Search

Actual situation of sonographic diagnostics stresses the performance of screening investigations in each trimester of pregnancy. Recommended periods are the 10th, 20th and 32nd week of gestation. The major intention of the programme consists of the assessment of abortions, fetal malformations and fetal growth retardation. The efficiency of the screening in the detection of clinically latent pathology attains 15, 0.5, and 4.5 per cent, respectively, in each trimester.

Besides characteristic morphological differences, carcinomas of the breast show remarkable changes of vascularity, which are essential for their enhanced metabolism. High-frequency CW Doppler allows to investigate normal and pathological vascularisation in the breast. In our basic study we examined 200 patients, 37 with breast malignancies (6 non-palpable lesions). 33 of the carcinomas showed pathological vascularisation. In an extended examination procedure we investigated also normal breast vascularisation and compared it with blood flow in lesions. We developed therefrom an easy and rational method which allows physiological blood flow measurements as well as a differentiation of breast lesions within a few minutes' time.

Breast ultrasound has mainly been used for differentiation of cystic and solid lesions. With high resolution technique, which was introduced several years ago, early cancers can now be detected by ultrasound. In this study, 1016 women were examined within 3 months. Mammography was used independently. According to the expected prevalence, 4 nonpalpable carcinomas were detected by sonography. The study proves that high-quality ultrasound equipment allows a primary detection of subclinical breast cancers. In premenopausal patients the sensitivity of mammography is reduced. Therefore, ultrasound should be used complementary to mammography in this age group. Widespread use is not possible due to a deficiency in experienced staff. However, in experienced centres, ultrasound could be used as a supplement to mammographic screening to prove if breast cancer mortality in premenopausal women can be reduced.

Theoretical and experimental studies were performed on the propagation of ultrashort optical terawatt pulses through the atmosphere. Propagation simulations of intense sub-picosecond pulses show that non-linear processes, such as white light generation, can be initiated at a chosen distance by selecting an appropriate group velocity dispersion. With this technique, a white light continuum was generated in the atmosphere whose spectral distribution was characterised in the visible and near infra-red. Applications of this novel light source for atmospheric remote sensing were investigated, combining lidar and time-resolved broadband absorption spectroscopy techniques. Measurements were performed on the oxygen molecule and water vapour. A comparison between the experimental results and the tabulated spectroscopic data led to an excellent correlation with measurements made on water vapour whereas observations on the oxygen showed discrepancy. This study demonstrates that the remote generation of a white light source represents a new way to access the range-resolved multi-trace gas analysis in the atmosphere.

Development in the field of high-power laser systems with repetition rates of several Hz and energies of few joules is highly active and opening, giving new possibilities for the design of laser ions sources. Preliminary investigations on the use of four different laser and target configurations are presented: (1) A small CO2 laser (100 mJ, 10.6 μm) focused onto a polyethylene target to produce C ions at 1 Hz repetition rate (CERN). (2) An excimer XeCl laser (6 J, 308 nm) focused onto solid targets (Frascati). (3) A femtosecond Ti: sapphire laser (250 mJ, 800 nm) directed onto a solid targets (Jena). (4) A picosecond Nd: yttrium–aluminum–garnet (0.3 J, 532 nm) focused into a dense medium of atomic clusters and onto solid targets (London). The preliminary experimental results and the most promising schemes will be discussed with respect to the scaling of the production of high numbers of highly charged ions. Different lasers are compared in terms of current density at 1 m distance for each charge state.

>1012 cm-3) in the filaments, which plays a crucial role in the interplay of diffraction and self-focussing, leading to the formation of long stable channels. These filaments may have applications for laser-triggered lightning.

