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Eckel F, Carlin G, Mayer S, Polterauer S, Chalubinski K. Krukenberg Progression of Gastric Carcinoma in Pregnancy: Is Early Diagnosis Possible? Case Report and Review of the Literature. J Clin Med 2023; 12:5397. [PMID: 37629439 PMCID: PMC10455580 DOI: 10.3390/jcm12165397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/04/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Krukenberg tumors are metastatic tumors of the ovaries, associated with poor outcomes. Most commonly, these tumors are of gastric origin. The diagnosis of Krukenberg tumors in pregnant patients is extremely rare and poses specific difficulties for clinicians. We report a case of a pregnant woman presenting with an unknown abdominal tumor. Through the use of magnetic resonance imaging, multiple differential diagnoses were proposed, including a malignant ovarian tumor. A cesarean section and explorative laparotomy were conducted, revealing Krukenberg metastases of a gastric tumor, discovered during intraoperative gastroscopy. Tumor resection with concomitant chemotherapy was conducted. The main aim of this paper was to evaluate whether earlier diagnosis seems possible in such cases. A thorough literature review was conducted, unfortunately revealing no reliable method for early detection. Furthermore, no consensus regarding diagnostics or therapy exists to date. Thus, more research should be conducted regarding this rare condition to offer recommendations regarding early detection, diagnostics, and therapeutic approaches.
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Affiliation(s)
- Fanny Eckel
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Greta Carlin
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefanie Mayer
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Stephan Polterauer
- Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, 1090 Vienna, Austria
| | - Kinga Chalubinski
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria
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Huhn EA, Linder T, Eppel D, Weißhaupt K, Klapp C, Schellong K, Henrich W, Yerlikaya-Schatten G, Rosicky I, Husslein P, Chalubinski K, Mittlböck M, Rust P, Hoesli I, Winzeler B, Jendle J, Fehm T, Icks A, Vomhof M, Greiner GG, Szendrödi J, Roden M, Tura A, Göbl CS. Effectiveness of real-time continuous glucose monitoring to improve glycaemic control and pregnancy outcome in patients with gestational diabetes mellitus: a study protocol for a randomised controlled trial. BMJ Open 2020; 10:e040498. [PMID: 33257486 PMCID: PMC7705524 DOI: 10.1136/bmjopen-2020-040498] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Real-time continuous glucose monitoring (rt-CGM) informs users about current interstitial glucose levels and allows early detection of glycaemic excursions and timely adaptation by behavioural change or pharmacological intervention. Randomised controlled studies adequately powered to evaluate the impact of long-term application of rt-CGM systems on the reduction of adverse obstetric outcomes in women with gestational diabetes (GDM) are missing. We aim to assess differences in the proportion of large for gestational age newborns in women using rt-CGM as compared with women with self-monitored blood glucose (primary outcome). Rates of neonatal hypoglycaemia, caesarean section and shoulder dystocia are secondary outcomes. A comparison of glucose metabolism and quality of life during and after pregnancy completes the scope of this study. METHODS AND ANALYSIS Open-label multicentre randomised controlled trial with two parallel groups including 372 female patients with a recent diagnosis of GDM (between 24+0 until 31+6 weeks of gestation): 186 with rt-CGM (Dexcom G6) and 186 with self-monitored blood glucose (SMBG). Women with GDM will be consecutively recruited and randomised to rt-CGM or control (SMBG) group after a run-in period of 6-8 days. The third visit will be scheduled 8-10 days later and then every 2 weeks. At every visit, glucose measurements will be evaluated and all patients will be treated according to the standard care. The control group will receive a blinded CGM for 10 days between the second and third visit and between week 36+0 and 38+6. Cord blood will be sampled immediately after delivery. 48 hours after delivery neonatal biometry and maternal glycosylated haemoglobin A1c (HbA1c) will be assessed, and between weeks 8 and 16 after delivery all patients receive a re-examination of glucose metabolism including blinded CGM for 8-10 days. ETHICS AND DISSEMINATION This study received ethical approval from the main ethic committee in Vienna. Data will be presented at international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03981328; Pre-results.
