Gynakologisch-geburtshilfliche Rundschau最新文献

{"title":"[Ogilvie's syndrome (acute idiopathic colonic pseudo-obstruction) after Caesarean section].","authors":"Rahel Meier Ernst,&nbsp;René C Müller,&nbsp;Thomas Hess","doi":"10.1159/000107265","DOIUrl":"https://doi.org/10.1159/000107265","url":null,"abstract":"<p><p>Due to incipient HELLP syndrome and no progression in labour, a caesarean was performed on a 33-year-old para I gravida I. During the operation she suffered a heavy blood loss as a result of uterine inertia. In the postoperative stage she developed an acute idiopathic colonic pseudo-obstruction, also known as Ogilvie's syndrome. Only 6 days after the operation did she slowly recover. Additional factors that could have led to Ogilvie's syndrome are the caesarean, the HELLP syndrome and the postpartal haemorrhage. Due to her reduced physical health, the mobilization of the patient was restricted, which further prolonged the recovery. However, an early initiation of supportive treatment, the timely diagnosis of Ogilvie's syndrome and two colonoscopic decompressions prevented a caecal rupture. After 3 weeks of hospitalization, the patient was discharged in good general health.</p>","PeriodicalId":12827,"journal":{"name":"Gynakologisch-geburtshilfliche Rundschau","volume":"47 4","pages":"236-9"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000107265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27029250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[New insights into the pathophysiology of endometriosis].","authors":"Corinne Neukomm,&nbsp;Michael D Mueller","doi":"10.1159/000102572","DOIUrl":"https://doi.org/10.1159/000102572","url":null,"abstract":"<p><p>Endometriosis is a fascinating and complex disease resulting from a dysregulation between exfoliated menstrual endometrium and the intra-abdominal environment. Increased concentrations of activated pelvic macrophages and lymphocytes and elevated levels of specific cytokines and growth factors in the peritoneal fluid support this hypothesis. The precise roles of these soluble factors are currently unknown, but we propose that a complex interplay of these locally produced cytokines, growth factors, steroids and eicosanoids modulates the growth and inflammatory behavior of ectopic endometrial implants via neovascularization. The enhanced secretion of local proangiogenic proteins by endometriosis lesions and associated immune cells (and the concomitant reduction of antiangiogenic principles) promotes the recruitment of capillaries toward the growing lesions. Ultimately, a cascade of effects on the peritoneal microenvironment results in implant proliferation and invasion. Future therapeutic strategies to target these angiogenic stimuli have the potential to block the vascular pathogenesis of endometriosis. This article gives an overview of the different factors involved in the development, growth and progression of endometriosis.</p>","PeriodicalId":12827,"journal":{"name":"Gynakologisch-geburtshilfliche Rundschau","volume":"47 3","pages":"113-7"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000102572","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26837583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Water contamination and infection rate after water births].","authors":"A Thoni,&nbsp;N Zech,&nbsp;L Moroder,&nbsp;F Ploner","doi":"10.1159/000098123","DOIUrl":"https://doi.org/10.1159/000098123","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed at examining the water of the birthing tub for pathogenic germs and at comparing the infection rates of the children born conventionally.</p><p><strong>Method: </strong>In a prospective study, the germs found in the water of 300 water births were determined . The tub water was sampled twice: sample A was taken after filling the tub with tap water, sample B after the water delivery. In addition, the paediatrician documented any signs of infection of the neonates during their hospital stay.</p><p><strong>Results: </strong>The A samples contained Legionella in 29%, Pseudomonas aeruginosa in 22%, enterococci in 18%, colibacilli in 32% and Escherichia coli in 8%. After fitting a filter system, no Legionella was detected any more. P. aeruginosa was found in only 3% of the samples. In the B samples, we found an increased contamination by colibacilli in 81%. A marked burden with E. coli was detected in 58% of the samples. Due to a clinically an biochemically suspected beginning infection, 1.15% of the water-born children (14 out of 1,215) were given antibiotics. In contrast, 2.30% of the conventionally born neonates (19 out of 817) were treated with antibiotics.