in these concentrations was observed particularly in the mother's blood 864 ng/ml whereas in the baby's blood the concentration was 312 ng/ml. Three days after the delivery the patient was able to urinate normally so that the nephrostomy could be removed.

[Upper Austria model study to assess the prevalence and incidence of congenital abnormalities]

Among the 15.998 live births recorded in Upper Austria in the year 1985, a representative malformation rate of 1.79, respectively a representative incidence of 17.94 in 1000 live births is reported. The incidences of characteristic malformations and of single malformations combined in malformation groups are determined. An instrument of investigation, especially developed for and successfully used in this examination in form of an illustrated questionnaire is introduced.

[Correlation of labor onset, membrane rupture and birth with meteorological events]

The birth-physiological events: beginning of labour, rupture of membranes and delivery of 6 539 cases in the years 1976 to 1981 can be correlated with five groups of weather situations: no definite pressure gradient, anticyclonic, meridional, zonal mild maritime, and cyclonic.

THE RESULTS

temporary increase of the frequency of births in weather with no definite pressure gradient in summer, in anticyclonic weather in winter and in cyclonic weather in the first half of the year, correspond only partly (namely for the changes within the group of cyclonic weather) with the temporarily increasing number of births during a weather front, as it ist known from experience. The causes of the correlations found out are unknown, and the setting up of a statistical model and consequently an obstestrical-metereological forecast is impossible for the time being.

The prevalence of ureaplasma, mycoplasma and antibodies against chlamydia group antigen in gynecological outpatients

177 women with an average age of 30 years were investigated for ureaplasma, mycoplasma and for antibodies against the chlamydia group antigen. Specimen of endocervical mucus and catheter specimens of urine were cultured and the ELISA ("enzyme-linked immunosorbent assay") technique applied. In addition the purity class (I to III) of gram-stained vaginal smears was determined. Ureaplasma were isolated from 45.8 and 26.0%, mycoplasma from 9.0 and 7.9% of cervical and urine specimens respectively. The patients were divided into 5 clinical groups. Patients in the first three groups (I-III, inflammatory disorders, bleeding anomalies, benign and malignant neoplasms of the genital tract) showed a significantly (p less than or equal to 0.05) higher colony count of ureaplasma in their urine than patients in the other two groups (IV and V, who had attended the hospital for reproductive problems or for routine examination). There was a clear correlation between the isolation rates of ureaplasma and mycoplasma and the purity classes of the vaginal smears. The rate of isolation increased progressively with class II and III smears. Antibodies against the chlamydia group antigen were detected in about 40% of all sera tested. A very high titer of antibodies reflecting a recent chlamydial infection was found in 11% of the sera tested.

[Sonographic study of the growth of the uterus and ovaries between the ages of 1 and 14]

Ultrasonic median values of the dimensions of the uterus and volume of the ovaries were determined in a statistically sufficiently large group of girls in the hormonally inactive stage between 1 and 14 years of age who were healthy from the paediatric-gynaecological viewpoint. The graphic presentation of the results is an essential prerequisite for routine outpatient sonography. The most striking result is an almost linear, significant growth of the uterus and ovaries even before the menarche.

[Sonographic detection of prenatal rupture of spina bifida cystica]

Demonstration of a case of echographically diagnosed spina bifida cystica; the cyst, which is full of liquor cerebrospinalis, can be shown by ultrasonography before and after the rupture.

[Velamentous insertion--epidemiology and clinical aspects of the pathological insertion of the umbilical cord]

Among 9460 birth an incidence of 1.6% of velamentous insertion of the umbilical cord is recorded and the clinical relevance of this anomaly is examined. Apart from statistical confirmation of well-known connections between membranous insertion of the umbilical cord on the one hand, and malformations, multiple pregnancies and bleeding sub partu on the other hand, the present investigation is mainly concerned with premature births and/or placental insufficiency in the case of velamentous insertion of the umbilical cord, which is associated with "late premature births" in the 35th, 36th and 37th week of pregnancy as characteristic finding.

[The effect of calf blood dialysate on the excretion of estriol in placental insufficiency]

The efficacy of a dialysate of calf blood in the treatment of chronic placental insufficiency is assessed using the urinary oestriol elimination as parameter. Compared with a control group, those cases receiving 2 times 250 ml protein-free dialysate of calf blood (Solcoseryl) in saline solution over 9 days showed a significant increase in the daily quantity of urinary oestriol elimination already from the second day of treatment onwards. Other conventional procedures in the medical treatment of placental insufficiency are discussed. Some of these are known to have secondary effects or must be regarded as invasive.

[Uterine prolapse after episiotomy]

The value of episiotomy in regard to the prevention of descensus vagina et uteri is examined in a statistically reliable number of patients (64 cases). Women who were delivered without episiotomy provided the control group (70 cases). In both groups factors promoting pelvic relaxation were taken into consideration. According to the results of this examination the importance of episiotomy as prophylaxis of pelvic relaxation does not justify any obligatory use.

[Management of breech delivery in primiparas - on the incidence of cerebral lesions. (author's transl)]

The investigation comprises a group of infants of primiparae with breech presentation after caesarean section and a group of infants delivered by means of manual aid. The school age children were examined on the incidence of brain injury. The investigation consisted of four parts; anamnesis, neurological status, EEG, psychological examination. Between these two groups there is not statistically-significant difference in the incidence of brain injury. The result of the investigation advocates the maintenance of selective sectioindication in case of primiparae and points to a possibly existing brain injury of infants with breech presentation before delivery.