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Affiliation(s)
- Evelyn Annegret Huhn
- Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland
| | - Tina Linder
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Daniel Eppel
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Karen Weißhaupt
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christine Klapp
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Karen Schellong
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Wolfgang Henrich
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gülen Yerlikaya-Schatten
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Ingo Rosicky
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Peter Husslein
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Kinga Chalubinski
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Martina Mittlböck
- Center of Medical Statistics, Informatics, and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria
| | - Petra Rust
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Irene Hoesli
- Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland
| | - Bettina Winzeler
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Johan Jendle
- Institution of Medical Sciences, Örebro University, Örebro, Sweden
| | - T Fehm
- Department of Obstetrics and Gynaecology, Medical Faculty, Heinrich-Heine University Düsseldorf, Dusseldorf, Germany
| | - Andrea Icks
- Institute of Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center at Heinrich-Heine University Düsseldorf, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
- German Center for Diabetes Research, München-Neuherberg, Oberschleißheim, Germany
| | - Markus Vomhof
- Institute of Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center at Heinrich-Heine University Düsseldorf, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
- German Center for Diabetes Research, München-Neuherberg, Oberschleißheim, Germany
| | - Gregory Gordon Greiner
- Institute of Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center at Heinrich-Heine University Düsseldorf, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
- German Center for Diabetes Research, München-Neuherberg, Oberschleißheim, Germany
| | - Julia Szendrödi
- German Center for Diabetes Research, München-Neuherberg, Oberschleißheim, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Centre, Leibniz Institute for Diabetes Research at Heinrich-Heine University, Düsseldorf, Germany
| | - Michael Roden
- German Center for Diabetes Research, München-Neuherberg, Oberschleißheim, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Centre, Leibniz Institute for Diabetes Research at Heinrich-Heine University, Düsseldorf, Germany
| | - Andrea Tura
- Metabolic Unit, Institute of Neuroscience, National Research Council, Padova, Italy
| | - Christian S Göbl
- Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
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Feichtinger M, Falcone V, Schönleitner T, Stopp T, Husslein P, Eppel W, Chalubinski K, Göbl C. Pre-pregnancy gastric bypass surgery is associated with severe fetal growth delay during the second half of pregnancy. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Javor D, Nasel C, Dekan S, Gruber GM, Chalubinski K, Prayer D. Placental MRI shows preservation of brain volume in growth-restricted fetuses who suffer substantial reduction of putative functional placenta tissue (PFPT). Eur J Radiol 2018; 108:189-193. [PMID: 30396654 DOI: 10.1016/j.ejrad.2018.08.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/11/2018] [Accepted: 08/21/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Recently, a potentially useful diagnostic approach based on MR diffusion-tensor-imaging (DTI) was reported for the estimation of putative functional placenta tissue (PFPT), thus providing direct information about placental function. Yet, the relation between reduced PFPT and the phenomenon of brain-sparing remains unclear. This study aimed to investigate the relation between brain-sparing and reduced PFPT volume, as found in fetuses with intrauterine growth restriction (IUGR). METHODS A total of 40 consecutive patients with a US-based diagnosis of placental IUGR were examined using fetal MRI. A control group of 78 patients who received fetal MRI, due to non-placental pathologies, was established. A somatic energy index was calculated as IE=1-(Vbrain/Vpfpt) from brain and PFPT volumes measured with DTI in both groups. IE, Vpfpt, and Vbrain were analyzed with respect to the gestational week. RESULTS Vbrain corrected for gestational weeks was no different between both groups, while Vpfpt was significantly reduced in IUGR patients. IE was significantly different between both groups and indicated a higher Vbrain at a comparable Vpfpt. CONCLUSIONS Fetuses with IUGR show preserved energetic resources necessary for brain growth. Because IE drops in IUGR more rapidly as pregnancy progresses, depending on Vpfpt, IE could prove useful for estimating fetal well-being.
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Affiliation(s)
- D Javor
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna MUW, Austria; Department of Radiology, University Hospital Tulln, Karl Landsteiner University of Health Sciences, Tulln, Austria.