</p><p><strong>Conclusion: </strong>It is evident that during the bearing-down phase faeces are discharged into the birthing tube and that the water is contaminated mainly by E. coli and colibacilli, but also slightly by Staphylococcus aureus. The contamination of the tap water by Legionella and Pseudomonas could clearly be reduced by installation of a filter system into the supply hose of the birthing tub. Neonatal infections were not more frequent after water births than after conventional deliveries.</p>","PeriodicalId":12827,"journal":{"name":"Gynakologisch-geburtshilfliche Rundschau","volume":"47 1","pages":"33-8"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000098123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26530264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recommendations for estrogen and progesterone substitution in climacteric and postmenopause].","authors":"M Birkhauser,&nbsp;W Braendle,&nbsp;P J Keller,&nbsp;L Kiesel,&nbsp;H Kuhl,&nbsp;J Neulen","doi":"10.1159/000098125","DOIUrl":"https://doi.org/10.1159/000098125","url":null,"abstract":"2. Östrogene fördern die Durchblutung und Rehydratisierung, steigern Bildung und Umsatz von Kollagen und haben dadurch eine günstige Wirkung auf Muskeln und Gelenke. Darüber hinaus haben sie vorteilhafte Auswirkungen auf Haut und Schleimhäute (Mund, Nase, Augen). Sie wirken Androgenisierungserscheinungen entgegen, die wegen des Überwiegens der Androgenwirkung bei einem Östrogenmangel auftreten können (Akne, Seborrhoe, Hirsutismus, Haarausfall). Mit der erwünschten Rehydratisierung des Gewebes kann eine leichte Gewichtszunahme verbunden sein. Der altersabhängige Anstieg des Körpergewichts wird eher günstig beeinfl usst. 3. Atrophische Veränderungen im Urogenitaltrakt und deren Folgeerscheinungen (z. B. vulvovaginale Beschwerden, Dyspareunie, Kolpitis, Urethrozystitis) werden durch eine systemische oder lokale Östrogentherapie gebessert. Die dadurch hervorgerufenen Beschwerden können günstig beeinfl usst werden. 4. Pfl anzenextrakte können ebenso wie Placebopräparate leichtere klimakterische Beschwerden bessern. Einige der Extrakte enthalten in nicht geringen Mengen östrogenwirksame Substanzen (Phytoöstrogene), deren Effekte im Einzelnen nicht ausreichend untersucht sind. Psychopharmaka haben ihre eigene Indikation; sie sind primär nicht zur Behandlung von Beschwerden geeignet, die auf einen Östrogenmangel zurückzuführen sind. 5. Eine sachgerechte Substitution (auch in niedriger Dosis) verhindert den durch ein Östrogendefi zit bedingten Knochenmasseverlust und senkt die Frakturrate. Einige Gestagene (z. B. Norethisteron) können hierbei die Wirkung der Östrogene verstärken. Durch diese osteoprotektive Wirkung wird das Erreichen der Frakturschwelle entsprechend verzögert, sodass die Gabe von Östrogenen in den ersten Jahren nach der Menopause das Mittel der Wahl zur Osteoporoseprävention ist (siehe Addendum). Körperliche Aktivität und eine ausreichende Versorgung mit Kalzium und Vitamin D sind entscheidende Voraussetzungen für einen normalen Knochenstoffwechsel. Bei manifester Osteoporose ist eine spezifi sche Behandlung erforderlich (z. B. Bisphosphonate, Teriparatid, Strontiumranelat), deren Langzeiteffekte jedoch noch nicht hinreichend untersucht sind. Sexualhormone haben nicht nur eine essentielle Bedeutung für die Fortpfl anzung, sondern auch für den Stoffwechsel, das HerzKreislauf-System und das körperliche und seelische Wohlbefi nden. Nach Ausfall der reproduktiven Ovarialfunktion kann es daher als Folge des Östrogendefi zits und von Änderungen des Endokriniums zu Störungen im Bereich des vegetativen und zentralen Nervensystems, der allgemeinen Befi ndlichkeit und zu Stoffwechselveränderungen mit möglichen Folgeerkrankungen kommen (z. B. postmenopausale Osteoporose, kardiovaskuläre Erkrankungen, Morbus Alzheimer, Diabetes mellitus). Deshalb ist bei Östrogenmangelsymptomen eine Hormonsubstitution aus therapeutischen Gründen indiziert; eine langfristige Substitution kann bei individueller Indikation in Erwägung gezogen werden. In einem ärztlichen","PeriodicalId":12827,"journal":{"name":"Gynakologisch-geburtshilfliche Rundschau","volume":"47 1","pages":"45-8"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000098125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26530266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Aesthetic and functional corrections of the female genital area].","authors":"Stefan Gress","doi":"10.1159/000098122","DOIUrl":"https://doi.org/10.1159/000098122","url":null,"abstract":"<p><p>In the last few years, we have performed an increasing number of genital reshaping procedures in females. Most frequently we carried out corrections of the labia, followed by operations to reduce the size of the clitoris and the pubic area. Psychological as well as functional complaints were the reasons for the decision to undergo a surgical correction. After a large number of operations we have gained great experience and developed specific operation techniques. The results are functionally reliable and aesthetically pleasing with a very low rate of complications and a high level of patient satisfaction.