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A case of ovarian venous thrombosis in the puerperal period after caesarean section (twin pregnancy) of a 14 year old patient is reported. After removal of the attacked vein, ovary, and fallopian tube antibiotics and heparin were given. The uterus could be maintained. The problems of diagnosis and treatment were discussed.

A case of an extraperitoneal injury of the urinary bladder by an endoscopical sterilization of the fallopian tubes is reported. The occurrence of clinical symptoms in a temporary difference to operation makes diagnosis of this rare complication difficult.

Prostaglandin E2 is often used for induction of labour. A procedure appropriate for obstetrical condition of the cervix uteri is recommended. 1,472 births with a medical indication were induced in a multicenter-study. With a bishopscore < 5 prostaglandin E2 gel intracervical and with a score between 5 and 8 vaginal tablets were used for induction. Appropriate for the condition of cervix it was allowed to continue the induction. With a bishopscore > 8 an infusion of oxytocin was given. The fetal outcome was evaluated appropriate for the condition of cervix before and during induction of labour. The APGAR-score one minute post partum was < 8 in 10.8 per cent of all neonates. This part was near the same in the gel- and in the tablet group (p > 5%). By continuation of induction, the part with pathological findings was at all times not in relation to the different groups of cervical condition. It's the same by APGAR-scores 5 and 10 minutes after delivery. The acidotic morbidity at all was 10.7%. Also in this connection it was only an unimportant (p > 5%) increasing to observe then the induction was continued. There is no relation between the different groups of cervical condition and the acidotic morbidity. Under observation of mother and child the to cervical condition appropriated used method of induction of labour does not expect a bad neonatal outcome. The longer the cervix is unripen, the higher is the rate of delivery by caesarean section. The exploitation of the possibilities of induction by drugs can be recommended.

Because tramadol does not exhibit an depressive effect on ventilatory activity it is often be used in the obstetrical analgesia, at most in form of an intramuscularly injection. In a prospective study on at all 49 women under labour the clinical effect of the noninvasive rectal application of Tramadol, Pethidin, and Denaverin has been compared. The first dosage was 100 mg of all substances. Around the half of the women said that analgetic effect was good or very good. On only every fifth it was sufficient or not enough. The effect was at near the same in all treatment groups. Because of a low incidence of maternal side effects, the absence of side effects on the newborn, and near the same results on the analgetic effect of parenteral application in other studies, tramadol suppositories can be recommended for obstetrical analgesia.

The induction of labour was started with an intracervical administration of 0.5 mg PGE2-Gel (Prepidil) in 30 gravidae at or near term with an unripe score of the cervix and for a medical indication. After excluding patients, where labour had already started subsequent to this measure, induction of labour was continued randomised with PGE2-gel intravaginal versus intravenous oxytocin. The progress of labour, the neonatal condition, and paraclinic values were examined. In 11 cases, labour had already started after the intracervical administration of PGE2. The Bishop-score of the other gravidae was improved in the mean from 2.5 +/- 1.1 to 5.5 +/- 1.7. Was the induction carried out with PGE2 vaginal, the rate of success rose to 5 of 9, and after infusion of oxytocin in 6 of 10 cases. The continued PGE2 vaginal inductions were insignificantly slower (p greater than 5%) than the inductions continued which oxytocin. The mean duration of labour was 7.7 +/- 3.4 hours in the PGE2-group and 4.5 +/- 2.6 hours in the oxytocin group. No disadvantages resulted for mother and child from the vaginal administration of PGE2. Because of the high rate of acceptance, vaginal administration of PGE2 is a suitable method for the safe induction of labour.

This paper describes first observations with a new computer aided analysis of tocogram. It seems that length of uterine contraction is an important parameter for quality of labour. In 9 from 12 cases promotion to constant length of labour with relatively low absolute duration of contractions was connected with a distinct increase of the velocity of cervical dilatation. The uniformity can be an important factor for the conversion into active phase of labour.

Report on first experiences in chorionic villi sampling in the first trimester of 131 pregnancies. Chorion biopsy was performed just before termination of pregnancy in the 9th-11th week of gestation. Of 3 tested biopsy methods we found the biopsy with a flexible forceps under guidance of real-time ultrasound to be the best.

A case of uncontrolled, overdosed therapy with a coumarin in unknown pregnancy is reported on. Informations are discussed from the literature about the use of coumarin-derivates during pregnancy.

In this paper 4 cases with fetal nonimmunologic ascites are reported. Etiology from ascites and outcome of pregnancies are discussed. To elucidate the cause of ascites may be important for further pregnancies.