| | - C Nasel
- Department of Radiology, University Hospital Tulln, Karl Landsteiner University of Health Sciences, Tulln, Austria
| | - S Dekan
- Department of Pathology, Medical University of Vienna MUW, Austria
| | - G M Gruber
- Department of Anatomy, Medical University of Vienna MUW, Austria
| | - K Chalubinski
- Department of Gynecology, Medical University of Vienna MUW, Austria
| | - D Prayer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna MUW, Austria
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Pils S, Springer S, Wehrmann V, Chalubinski K, Ott J. Cervical length dynamics in triplet pregnancies: a retrospective cohort study. Arch Gynecol Obstet 2017; 296:191-198. [PMID: 28540576 PMCID: PMC5509777 DOI: 10.1007/s00404-017-4402-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 05/16/2017] [Indexed: 11/29/2022]
Abstract
Purpose To review our experience with a screening program that included sequential cervical length measurements in our large population of triplet pregnancies. Methods Seventy-eight triplet pregnancies were retrospectively included. Cervical length measurements were performed by transvaginal ultrasound in 2-week intervals from week 16 + 0 onwards in a tertiary-care center in Vienna. The main outcome measurement was preterm delivery prior to 32 + 0 weeks of gestation. Statistical analyses were performed using paired and unpaired t tests and a stepwise linear regression model. Results There were 26 cases of preterm delivery (33.3%). Women with preterm delivery revealed significant cervical length shortening from week 22 + 0 (median 33 mm, interquartile range, IQR 17–39) to 24 + 0 (median 21 mm, IQR 7–30; p = 0.005). This was not observed in women without preterm delivery. From week 22 + 0 onwards, both groups showed further significant 2-week differences in cervical length (p < 0.05). Univariate analysis of cervical length in weeks 20 + 0, 22 + 0, and 24 + 0 as well as cervical length dynamics from 22 + 0 to 24 + 0 predicted preterm delivery. Conclusions In triplet pregnancies, a decrease in cervical length seems physiological from week 22 + 0 onwards. A sharp decrease in cervical length from the 22 + 0 to the 24 + 0 week as well as the smaller cervical length in weeks 20 + 0, 22 + 0, and 24 + 0 increase the risk of preterm delivery.
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Affiliation(s)
- Sophie Pils
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Stephanie Springer
- Clinical Division of Obstetrics and Fetomaternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Verena Wehrmann
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Kinga Chalubinski
- Clinical Division of Obstetrics and Fetomaternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Johannes Ott
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Pateisky P, Dekan S, Binder J, Chalubinski K. Varianten von abnormer Plazentation bei Zustand nach Kaiserschnitt – retrospektive Fallanalyse und mögliche Konsequenzen für zukünftiges klinisches Management. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- P Pateisky
- Universitätsklinik f. Frauenheilkunde, Medizinische Universität Wien
| | - S Dekan
- Universitätsklinik f. Frauenheilkunde, Medizinische Universität Wien
| | - J Binder
- Universitätsklinik f. Frauenheilkunde, Medizinische Universität Wien
| | - K Chalubinski
- Universitätsklinik f. Frauenheilkunde, Medizinische Universität Wien
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Yerlikaya G, Pils S, Springer S, Chalubinski K, Ott J. Velamentous cord insertion as a risk factor for obstetric outcome: a retrospective case-control study. Arch Gynecol Obstet 2015; 293:975-81. [PMID: 26498602 DOI: 10.1007/s00404-015-3912-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Velamentous umbilical cord insertion (VCI) is associated with adverse pregnancy outcomes. Literature lacks data on Doppler. We aimed to evaluate obstetric outcomes and results of uterine and umbilical artery Doppler flowmetry associated with VCI. MATERIALS AND METHODS In a retrospective case-control study, 108 singleton pregnancies with VCI were age- and body mass index-matched to 108 singleton pregnancies without VCI. The main outcome parameters were obstetric outcome, pregnancy-related complications, uterine artery flowmetry at the second-trimester screening, and umbilical artery flowmetry before delivery. Statistical analysis was accomplished using Pearson's Chi-square test or Fisher's exact test, and the Mann-Whitney U test, where appropriate. RESULTS Pregnancies with VCI revealed a significantly higher PI in the umbilical artery during the last measurement before delivery (1.00 ± 0.25 vs. 0.90 ± 0.10; p = 0.001). Gestational age at this measurement did not differ between the groups. Fetal malformations and intrauterine fetal death were more common in pregnancies with VCI (12.7 vs. 0 %; p < 0.001, and 6.5 vs. 0 %; p = 0.014, respectively). Patients with VCI delivered significantly earlier (36.2 ± 4.5 vs. 38.4 ± 2.6; p < 0.001). CONCLUSION Higher rates of (early) preterm delivery were found in pregnancies with VCI. Fetuses with VCI also suffered from malformations and IUFD more frequently. The last pulsatility index value in the umbilical artery, before delivery, was significantly higher in pregnancies with VCI, which is of uncertain clinical value.
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Affiliation(s)
- Gülen Yerlikaya
- Department of Obstetric and Gynecology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria
| | - Sophie Pils
- Department of Obstetric and Gynecology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria
| | - Stephanie Springer
- Department of Obstetric and Gynecology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria
| | - Kinga Chalubinski
- Department of Obstetric and Gynecology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria
| | - Johannes Ott
- Department of Obstetric and Gynecology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria.