</p>","PeriodicalId":12827,"journal":{"name":"Gynakologisch-geburtshilfliche Rundschau","volume":"47 1","pages":"23-32"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000098122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26538922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnosis and management of vulvar intraepithelial neoplasias and invasive vulvar cancers].","authors":"Philippe Sauthier,&nbsp;Patrick Petignat","doi":"10.1159/000100338","DOIUrl":"https://doi.org/10.1159/000100338","url":null,"abstract":"<p><strong>Objective: </strong>Update on the diagnosis and management of vulvar intraepithelial neoplasia (VIN) and vulvar carcinoma.</p><p><strong>Method: </strong>Review of the literature.</p><p><strong>Results: </strong>The classification of VIN is leaning towards the development of two distinct anatomoclinical models. VIN of the usual type and of a differentiated type. New forms of treatment of preinvasive lesions that are less traumatic and as efficient will have to be evaluated in the future such as immunomodulators and photodynamic therapy. The invasive carcinoma is generally rapidly symptomatic and visible; however, more than one third of patients are still diagnosed at an advanced stage. New therapeutic alternatives are being examined such as the sentinel lymph node in early stages and the preoperative radiochemotherapy in advanced stages.</p><p><strong>Conclusions: </strong>VIN and vulvar cancer need specialized treatment which may be mutilating, despite the fact that therapeutic options are well defined today and tend towards less aggressive surgery.</p>","PeriodicalId":12827,"journal":{"name":"Gynakologisch-geburtshilfliche Rundschau","volume":"47 2","pages":"88-93"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000100338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26671439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prematurity in multiple pregnancies].","authors":"Elisabeth Krampl,&nbsp;Katharina Klein","doi":"10.1159/000100334","DOIUrl":"https://doi.org/10.1159/000100334","url":null,"abstract":"<p><p>At present, 1.5% of all pregnancies are twin pregnancies, but twin pregnancies account for 25% of all premature infants. The chorionicity plays an important role: the risk of preterm birth before 32 weeks is 5.5% in dichorial twins and almost double (9%) in monochorial twins. The rate of intrauterine growth restriction and also the perinatal mortality are twice as high in monochorial compared to dichorial twins. In cases of imminent preterm labour, tocolysis is recommended until lung maturity has been achieved. The preferred drugs, are oxytocin antagonists because of the increased cardiorespiratory strain in multiple pregnancies. Prophylactic bed rest and 'home uterine activity monitoring' have not been shown to improve the outcome, and a recent review (2005) demonstrated a twofold increase in preterm labour after cervical cerclage. In two large placebo-controlled studies, the rate of preterm delivery in high-risk singleton pregnancies was significantly reduced by the regular application of progesterone. A potential effect on multiple pregnancies is yet to be shown.</p>","PeriodicalId":12827,"journal":{"name":"Gynakologisch-geburtshilfliche Rundschau","volume":"47 2","pages":"64-9"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000100334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26671536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Report by the President of the Swiss Society of Gynecology and Obstetrics].","authors":"David Stucki","doi":"10.1159/000101909","DOIUrl":"https://doi.org/10.1159/000101909","url":null,"abstract":"","PeriodicalId":12827,"journal":{"name":"Gynakologisch-geburtshilfliche Rundschau","volume":"47 2","pages":"105-8"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000101909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26713592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beckenbodenchirurgie und weibliche Sexualfunktion im Blickfeld. Bericht von der 31. Jahresversammlung der International Urogynecological Association, Athen, 6.