One of the current questions in Si based thin film applications is how to prepare silicon layers with acceptable crystalline quality on low cost substrates such as glass for thin-film-transistors. We describe an approach of pulsed laser crystallization of an amorphous silicon starting layer with pulse lengths in the range of 10 to 10—4 ns under a transparent confinement layer during laser crystallization. The system is inertially confined and excurses into an extreme state (high temperature/high pressure in the laser-induced molten silicon). As a result one laser pulse of this short time, high temperature–high pressure (HiTP) experiment crystallizes grains of around 1 μm in size with a low density of extended defects.

The innershell photoionisation soft X-ray laser proposed by Duguay and Rentzepis [Appl. Phys. Lett. 10 (1967) 350] is investigated. Based on dynamic calculations, we propose a new operating regime at high atomic densities (∼ 1017 cm−3) for this lasing system which is suitable for the recently developed short pulse ( 1012 W) laser systems. At high densities, a short rising edge of the soft X-ray pumping radiation is shown to be critical for high gain performance. The calculated gain duration suggests that this laser could be operated as a sub-picosecond laser using traveling wave excitation.

Second-harmonic (SH) generation is a versatile method applicable to in-situ characterization of even non-centrosymmetric media like silicon carbide (SiC). In particular, the azimuthal rotational anisotropy of the SH response from SiC observed in reflection allows identification of various polytypes. The nonlinear-optical results are compared to X-ray diffraction data. The abundance of information obtained through the SH studies makes characteristic fingerprinting of the 6H, 15R, and 3C polytypes of SiC is possible. The spatial resolution of the optical sampling was about 50 μm in the lateral direction with a typical penetration depth of 100 nm for the fundamental radiation. Defect regions of different crystallographic structures in large SiC samples were identified by observing the spatially resolved dependence of the SH intensity.

After a largely inconspicuous pregnancy, a 31-year old primipara suffered from a status epilepticus in the third trimenon. The convulsions could not be terminated by emergency medical services, resulting in aspiration of gastric contents. Assuming eclampsia, an emergency caesarean section was performed immediately in a central hospital. Postoperatively, a pathological pattern of tendon reflexes was noticed. A CT scan revealed subarachnoid haemorrhage. The causal aneurysm of the right A. pericallosa was clipped subsequently. Eclampsia is the leading cause of epileptic seizures during pregnancy. However, a different aetiology should always be considered, especially if medical history does not reveal symptoms of pre-eclampsia.

The obstetrician's expectations of anaesthetists are high and include a high level of competence at a specialist level, experience of the delivery room, a calm but fast and ordered way of working, a tactful and enquiring approach and the ability to work in an interdisciplinary environment. In the area of organisation the obstetrician and the anaesthetist should, through optimal cooperation, have a good understanding of the procedural plan to ensure the safety of mother and child. This includes working in close proximity, regular joint consultations and early preinterventional contact with the pregnant patient in order to inform them of the anaesthetic options and their inherent risks. Despite the undoubted successes resulting from the cooperation between obstetricians and anaesthetists, as shown by the reduction in mother and child mortality rates, the current structured and medical circumstances are not optimal and should motivate both disciplines towards improved joint care.

Reaction of [Ni(‘MeS2’)2] (1) (‘MeS2’−=o-(methylthio)thiophenolate(1−)) with methyl lithium yields the methyl complex anion [Ni(CH3)(‘MeS2’)2]− which can be isolated as (NMe4)[Ni(CH3)(‘MeS2’)2] (2). The molecular structures of 1 (monoclinic, P21/c, Z=2, a=791.5(5), b=1083.1(8), c=894.1(6) pm, β=92.79(5)°, R/Rw=0.063/0.049) and 2·MeOH (monoclinic, P21/c, Z=4, a=1901.0(12), b=830.3(9), c=1716.1(14) pm, β=113.84(5)°, R/ Rw=0.072/0.053) were elucidated by X-ray structure analysis. 1 contains a planar [NiS4] core, 2·MeOH exhibits a planar [NiS3C] core, one thioether donor being decoordinated. 1 does not react with CO but 2 undergoes immediate reaction with CO. Monitoring the reaction by IR spectroscopy yields evidence for the intermediate formation of labile Ni-acetyl complexes. Reaction of 2 with protonic acids (HBF4/Et2O, HCl/THF) yields CH4 and 1. Thermolysis of 2 in solid state as well as in acetone solution at room temperature, however, gives C2H6, and 1 was identified as one of the resulting nickel species.