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Schlembach D, Mörtl MG, Girard T, Arzt W, Beinder E, Brezinka C, Chalubinski K, Fries D, Gogarten W, Hackelöer BJ, Helmer H, Henrich W, Hösli I, Husslein P, Kainer F, Lang U, Pfanner G, Rath W, Schleussner E, Steiner H, Surbek D, Zimmermann R. [Management of postpartum hemorrhage (PPH): algorithm of the interdisciplinary D-A-CH consensus group PPH (Germany - Austria - Switzerland)]. Anaesthesist 2014; 63:234-42. [PMID: 24584885 DOI: 10.1007/s00101-014-2291-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Postpartum hemorrhage (PPH) is one of the main causes of maternal deaths even in industrialized countries. It represents an emergency situation which necessitates a rapid decision and in particular an exact diagnosis and root cause analysis in order to initiate the correct therapeutic measures in an interdisciplinary cooperation. In addition to established guidelines, the benefits of standardized therapy algorithms have been demonstrated. A therapy algorithm for the obstetric emergency of postpartum hemorrhage in the German language is not yet available. The establishment of an international (Germany, Austria and Switzerland D-A-CH) "treatment algorithm for postpartum hemorrhage" was an interdisciplinary project based on the guidelines of the corresponding specialist societies (anesthesia and intensive care medicine and obstetrics) in the three countries as well as comparable international algorithms for therapy of PPH.The obstetrics and anesthesiology personnel must possess sufficient expertise for emergency situations despite lower case numbers. The rarity of occurrence for individual patients and the life-threatening situation necessitate a structured approach according to predetermined treatment algorithms. This can then be carried out according to the established algorithm. Furthermore, this algorithm presents the opportunity to train for emergency situations in an interdisciplinary team.
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Affiliation(s)
- D Schlembach
- Abteilung für Geburtshilfe, Universitätsfrauenklinik, Universitätsklinikum Jena, Bachstr. 18, 07732, Jena, Deutschland,
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Langer M, Chalubinski K, Speiser P. Primäre Hysterektomie bei sonographisch gesicherter Plazenta percreta. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pateisky P, Wild J, Küssel L, Chalubinski K, Zeisler H. Eizellspende als Risikofaktor für die Entstehung einer Präeklampsie? - Ein Fallbericht. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Pateisky P, Wild J, Küssel L, Chalubinski K, Zeisler H. Eizellspende als Risikofaktor für die Entstehung einer Präeklampsie? - Ein Fallbericht. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Wild J, Pateisky P, Küssel L, Chalubinski K, Zeisler H. Schwere Pfropf-Präeklampsie in der 23. Schwangerschaftswoche - Schwangerschaftsabbruch indiziert? - Ein Fallbericht. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Wild J, Pateisky P, Küssel L, Chalubinski K, Zeisler H. Schwere Pfropf-Präeklampsie in der 23. Schwangerschaftswoche - Schwangerschaftsabbruch indiziert? - ein Fallbericht. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Decker G, Chalubinski K. Nabelschnurzysten – klinische Signifikanz für das neonatale Outcome? Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1278596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Küssel L, Prayer D, Husslein P, Chalubinski K. Abklärung und Management von großen, persistierenden, maternalen Adnextumoren in der Schwangerschaft. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1254933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Linduska N, Dekan S, Messerschmidt A, Chalubinski K, Pollak A, Pollak A, Prayer D. Plazentapathologien in der fetalen MR Untersuchung – Vorstellung einer neuen Methode und des kindlichen Outcome. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Joura E, Yücel Y, Zeisler H, Seifert M, Chalubinski K, Husslein P. Vereinfachter Wundverschluß bei Sectio caesarea. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2007-1023019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Schmid M, Chalubinski K, Krampl E. Erfolgreiches Management einer heterotopen Gravidität: Geburt eines gesunden Kindes nach intrauteriner Geminigravidität und zervikaler Simultangravidität – Ein Fallbericht. