Stellenwert der Hydratationssonografie in der Verlaufsprognose der schwangerschaftsbedingten Harnstauung

Ohne Zusammenfassung     

Die Berechtigung der Schnittentbindung in der Therapie der Placenta praevia

Archives of Gynecology and Obstetrics -     

Erkrankungen der Niere und der ableitenden Harnwege in der Schwangerschaft

During pregnancy physiological changes of the urinary tract occur due to hormonal and anatomical alterations. Dilatation of the upper urinary tract is the most important of these changes and causes an increased susceptibility for symptomatic urinary tract infections redulting from asymptomatic bacteriuria. Screening for asymptomatic bacteriuria and antibiotic treatment is therefore recommended. Symptomatic urinary tract infections are treated according to the results of urine cultures. The preferred antibiotics are penicillin, cephalosporin and fosfomycin trometamol. Stones in the urinary tract are treated with spasmoanalgetic medications. If there is no spontaneous stone passage after a reasonable time, uncontrollable pain or persistent fever, a ureteral stent or percutaneous nephrostomy tube are inserted. Functional or morphological abnormalities of the urinary tract can cause problems during pregnancy. The presence of a kidney transplant does not preclude a successful pregnancy; however in these cases an interdisciplinary approach is mandatory.     

Ergebnisse der organerhaltenden Therapie der Eileiterschwangerschaft

Worldwide, the incidence of nonruptured tubal pregnancy has increased, and so has the feasibility of conservative management of this condition. Following conservative surgery the rate of intrauterine pregnancy is significantly higher than after salpingectomy. The rate of ectopic pregnancy has not (or hardly) increased. For a surgeon skilled in this technique, the laparoscopic approach has advantages because it avoids laparotomy. For the time being, medical treatment of ectopic pregnancy with methotrexate, prostaglandins, and antiprogesterone should be confined to clinical studies. For nonviable, nonruptured tubal pregnancy with decreasing HCG titers expectant management seems possible; following conservative treatment, monitoring of HCG until it becomes undetectable is mandatory.