Search

In a multicenter study we have evaluated the effect of immunotherapy with pooled buffy coats on women with habitual abortions. 21 women were selected under the same criteria with respect to clinical, immunological and blood banking conditions. All women have had at least two miscarriages with the same partner and no living child (except one case). Additionally, all well-known reasons for abortions were excluded. The couples were tested for HLA-A, B and C antigens as well as for the presence of HLA-antibodies. The couples with recurrent spontaneous abortions suggested a significantly higher compatibility in two or more antigens in comparison to the control couples with children and without any abortion. Before treatment there was no case with cytotoxic HLA antibodies. 10 women received each two pooled buffy coats intravenously before pregnancy at time intervals of 3 weeks. 15 women were treated in early pregnancy until the 28th week of gestation at the same application intervals. In the meantime 10 of 15 women have delivered at term a healthy and mature child with normal weight. Four of 15 are still pregnant in the third trimester of pregnancy. In one case the pregnancy resulted in an abortion. The buffy coat transfusions were well tolerated and led in no case to the formation of antierythrocytic antibodies. 12 of 21 women treated developed HLA antibodies at various time intervals during immunotherapy, mainly with a low titre. In 7 of 10 cases the antibodies occurred in the treatment period before pregnancy, in 5 of 15 cases during pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

In a critical analysis the obstetric results of individual induced labour (socalled "programmed labour") are compared with a series of births with spontaneous start of labour and of indicated induced deliveries. The results shows a much superior outcome of programmed labour: a shorter period of labour, a much reduced number of cesarean sections, a lower frequency of hypoxia, fewer newborn with pronounced Clifford-signs. The technical, personal and organisational efforts in modern obstetric is enormous increased. The induced labour is a possibility, this efforts to put into practice.

Reported in this paper is the case of a woman, 43 years of age, with malignant haemangiopericytoma. The patient had undergone radical surgery and irradiation, following diagnosis of globucellular sarcoma. Metastasis occurred after an interval of six years from surgery. Histological checks revealed a pattern typical of haemangiopericytoma. The patient died one year later. - Morphology, incidence, clinical aspects, and general importance of this rare tumour are discussed against the background of relevant literature. The point is made that histological diagnosis may be quite difficult and that there is only limited possibility to draw conclusions from the morphological pattern of the tumour as to its biological importance.

We have performed class I HLA antigen testing in 42 women with recurrent habitual abortions and in their husbands. The main criterion for inclusion in this group was a frequency of more than two abortions without the known reasons for abortion and without a living child. 29 couples with a least two healthy children and no abortion in the clinical history served as a control group. The data were evaluated in respect to the association of HLA and disease as well as to the level of histocompatibility within the couples. In our results we did not find any significant association between HLA-A, B, C phenotypes and the habitual abortion. On the other hand, we observed a significantly higher level of histocompatibility in the couples with habitual abortions in comparison to the control couples. The frequency of identity in one and more histocompatibility antigens was in the patient group significantly higher than in the control group and as it could be expected by chance, calculated on the basis of antigen distribution within the loci A, B, C in the population in the southern part of the GDR. In no case we have revealed lymphocytotoxic antibodies as a possible cause for miscarriage. Our results are in favour of the hypothesis that a higher level of histocompatibility could be an immunological explanation for the habitual abortions. In addition, this hypothesis was supported by the successful immunotherapy with leukocytes derived from the husband or nonrelative donors.

In the 9-years period (1967 to 1975) we are using the amnioscopy increasing generously. Nevertheless the percentage on pathological findings of the amniotic fluid altogether and in the seperate groups of indication is nearly has been always the same. It is'nt exact correlation between the severity of the symptoms of risk and the occurrence of the pathological findings in the amniotic fluid. The grand reliability of the amnioscopy also follows from the material of ourselves: The perinatal mortality in the group of supervised pregnant women by amnioscopy is clear less than in the group of nonsupervised. That comes true to all three parts of perinatal mortality. Our own experiences speak in generous use of the optical evaluation of amniotic fuuid by was of screening.

Reported in this paper is progress obtained from palliative treatment of patients with advanced ovarian carcinoma in an area under the control of a district hospital, between 1957 and 1978. Particular reference is made to the favourable effects of combination chemotherapy on survival rates and general condition. This study is intended to underline that the above therapeutic approach should not be restricted to few highly specialised centres and that it is practicable to the benefit of the patients concerned also under routine conditions at district hospitals. However, everything depends on high-continuity and persistent monitoring of these women on the basis of unity of hospital and outpatient attention.