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1078309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Bodner-Adler B, Bodner K, Pateisky N, Kimberger O, Chalubinski K, Mayerhofer K, Husslein P. Influence of labor induction on obstetric outcomes in patients with prolonged pregnancy. Wien Klin Wochenschr 2005; 117:287-92. [PMID: 15926620 DOI: 10.1007/s00508-005-0330-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Prolonged pregnancy is the most frequent reason for induction of labor. This study aims to determine the effects of labor induction on delivery outcome and to quantify the risks of cesarean delivery associated with labor induction in post-date pregnancies. PATIENTS AND METHODS This retrospective case-control study included a total of 205 women who reached 42 weeks' gestation (41 weeks and 3 days) between January 2002 and April 2004 and who were scheduled for induction of labor with vaginal prostaglandins. These cases were matched for age and parity with controls in spontaneous labor beyond 41 weeks' gestation. Women with any additional medical or obstetric risk factors were excluded from the study. Maternal, neonatal and delivery outcomes were the main variables of interest. RESULTS During the study period the data of 410 women were available for analysis. Our data revealed that the use of amniotomy (p=0.02), oxytocin (p=0.006) and epidural analgesia (p=0.001) was increased significantly in the induction group compared with the control group of women with spontaneous onset of labor beyond term. The frequency of cesarean delivery and vacuum extraction was also significantly higher in the induction group (p=0.0001). The Bishop score before induction was an important factor that affected the delivery outcome, resulting in significantly higher rates of cesarean section and vacuum extraction when the score was unfavorable (p=0.0001). A univariate regression model revealed induction per se (p=0.0001), primiparity (p= 0.0001), increased maternal age (p=0.006) and an unfavorable Bishop score (p=0.0001) as statistically significant risk factors for cesarean section. In a multivariate logistic regression model, primiparity (p=0.03), increased maternal age (p=0.02) and an unfavorable Bishop score (p=0.01) remained independent risk factors for cesarean section. High infant birth weight was also an independent risk factor (p=0.03). CONCLUSIONS Our data suggest that women undergoing labor induction because of prolonged pregnancy should be sufficiently informed regarding the risks of a cesarean section or a vacuum extraction. Furthermore, the option of elective cesarean section should be considered, particularly in primiparous women with an unfavorable cervix, higher age, and high estimated infant birth weight.
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Affiliation(s)
- Barbara Bodner-Adler
- Department of Obstetrics & Gynecology, University of Vienna Medical School, Vienna, Austria.
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Hohlagschwandtner M, Chalubinski K, Nather A, Husslein P, Joura EA. Continuous vs interrupted sutures for single-layer closure of uterine incision at cesarean section. Arch Gynecol Obstet 2003; 268:26-8. [PMID: 12673471 DOI: 10.1007/s00404-002-0308-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2001] [Accepted: 01/07/2002] [Indexed: 11/26/2022]
Abstract
In a non-randomized cohort study, we compared continuous with interrupted sutures for the closure of the lower uterine segment at cesarean section. Eighty-two women, who underwent cesarean section at the Department of Obstetrics at the University Hospital of Vienna between January and May 2000, were included in the study. Thirty-eight patients had single-layer closure of the lower uterine segment and 43 patients had closure with interrupted sutures. There were significant differences in total operating-time (32 min vs 40 min, P=0.001) and in the pre- and postoperative maternal hemoglobin (DeltaHb 0.6 g/dl vs 1.1 g/dl, P<0.01), but there was no significant difference in sonographically diagnosed hematomas (32% vs 21%, P=0.27). No woman had fever, the median hospitalization time was 6 days, and there were no re-admissions. In both groups, the median need for analgesics was 150 mg diclofenac ( P=0.22). Continuous single-layer closure of the lower uterine segment at cesarean section saves operating time, reduces blood loss, and introduces less foreign material into the wound.
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Affiliation(s)
- M Hohlagschwandtner
- University Hospital of Vienna, Department of Obstetrics and Gynecology, Waehringer Guertel 18-20, 1090 Vienna, Austria.
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Hohlagschwandtner M, Chalubinski K, Nather A, Husslein P, Joura EA. Sectio caesarea ohne Blasenpräparation: Eine sonographische Nachuntersuchung. Geburtshilfe Frauenheilkd 2002. [DOI: 10.1055/s-2002-22116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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22
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Abstract
Chronic fetal hypoxia in fetal growth restriction due to impaired placentation is associated with centralization of blood flow to the vital organs, such as brain, heart and adrenal glands, in order to maintain oxygenation. There is a correlation between fetal hypoxemia and low impedance to blood flow in the middle cerebral artery. However, there is no association between abnormal flow velocity waveforms and fetal distress in an unselected population, and this reported case also suggests that Doppler ultrasound is of no value in identifying acute fetal distress.