Ni(II) salts and the tetradentate thioether-thiolate ligand ′S4-C2′2- (= 1,2-bis(2-mercaptophenylthio)ethane(2-)) yield [Ni(′S4-C2′)]x (1), that also forms when Na2[Ni(′S2′ )2] (′S2 2-′ = o-benzenedithiolate(2-)) is alkylated by 1,2-dibromoethane. In boiling pyridine 1 adds two solvent molecules and gives pseudooctahedral [Ni(pyr)2(′S4-C2′ )] (2) which was characterized by X-ray structure determination. Reaction of 1 with PMe3 yields [Ni(PMe3)(′S4-C2′)] (4). X-ray structure determination of 4 showed that the Ni center is surrounded by one P and four S atoms in a distorted tetragonal pyramid in which the P atom, one thioether S atom and both of the thiolate S atoms form the base while the second thioether S atom occupies the apical position. Reaction of 1 with n-BuLi leads to removal of the C2H4 bridge of the ′S4-C2′2- ligand and formation of Li2[Ni(′S2′)2]. When [Ni(acac)2]3 is reacted with ′buS4-C2′2 (= 1,2-bis(3,5-ditertiarybutyl-2-mercaptophenylthio)ethane(2-)) which is analogous to ′S4-C2′2-, the trinuclear [Ni(′buS4-C2′)]3 (3) forms. 3 · THF was characterized by X-ray structure determination. It contains one tetrahedrally distorted and two planar [NiS4] cores that are connected via the C2H4 groups of the ligands such that a macrocycle forms. PMe3 cleaves 3 to give mononuclear [Ni(PMe3)(′buS4-C2′)] (5). Due to its lability, it was characterized only by spectroscopic methods.

In order to elucidate specific properties of nickel-sulfur complexes, addition and substitution reactions of [Ni(′MeS2′)2] (1) were investigated. 1 is rapidly hydrolyzed by aqueous HCl yielding ′MeS2′–H and Ni(II) ions. 1 coordinates phosphines as coligands, thioether donors decoordinate, however, simultaneously. The monophosphine complex [Ni(PMe3)(′MeS2′ )2] (2) was characterized by X-ray structure determination. It contains a square-planar NiS3P unit and one decoordinated thioether group. Redox reactions of 1 occur with NO+ and NO, yielding the binuclear nitrosyl complexes cis- and trans-[Ni(NO)(′MeS2′)]2 (3) and the disulfide [′MeS2']2•

The amount of amniotic fluid was determined semiquantitatively in 600 pregnancies between the 12th and 41st week of gestation. Pregnancies at risk were excluded. The largest amniotic fluid area was measured sonographically in two dimensions. The mean plus/minus standard deviations are correlated with gestational age. A diagram has been prepared. Our results show good correlation with values from invasive quantitative examinations of amniotic fluid amount. However, our procedure is easy to perform and without hazard for the pregnancy, since it is non-invasive.

Malignant growth requires a high metabolism. This allows the differentiation of lesions by Doppler measurements of their vascularisation. In this study of 224 patients with 45 malignancies (37 breast cancers and 8 local recurrences), 87% of the cases were correctly identified. Differentiation of palpable lesions was possible in 93%. The flow in normal breast arteries was studied as well as in carcinomas, comparing continuous-wave (CW) Doppler with frequencies at 4 and 8 MHz. To improve flow evaluations in nonpalpable lesions, pulsed Doppler was used at 3 MHz and color mapping systems at 5 MHz in another 37 patients. Color Doppler at 5 MHz identified 17 of the 21 malignancies; in all cases pulsed Doppler at 3 MHz failed.