-9. September 2006.","authors":"D Scheiner,&nbsp;C Betschart","doi":"10.1159/000098126","DOIUrl":"https://doi.org/10.1159/000098126","url":null,"abstract":"Hier waren Bildgebung und Rolle der Urodynamik in der Urogynäkologie, Netze in der Inkontinenzund Beckenbodenchirurgie sowie aktuelle und künftige Entwicklungen das Thema. Stefano Salvatore aus Italien und Daniele Perucchini aus der Schweiz erörterten in einem dialektischen Dialog die Rolle der Urodynamik. Dazu verglichen sie die eigenen, unterschiedlichen Patientinnenkollektive im Hinblick auf die Kernfrage, ob die urodynamische Untersuchung das Management ändere. Einerseits würden Dysfunktionen des unteren Harntraktes mittels Urodynamik objektiviert und analysiert. Andererseits liege die Interpretation der Symptome im Spannungsfeld zwischen den Symptomen der Dysfunktion, deren Schilderung durch die Patientin und letztlich deren Interpretation durch den Kliniker, der diese Beobachtungen in die Resultate der klinischen und urodynamischen Untersuchungen integrieren muss. Der Einsatz der verschiedenen urodynamischen Techniken im klinischen Alltag ist häufig durch fehlende Standardisierung, Equipment oder Fachkenntnis sowie kostenbedingt beschränkt. Die Kontinenzfunktion muss jedenfalls wissenschaftlich besser mit urodynamisch messbaren, standardisierten und reproduzierbaren Begriffen erfasst werden. Die Parameter für «krank» oder «gesund» müssten genügend spezifisch und sensitiv sein mit klarem «cut-off level» ohne Überlappung, der Therapiewahl nutzen sowie mit dem Outcome korrelieren. Die beiden Sprecher folgerten, dass Anamnese und klinische Untersuchung die Grundlage der Diagnostik bilden und für den Beginn einer konservativen oder minimal invasiven Therapie ausreichen. Eine weiterführende urodynamische Untersuchung wird vor den meisten invasiven Behandlungen, bei Misserfolg nach Operation, wenn weitere Informationen zur künftigen Therapieplanung benötigt werden, als Teil der Langzeitüberwachung bei neurogener Störung des unteren Harntraktes sowie bei komplizierter Inkontinenz empfohlen (ICI 2004). Urodynamische Die diesjährige Jahresversammlung der International Urogynecological Association (IUGA) fand vom 6. bis zum 9. September in Athen statt und war mit über 1500 Teilnehmern aus 61 Ländern die grösste in ihrer Geschichte. Die IUGA fördert als Non-profit-Organisation weltweit das urogynäkologische Fachwissen sowie die Grundlagenund klinische Forschung. Am Vortag des Kongresses fand die Jahresversammlung der European Urogynaecological Association statt. Neben den Hauptvorlesungen wurden 70 Kurzreferate, 92 diskutierte und 387 nicht diskutierte Poster sowie 136 Videopräsentationen vorgestellt 1 . Generell waren die Workshops zu Prolapschirurgie, transobturatorischem Zugang in der Beckenbodenchirurgie, Innovationen in der Beckenbodenforschung, überaktiver Blase, Botulinumneurotoxin (bei der überaktiven Blase und «pelvic pain syndrome»), «chronic pelvic pain» und interstitielle Zystitis, «bulking agents», «anal sphincter repair», Alter und Laparoskopie gut besucht. Mehrere Satellitensymposien fanden zu Themen wie Lebensqualität, Fortschritte in d","PeriodicalId":12827,"journal":{"name":"Gynakologisch-geburtshilfliche Rundschau","volume":"47 1","pages":"49-51"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000098126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26530267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hypertensive diseases during pregnancy: an interdisciplinary challenge].","authors":"M Schmidt,&nbsp;D Fink,&nbsp;U Lang,&nbsp;R Kimmig","doi":"10.1159/000107258","DOIUrl":"https://doi.org/10.1159/000107258","url":null,"abstract":"<p><p>Hypertensive diseases in pregnancy are one of the main reasons of maternal, fetal and neonatal morbidity and mortality. As preeclampsia is a multisystem disorder with different clinical characteristics, prevention, diagnosis and therapy of this disease require a close interdisciplinary cooperation. The present papers will summarize the status quo of the management of preeclampsia.</p>","PeriodicalId":12827,"journal":{"name":"Gynakologisch-geburtshilfliche Rundschau","volume":"47 4","pages":"197-8"},"PeriodicalIF":0.0,"publicationDate":"2007-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000107258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27028797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}