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Affiliation(s)
- E Krampl
- Department of Obstetrics and Gynaecology, Klinisches Sekretariat Ebene 8C, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
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23
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Kudielka I, Nagele F, Chalubinski K, Dörfler-Grassauer D, Husslein P. B 19 parvovirus infection in a primipara with congenital spherocytosis. Acta Obstet Gynecol Scand 1998; 77:785-6. [PMID: 9740531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- I Kudielka
- Department of Obstetrics and Gynaecology, University Hospital, Vienna, Austria
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24
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Abstract
Ehlers-Danlos syndrome type II is a rare connective tissue disorder with unknown pregnancy-related maternal and fetal morbidity. The course and outcome of pregnancy in a primigravid woman with Ehlers-Danlos syndrome type II is described. At 17 weeks' gestation a prophylactic Shirodkar cerclage was performed without complications. From the 29th week on, decreased blood flow of the umbilical artery was measured, and fetal growth retardation was evident from 34 weeks' gestation on. Pregnancy ended at 41 weeks by spontaneous vaginal delivery of a healthy 2900-g female infant. Previous reports of 16 women with Ehlers-Danlos syndrome type II, who had a total of 24 pregnancies, are reviewed.
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Affiliation(s)
- B Ploeckinger
- Department of Prenatal Diagnosis and Therapy, University of Vienna, Austria
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25
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Plöckinger B, Ulm MR, Chalubinski K, Schaller A. [When children "have children"--reproduction biological problems in girls between 11 and 15 years of age]. Geburtshilfe Frauenheilkd 1996; 56:248-51. [PMID: 8768063 DOI: 10.1055/s-2007-1022269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The aim of the present study was to evaluate the obstetric risk in pregnant adolescents under 16 years of age. From July 1, 1970 to June 30, 1993, 188 girls aged 11-15 years were delivered at the 2nd Department of Obstetrics and Gynaecology, Vienna; 4569 primiparous women between 20 and 24 years with singleton pregnancies served as a control group. No significant differences between the two groups were found for the frequency of pregnancy-induced hypertension (2.1% vs. 3.5%), premature delivery rates (24.4% vs. 29.8%), percentage of babies weighing less than 2500 g (10.1% vs. 9.1%), mean birthweight (3082 g vs. 3117 g), frequency of intrauterine growth retardation (2.1% vs. 2.4%) and malformations (1.6% vs. 3.1%) and perinatal mortality to the end of the first week (1.1% vs. 0.5%). Adolescent mothers were found to have more spontaneous deliveries (85.1% vs. 74.9% in the control group, p < 0.005), lower Caesarean section rates (6.4% vs. 11.3%, p < 0.05) and fewer babies with a birthweight exceeding 4000 g (1.1% vs. 4.3%, p < 0.05). For the first time, the pregnancy outcome of European adolescents was studied over a period of 23 years. We conclude on the basis of our results that maternal and neonatal risk in mothers under 16 years of age does not exceed the obstetric risk in adult mothers.
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Affiliation(s)
- B Plöckinger
- Abteilung für Pränatale Diagnostik und Therapie, Universitätsklinik für Frauenheilkunde Wien
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26
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Plöckinger B, Povse B, Ulm MR, Chalubinski K, Deutinger J, Bernaschek G. [Does the risk of complications after amniocentesis depend on the indications for intervention? An evaluation of 2,066 punctures]. Geburtshilfe Frauenheilkd 1996; 56:128-31. [PMID: 8674958 DOI: 10.1055/s-2007-1022278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Data from 2066 amniocenteses were analysed retrospectively to test the hypothesis whether the indications for amniocentesis influence the risk of post-procedural complications. Compared to the reference group of 35-39 year-old gravidae, the complication rates were similar in women with a previous child with chromosomal abnormality, in cases with maternal disease, abnormal biochemical markers, maternal anxiety, and translocation carriers. If the maternal age was 40 years and over, only the percentage of pregnancy terminations for fetal abnormalities was higher than in the reference group; high parental age was associated with a significantly decreased fetal loss rate. In the group of amniocenteses performed for sonographic evidence of fetal malformation, the highest total complication rates and the highest fetal loss rates were observed.