We report simultaneous measurements and ab initio calculations of the second-order nonlinear coefficients for SiC polytypes. Our measured values for χzzz (χzxx) are 18 (−4) pm/V for 4H SiC and 24 (−4) pm/V for 6H SiC. They are in good agreement with our theoretical results.

The interaction of 100-fs Ti:sapphire laser pulses with thin foil targets was experimentally investigated at intensities exceeding 10(18) W/cm(2). High harmonics were observed in transmission through an overdense plasma in the direction of the incident beam. From the cutoff frequency of the harmonics an electron density of 1 x 10(24) cm(-3) is inferred, indicating a compression of the plasma by the ponderomotive force of the laser pulse.

31 triplet pregnancies (DG), treated during 1975-1989, were analysed retrospectively. 13 DG (D10) were registered up to the end of the 10th week of pregnancy, 16 (DG) (D16) were intact between the 11th and the 16th gestational week. 3 DG resulted from the reduction of high grade multiple pregnancies. 18 DG (62%) of the initial 29 DG had previously been treated for sterility. The spontaneous foetal loss (DF) in group D10, including the perinatal mortality, amounted to 26% (10 of 39 DF). In one case of this group, a previously vital DF died. In another case, a partial bi-phasic abortion occurred followed by a premature birth of the surviving 3rd DF. The mortality rate in group D16, including the perinatal mortality (4 DF), was 25% (12 of 48 DF). 30 DG were still intact after the 16th week of pregnancy. 2 DG (7%) suffered from EPH-gestosis. In 4 DG (13%) a foeto-foetal transfusion syndrome occurred. 5 DF (6%) had some of the serious malformations. 27 DG were completed. 7 DG (26%) ended before the 32nd gestational week. In 13 DG (48%), a Caesarean section was performed. The perinatal mortality amounted to 11% (9 of the 81 DF) including all the births from the 25th gestational week upwards. On comparing these results with the data in the literature, a significant improvement in the prognosis of DG in recent years can be observed. This is due to the progress in antenatal and neonatal care.

During 1986-1988, the Arabin-cerclage pessary was used alternatively to surgical cerclage in 58 patients for prophylactic and in 44 cases of therapeutic indications. In 5 additional patients, the pessary was applied instead of emergency cerclage. The advantages of the cerclage pessary compared to other rigid pessary types, are based on its flexibility and adjustment to the anatomic conditions of vagina and cervix. The bowl-shaped pessary is inserted with the curvature upwards and the cervix is fixed in the central opening of the cerclage pessary. Thus a constriction, reconfiguration, and elongation of the incompetent cervix is obtained as evidenced by ultrasonography. The only side effect of the pessary treatment is an increase in cervical secretion and subsequent vaginal discharge. No infectious complications occurred. In 92% of the treated gravidae the cerclage pessary could be removed after the 36th week of gestation. Cerclage pessary can be recommended as a favourable alternative to surgical procedures as prophylactic or therapeutic approach, reducing surgical treatment significantly to less than 0.5%.

Summary form only given. The interaction of femtosecond laser pulses with solids at high intensities leads to the formation of high-density plasmas with high electron densities. It is well known that frequency-resolved measurements of reflected laser light from a plasma surface reveal the mass motion driven by the heating laser pulse. A more complete picture of the plasma motion can be obtained by measuring the phase and amplitude of the reflected pulse. Frequency-resolved optical gating (FROG) detection is a method that provides a two-dimensional temporally resolved spectrum from which phase and amplitude information can be retrieved. We have used this technique, to our knowledge for the first time, to measure the reflected waveform in a high-intensity laser-solid interaction experiment.

Measurements of three-halves harmonic radiation (3omega(0)/2) produced by femtosecond, Ti:sapphire laser pulses (less than or equal to2x10(17) W/cm(2)) in long density scale length plasmas generated from solid aluminum targets are presented. The 3omega(0)/2 emission yield shows excellent agreement with theories of the two-plasmon decay instability in the predominantly linear regime. (C) 2002 American Institute of Physics.