[Congenital abnormalities--risk, incidence and etiology. Catamnestic studies on causal teratogenesis]

Questionnaires were sent to the mothers of infants with congenital malformations delivered at the Second Department of Obstetrics and Gynecology, Vienna University Medical School, between 1972 and 1978 and to a group of controls. The response rate was 48%. On evaluation, the incidence of maternal disease and therapeutic drug intake was found to be significantly higher in the group with congenital malformations. In addition, malformations were significantly more common in planned pregnancies. A teratogenetic role of emotional stresses was not verifiable with statistical significance. As inheritance of numerous malformations tends to be multifactorial, endogenous factors were equally considered, but failed to show significant differences.

[Intrauterine pressure and fetal and maternal heart rate on administration of the betamimetic agent, hexoprenaline during labour (author's transl)]

The tocolytic effect of hexoprenaline was determined in 20 women by internal cardiotocography during labour. After 30 minutes of intravenous medication (0.3 microgram/min = dosage for massive tocolysis) the uterine activity decreased on average by 73.6%; the maternal pulse rate increased by 25.0%; the fetal heart rate showed no significant change.

[Pregnancy and delivery in 12 to 15 year-old girls (author's transl)]

From January 1st 1974 to March 1st 1980, altogether 51 girls under the age of 16 were admitted for delivery at the 2nd Department of Obstetrics and Gynaecology, University of Vienna, Medical School. By means of the following parameters, i. e. premature birth rate = 5.9%, rate of gestosis (GI greater than 3) = 3.9 and perinatal mortality rate = 0, the question of clinical assessment of gestation as high-risk pregnancy in the case of young girls in discussed yet again. For the total number of reported cases within the specified period, the rate of premature birth is 8.7%, the corresponding rate of gestosis is 6.7 and the overall perinatal mortality rate is 1.6%.

[The pregnant and non-pregnant rudimentary horn of an uterus (author's transl)]

In the past 10 years three cases of pregnancy in a rudimentary horn of a double uterus and one case of haematometra were observed at the second university hospital for women in Vienna. The problems of the development of a pregnancy in the uterine cavity of a rudimentary horn which is not connected to the main uterine cavity are discussed. The clinical course of such a pregnancy is discussed reviewing our own cases and those reported in the literature.

[The influence of the beta-mimetic Ritodrine on the potassium balance under tocolytic therapy (author's transl)]

A time-dependent picture was to be obtained of the potassium concentration by means of a continual determination in serum, urine and red cells during tocolytic therapy with beta-mimetic drugs for inhibiting premature uterine activity. The results obtained under bulk tocolysis with Ritodrine (Prepar) infusions and after a twelve-hour interval of strict food deprivation, speak in favour of a rise in potassium elimination via the urine, and, therefore, of a substitution, contrary to the opinion held until now.

[Intramural gravidity - case report and account of literature (author's transl)]

Reference is made to a report on intramural pregnancy, the twelfth case so far described in accessible literature, and the authors' own views on the possible origin of this extremely rare location of pregnancy are added to other assumptions so far made on the pathogenesis. The hypothetical proposition made by the author's is based on the assumption of transperitoneal penetration of the uterine wall by the spermovium via a focus of endometriosis. Described are case histories, symptoms, tentative diagnoses, and surgical approach in the cases so far observed.

[The Second Gynaecological Department of Vienna University (author's transl)]

70 years ago, on October 21st, 1908, the new building of the Second Gynaecological Department of Vienna University--a fine example of Jugendstil--was opened. This jubilee takes place at the time when the whole structure of the university clinics is undergoing fundamental change, the new "Allgemeines Krankenhaus" is under construction and while the Jugendstil is enjoying new popularity. An attempt is made to outline the lives and work of the outstanding representatives of the Second Gynaecological Department of Vienna University and the history of the building.

A casuistic report on the Gruber or Meckel syndrome

A case of Meckel or Gruber syndrome is reported, together with a survey of the relevant literature of recent years (1971-1977), in reference to a probably autosomal recessive inheritance of this malformation.

[Connexions between instrumental delivery and cerebral damage in the infant (author's transl)]

An interdepartmental investigation was carried out on the incidence of brain injury, especially so-called minimal brain injury, after instrumental delivery of infants by means of forceps or vacuum extractor. There is no statistically-significant difference in the incidence of brain injury in infants delivered by means of forceps as compared with the vacuum extractor; there is, however, a significant increase in incidence of brain injury in infants following instrument-aided delivery as opposed to spontaneous delivery. A thorough explanation of the methods is given and the results are discussed.

[Problems and results of skull x-ray following vacuum extraction (author's transl)]

The vacuum extraction supplies the forceps nearly complete on the IInd Department of obstetrics and gynecology Vienna in the last years. Skull X-ray of 104 newborns following vacuum extraction and of 101 spontaneous delivered newborns are examined on the incidence of fractures, fracture-fissures, elevations and widening of skull sutures. Early pathological findings are rigid criteria for the possible danger due to a method of operative delivery but we have no typical late damage after vacuum extraction or forceps delivery, we don't find in spontaneous born children too.