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Affiliation(s)
- B Plöckinger
- Abteilung für Pränatale Diagnostik und Therapie, Universitätsklinik für Frauenheilkunde Wien
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27
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Abstract
Recently, sonography of the fetal face has gained increasing importance in prenatal diagnosis. It is not yet clear whether sonographic depiction of fetal tooth germs would have an influence on the prenatal diagnosis of ectodermal dysplasia syndromes. During routine malformation screening, horizontal sections of fetal jaws were visualized and examined for tooth germs in 124 pregnant women following sonographic 'facing'. Histological jaw sections of fetuses that had died in utero at various gestational ages were produced in order to examine the degree of correspondence between the sonographic and histological findings. At least four tooth germs were found in the jaws of all fetuses between 19 and 34 gestational weeks (n = 104). Although jaw visualization was possible between 14 and 18 gestational weeks (n = 20), the exact number and location of the tooth germs could not be determined. Assessment of tooth germs may become increasingly important, as aplasia of the tooth germs is one of the principal signs of various hereditary ectodermal diseases.
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Affiliation(s)
- M R Ulm
- Department of Obstetrics and Gynaecology, School of Dentistry, University of Vienna, Austria
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28
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Ulm MR, Ulm C, Reckendorffer H, Obwegeser R, Plöckinger B, Golaszewski T, Chalubinski K. [Ultrasound diagnosis of fetal tooth anlagen and their histologic correlates]. Ultraschall Med 1995; 16:18-21. [PMID: 7709213 DOI: 10.1055/s-2007-1003231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
AIM The present study was to examine the radiographic and histologic correlation of the respective ultrasonographic findings. METHODS Histologic examinations were performed in 12 fetuses who had died in utero between 16 and 34 weeks of gestation. The fetuses had been examined by intrauterine sonography for tooth germs and had been subjected to additional radiographic examinations post abortum or partum. During autopsy, the tooth germs were again examined sonographically and radiographically, and non-decalcified histological sections were obtained by means of the sawing and grinding technique. RESULTS The results obtained by histologically examining the 12 fetal jaws in the ultrasonic plane corresponded in all cases to those examined by sonography and radiology. CONCLUSION Sonographic proof of tooth germs might gain increasing importance in future because agenesia of tooth germs is one of the principal signs of a variety of hereditary syndromes, particularly those of ectodermal origin.
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Affiliation(s)
- M R Ulm
- Universitätsklinik für Frauenheilkunde Wien
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Chalubinski K, Plenk H, Schaller A. [Prenatal diagnosis of osteogenesis imperfecta. Report of a case classified as the classical Vrolik lethal type]. Ultraschall Med 1995; 16:25-28. [PMID: 7709216 DOI: 10.1055/s-2007-1003233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Report on prenatal sonographic diagnosis of osteogenesis imperfecta of the classical type "letalis Vrolik" in the case of a fetus in the 20th/21st week of pregnancy. The prenatal diagnosis of this kind of osteogenesis imperfecta is based on the soft membranous cranium (Caput membranacium), the microthorax caused by the bell-shaped configuration of the ribs and the diaphysis of the long bones which are too short for the age of pregnancy. These symptoms are first of all the consequence of a disturbed bone formation and mineralisation; its basis is a connatal deficit of collagen synthesis. The sonographic differential diagnosis to the type "Ekman Lobstein" of osteogenesis imperfecta and thanatophoric dwarfism are discussed.
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Affiliation(s)
- K Chalubinski
- Abteilung für Pränatale Diagnostik und Therapie, Universitätsklinik für Frauenheilkunde Wien
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30
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Ploeckinger B, Ulm MR, Chalubinski K, Gruber W. Epidural anaesthesia in labour: influence on surgical delivery rates, intrapartum fever and blood loss. Gynecol Obstet Invest 1995; 39:24-7. [PMID: 7890248 DOI: 10.1159/000292370] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We retrospectively analyzed 7,317 fully documented deliveries to assess the effect of epidural anaesthesia (EA) on surgical delivery rates, on the incidence of intrapartum fever and on peripartal blood loss. 1,056 (14.4%) had EA and 6,261 (85.6%) had no or other analgesia. The use of EA was associated with a decreased spontaneous delivery rate (50.0 vs. 79.2%), increased forceps delivery rate (30.7 vs. 4.0%) and increased vacuum extraction rate (3.5 vs. 0.7%). The caesarean section rate was not significantly changed in patients with EA (14.4 vs. 13.0%). Fever greater than 38 degrees C during labour and intrapartum haemorrhage exceeding 500 ml were associated with the use of EA.