The obstetrician's expectations of anaesthetists are high and include a high level of competence at a specialist level, experience of the delivery room, a calm but fast and ordered way of working, a tactful and enquiring approach and the ability to work in an interdisciplinary environment. In the area of organisation the obstetrician and the anaesthetist should, through optimal cooperation, have a good understanding of the procedural plan to ensure the safety of mother and child. This includes working in close proximity, regular joint consultations and early preinterventional contact with the pregnant patient in order to inform them of the anaesthetic options and their inherent risks. Despite the undoubted successes resulting from the cooperation between obstetricians and anaesthetists, as shown by the reduction in mother and child mortality rates, the current structured and medical circumstances are not optimal and should motivate both disciplines towards improved joint care.

TW-fs-laser pulses are used for a novel height-resolved LIDAR detection technique. This remote sensing technique should allow a multi-component analysis of atmospheric compounds in the visible and near-infrared. Results of the spectral content and conductivity of light-filaments generated by high-intensity lasers and height-resolved LIDAR-measurements in the visible are presented.

Mammographie und Ultraschall haben eine hohe Sensitivitat zur Erkennung von Mammatumoren [1, 2]. Allerdings resultieren aus beiden Untersuchungsmethoden haufig unklare Befunde, die eine operative Abklarung erfordern, obwohl eine benigne Veranderung vorliegt [5–8]. Daher mus die Spezifitat bei der Brustdiagnostik weiter verbessert werden.

We report on the prenatal diagnosis of a Pena-Shokeir syndrome sporadic case of the 27th week of pregnancy. Typical sonographical features are polyhydramnios, hypoplasia of lungs, foetal akinesia, reduced length of proximal and distal extremities and a striking discrepancy between biparietal and abdominal diameter. Differential diagnosis of polyhydramnios caused by foetal neuromuscular disorders is discussed.

When intense TW-fs-laser pulses propagate in the atmosphere, nonlinear selffocusing effects cause the intense laser beams to disintegrate into several filaments. Selffocusing ceases when an equilibrium is achieved between diffraction, selffocusing and ionization [1,2]

Leiomyosarcoma are malignant tumors showing smooth muscle differentiation, they are rare, representing only about 25 percent of all uterine sarcomas and mixed malignant tumors and slightly more than 1 percent of all corporeal malignant tumors. Usually they arise in postmenopausal women and are not known to be related to the known risk factors for endometrial carcinoma (nulliparity, obesity, diabetes mellitus, hypertension, etc.) or carcinosarcoma (prior radiation therapy). They may occur in uteri that also bear typical benign leiomyomas, but leiomyosarcoma rarely can be proven to have arisen in or from benign leiomyomas. We report on two premenopausal women with leiomyosarcoma--out of totally 31 cases in our clinic from 1975-1995 who got pregnant after surgical treatment preserving the uterus. The patients are alive without evidence of disease 3 and 6 years after surgical resection.

Accelerations up to 4×1019 m/s2 are measured in femtosecond laser-produced plasmas at intensities of 1018 W/cm2 using the Frequency Resolved Optical Gating (FROG) technique. A high density plasma is formed by focusing an ultrashort unchirped laser pulse on a plane carbon target and part of the reflected pulse is eventually detected by a FROG autocorrelator. Radiation pressure and thermal pressure accelerate the plasma which causes a chirp in the reflected laser pulse. The retrieved phase and amplitude information reveal that the plasma motion is dominated by the large light pressure which pushes the plasma into the target. This is supported by theoretical estimates and by the results of independently measured time integrated spectra of the reflected pulse.

Mass acceleration in femtosecond laser plasmas exceeding 1018 g is measured using the frequency resolved optical gating technique. Accelerations of this magnitude appear in the stretched horizon regime of black holes. Detection of chirped light from black hole candidates would allow for unique identification.

