Zeitschrift für Geburtshilfe und Neonatologie
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Z Geburtshilfe Neonatol · Nov 1999
[Normal Doppler ultrasound values of the anterior cerebral artery of premature and newborn infants with reference to cardiac function parameters and intestinal blood flow profile].
Hemodynamic impairements play an important role in the development of cerebral lesions. These changes may be detected by dopplersonographic flow measurements in cerebral arteries. For that reason it is necessary to establish normal values in relation to cardiac function and intestinal perfusion. ⋯ With these results it is possible to evaluate cerebral hemodynamic changes by dopplersonographic measurements in relation to gestational and postnatal age and under consideration of cardiac function and mesenteric perfusion.
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Z Geburtshilfe Neonatol · Nov 1999
[Gel agglutination test--a new test system for semiquantitative detection of feto-maternal transfusion in Rhesus incompatibility].
The postpartum administration of an adequate amount of anti-D immunoglobulin to the mother in cases of Rhesus incompatibility requires the exact quantification of the amount of Rh-positive fetal cells that may be present in the Rh-negative maternal circulation. The classical methods to detect an intrapartum fetomaternal hemorrhage are either time-intensive (such as the Kleihauer-Betke test), of low specificity (such as the indirect Coombs test), or technically cumbersome (such as flow cytometry). The goals of our study were to develop a simple screening test that may be used routinely to quantify fetomaternal hemorrhage in cases of Rhesus incompatability and to evaluate this test in clinical practice. ⋯ The GAT may be used as a screening method in routine clinical practice. This is a quick test that allows for the specific determination and semiquantitative evaluation of the Rh-positive erythrocyte concentration in clinically relevant concentrations. Thus, following a positive GAT screening test, a further specific test such as the Kleihauer-Betke test may be utilized to absolutely quantify the amount of blood transfused from fetus to mother. It is also possible to perform such a quantification test with the GAT by eventually using a diluted maternal blood sample.
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Z Geburtshilfe Neonatol · Nov 1997
Review[Treatment of hypertensive diseases in pregnancy--general recommendations and long-term oral therapy].
Hypertensive disorders are among the most common causes of maternal and perinatal mortality. Mild and uncomplicated chronic hypertension has a better prognosis than preeclampsia. The primary aims of therapy are to prevent cerebrovascular complications and to avoid the progression of chronic hypertension into superimposed preeclampsia with worse prognosis. ⋯ The indication for hospitalization are of particular clinical importance, since a delay in admission associated with maternal complications may lead to juridical troubles. The antihypertensive treatment is only a symptomatic therapy; the obstetrician must be aware that delivery is the ultimate cure of hypertensive disorders in pregnancy. In women with mild chronic hypertension or mild preeclampsia antihypertensive therapy is unlikely to be beneficial regarding the perinatal results, while in severe forms drug therapy is mandatory to avoid life-threatening maternal complications.