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Affiliation(s)
- B Ploeckinger
- Second Department of Obstetrics and Gynecology, University Hospital of Vienna, Austria
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31
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Chalubinski K, Schaller A. [Prenatal diagnosis of osteogenesis imperfecta. Report of a case classified as the classical Ekman Lobstein type]. Ultraschall Med 1994; 15:38-42. [PMID: 8165462 DOI: 10.1055/s-2007-1004003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Report on prenatal sonographic diagnosis of osteogenesis imperfecta of the classical type Ekman Lobstein (osteopsathyrosis) in the 35th week of pregnancy. We could demonstrate the marked penetration of ultrasound through the characteristically very thin long bones even before the occurrence of fractures. Difficulties in attributing our case to one of the four groups of osteogenesis imperfecta according to Sillence are discussed, as well as the obstetrical management of these prenatally diagnosed cases.
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Abstract
It has been recognized from experimental or invasive studies that the nonpregnant human uterus has an inherent contractibility. We used vaginosonography for imaging contractions of the inner third of the myometrium. The direction, frequency, and symmetry of contractions were noted. We studied 53 women and subdivided them into four groups based on the cycle phase. During menstruation we found contractions toward the cervix with irregular frequency varying between 1 and 3/min. In the periovulatory period we noted the highest frequency of 10/min of regular contractions toward the fundus. The results showed that active myometrial contractions can be detected sonographically throughout the whole menstrual cycle. Increased myometrial contractions toward the fundus in the periovulatory period may be involved in sperm transport to the tubes.
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Affiliation(s)
- K Chalubinski
- 2nd Department of Obstetrics and Gynecology, University of Vienna, Austria
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Chalubinski K, Deutinger J, Bernaschek G. [Transabdominal placental biopsy: indications, results, rate of complications]. Gynakol Geburtshilfliche Rundsch 1993; 33 Suppl 1:246-7. [PMID: 8118294 DOI: 10.1159/000272245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Abstract
Primary appearance of a malignant lymphoma in the vulvovaginal region is extremely rare. In this paper, we report on three such cases we observed during the last few years. There was no difference in clinical manifestation compared to cancer of the vulva/vagina. The diagnosis was made using histological and immunohistochemical methods. Choice of the treatment depended upon the stage of malignancy and spreading of the tumourous changes (radiation, chemotherapy). On reviewing the literature of the last 15 years, we could not find any description of primary malignant lymphoma in the vulva and vaginal region.
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36
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Chalubinski K, Deutinger J, Bernaschek G. Meconium peritonitis: extrusion of meconium and different sonographical appearances in relation to the stage of the disease. Prenat Diagn 1992; 12:631-6. [PMID: 1438058 DOI: 10.1002/pd.1970120802] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
By chance, we had the opportunity to make serial sonographic observations of the extrusion of meconium in a case of meconium peritonitis. Inflammation leads to exudative processes and production of fluid (ascites) in the fetal abdomen. Sonography at that stage of the disease may lead to a misdiagnosis such as 'fetal ascites' or 'non-immune hydrops'. After bowel perforation and extrusion of meconium, the latter appears as a solitary mass inside fetal ascites or as disseminated echogenic masses distributed subdiaphragmatically or perihepatically. Within a couple of days, in most cases the echogenicity of the masses increases. Calcifications lead to distinct shadowing. These calcifications are often the only visible signs of a previous meconium peritonitis. Serial sonograms are essential for the management of pregnancies with meconium peritonitis. If the amount of fetal ascites does not increase and no signs of cardiovascular stagnation appear, no invasive intrauterine diagnostic and therapeutic steps are required. In none out of the nine cases was a cause found.
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Affiliation(s)
- K Chalubinski
- 2nd Department of Obstetrics and Gynecology, University of Vienna, Austria
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37
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Chalubinski K, Brunner H. [Positive diagnosis of irritable colon: a scored chart or standardized anamnesis?]. Wien Klin Wochenschr 1987; 99:819-24. [PMID: 3433786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The diagnostic score of Kruis to diagnose the irritable bowel syndrome (IBS) has recently gained widespread application. We therefore evaluated the case histories of 373 patients attending the gastroenterological outpatient department retrospectively using the questionnaire of these authors. In contrast to Kruis et al's findings, by applying their discriminating score the diagnosis of irritable bowel syndrome was made in only 51% of the patients who underwent complete gastrointestinal survey without pathological findings. However, the group of IBS was significantly separable from malignant or inflammatory disease. We therefore conclude that the diagnosis of IBS should only be made by ruling out organic disease (except in the case of young people with normal physical and laboratory check up findings and a good response to treatment). For these patients we simplified the questionnaire, omitting calculations.
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Affiliation(s)
- K Chalubinski
- II. Universitätsklinik für Gastroenterologie und Hepatologie, Wien
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