After a largely inconspicuous pregnancy, a 31-year old primipara suffered from a status epilepticus in the third trimenon. The convulsions could not be terminated by emergency medical services, resulting in aspiration of gastric contents. Assuming eclampsia, an emergency caesarean section was performed immediately in a central hospital. Postoperatively, a pathological pattern of tendon reflexes was noticed. A CT scan revealed subarachnoid haemorrhage. The causal aneurysm of the right A. pericallosa was clipped subsequently. Eclampsia is the leading cause of epileptic seizures during pregnancy. However, a different aetiology should always be considered, especially if medical history does not reveal symptoms of pre-eclampsia.

Femtosecond laser-produced plasmas are sources of superhot electrons and consequently of hard radiation in the multi-MeV range via bremsstrahlung [1,2]. These sources offer the potential to observe nuclear effects using ultrashort laser pulses. Although still at the beginning these techniques might lead to a new femtosecond spectroscopy of nuclei.

Seit der Einfuhrung der Dopplersonographie ist die nichtinvasive Uberwachung des fetomaternalen Kreislaufes moglich [7, 8, 9]. Durch die qualitative Analyse der Flusgeschwindigkeitskurven mittels winkelunabhangiger Indizes werden Parame ter wie die kardiale Funktion, die Gefaswand-Compliance und der periphere Widerstand indirekt erfast [22, 31]. Durch pathologisch veranderte Flusmuster sowohl in der Aorta fetalis wie auch in der A. umbilicalis (A. umb.) kann eine drohende fetale Gefahrdung erfast werden [12, 14, 25].DerenddiastolischeFlusverlust(EDFV) und der Reverse flow sind als hochpathologische Veranderungen des Flusmusters in hohem Mase mit intrauteriner Asphyxie, intrauterinem Fruchttod (IUFT) und perinataler Mortalitat assoziiert [2, 6, 11, 18, 20, 29, 34]. Uber das geeignete geburtshilfliche Management bei EDFV bestehen noch Unsicherheiten bzw. Kontroversen. Wahrend einerseits bei EDFV die vorzeitige Entbindung empfohlen wird [27, 35], stellen z.B. Weis und Berle (1991) [34] bei EDFV die Indikation fur eine stationare Intensivuberwachung. Nachgewiesene gute Korrelationen zwischen Blutgasanalyse und Dopplerbefunden [4, 21 ] lassen eine bessere Beurteilung des fetalen Zustandes erwarten. Ziel dieser Arbeit ist, anhand der Analyse von 41 Fallen mit EDFV unsere Erfahrungen darzustellen.

Screeninguntersuchungen sind ein wesentlicher Bestandteil der Praventivmedizin. Ein Screening beinhaltet die Durchfuhrung einer Untersuchungsmethode bei einem durch bestimmte Eingangskriterien definierten Querschnittskollektiv. Im engeren Sinn bedeutet Screening das Durchmustern einer asymptomatischen Popu lation mit dem Ziel, klinisch okkulte Krankheitszeichen zu entdecken. Der mogliche Gewinn besteht in der Fruherkennung, die es ermoglicht, die Gesundheit durch rechtzeitige Therapiemasnahmen wiederherzustellen.

Breast ultrasound has mainly been used for differentiation of cystic and solid lesions. With high resolution technique, which was introduced several years ago, early cancers can now be detected by ultrasound. In this study, 1016 women were examined within 3 months. Mammography was used independently. According to the expected prevalence, 4 nonpalpable carcinomas were detected by sonography. The study proves that high-quality ultrasound equipment allows a primary detection of subclinical breast cancers. In premenopausal patients the sensitivity of mammography is reduced. Therefore, ultrasound should be used complementary to mammography in this age group. Widespread use is not possible due to a deficiency in experienced staff. However, in experienced centres, ultrasound could be used as a supplement to mammographic screening to prove if breast cancer mortality in premenopausal women can be reduced.

The Asterix IV high power iodine laser was projected to deliver output pulse energies of up to 2 kJ at pulse lengths tp >= 1 ns in one beam. Using a mode-locked or a long-pulse oscillator the pulse duration can be adjusted in the range between 0.1 and 3 ns. In addition, in the fundamental wavelength at 1315 nm the laser can be operated at either the second or third harmonic at (lambda) equals 658 nm and (lambda) equals 438 nm, respectively. Up to now a maximum output energy of 1.3 kJ could be extracted which was -- at tp equals 0.4 ns -- limited only by the damage threshold of optical components. Emphasis has been put on improving the laser performance; e.g., the energy density of the top hat beam profile shows a modulation as small as +/- 6% and the output pulse energy can be kept stable within +/- 4% during a period of several months. Since 1988 the laser has been used for 3000 target shots and it has proved a reliable tool.© (1993) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Hypotension in pregnancy represents an often underestimated danger for mother and fetus. Several investigators have described an increased incidence of miscarriages, premature delivery and small for date babies. In a first study 10 pregnant women with hypotension and severe orthostatic dysregulation were treated with norfenefrine hydrochloride (3 x 45 mg p. os/day). To investigate the effects of this therapy we monitored maternal blood pressure, subjective well being, CTG and furthermore fetal circulation by using pulsed doppler sonography. An average 4.2 days of treatment were required for complete alleviation of symptoms. Blood flow volume and resistance-index were determined for the fetal aorta descendens, and were found to be the same as in normal pregnancies. In addition no difference in fetal outcome was seen and there was no occurrence of premature contractions.

We report on biometric measurements of the fetal heart with the TM-technique; these measurements were carried out between the 20th and 40th gestational week. The right and left endsystolic atrial and ventricular diameters were, measured, as well as the diameters of the large vessels, i.e. aorta and pulmonary artery; finally, the septal thickness was determined. Our measurements show a linear progression of the diameters in question, the right-left ratio of the atria and ventricles was close to one, so was the ratio between aorta and pulmonary artery. Our results are compared, as far as possible, to the literature.

Mit der Doppler-Sonographie ist die nichtinvasive Uberwachung des fetomaternalen Kreislaufes moglich (7 – 10). Uber die Beurteilung der Flusmuster in der fetalen Aorta und in der A. umbilicalis kann eine drohende fetale Gefahrdung erfast werden, wobei der enddiastolische Flusverlust (EDFV) und der Reverse-Flow als hochpathologische Veranderungen des Flusmusters in hohem Mase mit intrauteriner Asphyxie, intrauterinem Fruchttod und perinataler Mortalitat assoziiert sind (2, 6, 12, 17, 19, 25, 27). Uber das geeignete geburtshilfliche Management bei EDFV bestehen noch Unsicherheiten bzw. Kontroversen (23, 27, 28). Mit der Analyse von 41 Fallen mit EDFV wird unsere Erfahrung und unser geburtshilfliches Management dargestellt.

Over a period of 18 months measurements of fetal Organs (cornu anterius of the lateral ventricle, medium diameter of the four-chamber-view of the heart, transverse diameter of lungs, stomach, gall bladder, colon and urinary bladder) were carried out in a population of 223 normal pregnancies. The measurements were correlated to the age of pregnancy and sonographic growth parameters (biparietal diameter--BPD, mean cephalic diameter--MCD, mean abdominal diameter--MAD). The results show different growth velocities of the particular organs, obviously depending on physiological function. The variability is increasing with fetal growth. We found no fundamental difference as far as correlation of organ measurements to age of pregnancy, to BPD, MCD or MAD. In summary the imaging and biometries of the fetal organs appear to be possible in relatively little time and such is a valuable method for the detection of fetal anomalies.

A retrospective study was conducted comprising 78 cases of fetal urinary tract obstructions diagnosed by ultrasound. Thirteen of the obstructions were subvesical and 65 supravesical. In only one fetus with a subvesical obstruction leading to megacystis was a puncture of the fetal bladder performed--in the 17th week of gestation--resulting in restitution of the bladder to its normal size. In all of the remaining fetuses the kidneys, lungs, and bladder changes had already reached an advanced stage by the time the ultrasound diagnosis was made. In the 65 fetuses with supravesical urinary tract obstructions in utero puncture to relieve a rapidly developing hydronephrosis only seemed advisable in two cases. All of the prenatal diagnoses were confirmed postpartum with the exception of two Potter IIa kidneys, which had been interpreted as being hydronephrosis. The time and method of postnatal management are described. The results of the study indicate that in utero intervention is only indicated in the very rare case. Nearly all of the supravesical obstructions remained unchanged, some even for months. In these cases there was no evidence of cystic-dysplastic renal changes after delivery.

Nach dem intrauterinen Fruchttod (IUFT) eines Zwillings (ZW) kann es zu Komplikationen der Mutter und des uberlebenden Feten kommen. Eine intensive Uberwachung dieser Schwangerschaften ist daher angezeigt.

An der Universitatsfrauenklinik Freiburg wurden in einem 5-Jahreszeitraum insgesamt 78 fetale Harnwegsobstruktionen diagnostiziert; darunter befanden sich 65 pra- und 13 subvesikale Obstruktionen. Der postpartale Beobachtungszeitraum lag zwischen 6 Monaten und 5 Jahren.

We report on a newborn with fetal acquired heart block (CHB). CHB is a rare, irreversible defect, commonly occurring in conjunction with myocarditis in the neonatal lupus syndrome. Development of CHB is strongly associated with maternal anti-SS-A(Ro)/SS-B(La) antibodies. Intrauterine therapy of CHB is not possible. Concomitant myocarditis, however, can be treated effectively with dexamethasone. Mothers with an elevated risk of fetal CHB can be identified by their history (underlying systemic connective tissue disease, previous pregnancies with CHB), an immunogenetic predisposition (HLA-DR3) and analysis of the SS-A/SS-B antibody pattern. In these pregnancies prevention of CHB with plasmapheresis plus dexamethasone during pregnancy may be possible.

31 triplet pregnancies (DG), treated during 1975-1989, were analysed retrospectively. 13 DG (D10) were registered up to the end of the 10th week of pregnancy, 16 (DG) (D16) were intact between the 11th and the 16th gestational week. 3 DG resulted from the reduction of high grade multiple pregnancies. 18 DG (62%) of the initial 29 DG had previously been treated for sterility. The spontaneous foetal loss (DF) in group D10, including the perinatal mortality, amounted to 26% (10 of 39 DF). In one case of this group, a previously vital DF died. In another case, a partial bi-phasic abortion occurred followed by a premature birth of the surviving 3rd DF. The mortality rate in group D16, including the perinatal mortality (4 DF), was 25% (12 of 48 DF). 30 DG were still intact after the 16th week of pregnancy. 2 DG (7%) suffered from EPH-gestosis. In 4 DG (13%) a foeto-foetal transfusion syndrome occurred. 5 DF (6%) had some of the serious malformations. 27 DG were completed. 7 DG (26%) ended before the 32nd gestational week. In 13 DG (48%), a Caesarean section was performed. The perinatal mortality amounted to 11% (9 of the 81 DF) including all the births from the 25th gestational week upwards. On comparing these results with the data in the literature, a significant improvement in the prognosis of DG in recent years can be observed. This is due to the progress in antenatal and neonatal care.

An active and passive mode-locked Nd:glass double laser system is built-up. It consists of two gain branches and a common antiresonant ring. The electro-optic Q-switch, the acousto-optic modulator and the saturable absorber are incorporated in the antiresonant ring. A Nd:phosphate glass rod, a Nd:silicate glass rod, and birefringent tuning elements are in the separate gain branches. Time synchronized pulses of 15 ps duration were be tuned over a frequency region of 0 to 200 cm −1 .