Noch 2197 Tage!
Statistische Auswertung
ZURÜCK
Galaktogenese (#R: -2; #F: 3)
Milchsekretion

- Hohe Prolaktinspiegel
Litzmann-Obliquität (#R: -1; #F: 2)
Hinterer Asynklitismus
- Geburtsstillstand → Sectio caesarea
Tokolytika (#R: -1; #F: 2)
- Fenoterol
- - Beta-2-Sympathomimetikum
- - CAVE: Tachykardie und Blutdrucksteigerung der Mutter

- Atosiban
- - Oxytocin-Antagonist

- Magnesiumsulfat
Pap IVb (#R: 0; #F: 1)
Schwere Dysplasien oder Carcinoma in situ nachweisbar, Invasivität nicht auszuschließen

- Differentialkolposkopie mit Biopsie
Plattenepithelkarzinom (z.B. an Zervix, Vagina, Vulva) - Tumormarker (#R: 1; #F: 1)
SCC - Squamous-cell-carcinoma
Molimina menstrualia (#R: 0; #F: 1)
Amenorrhö, die monatlich an Schmerzintensität zunimmt
testikuläre Feminisierung (#R: 1; #F: 1)
Genotyp männlich, der Phänotyp weiblich

komplette Androgenresistenz. Meist liegt eine (hoch-)normale Androgenkonzentration vor, jedoch sind die Androgenrezeptoren bzw. der nachfolgende Signalweg derart pathologisch verändert, sodass die Androgene am Endorgan keine Wirkung entfalten können.

Bei der testikulären Feminisierung findet sich ein weibliches äußeres Genital in Kombination mit intraabdominellen Hoden und fehlenden inneren, weiblichen Geschlechtsorganen (blind endende Vagina, fehlender Uterus und Ovarien) sowie einer fehlenden sekundären Geschlechtsbehaarung.
Clomifen (#R: 0; #F: 1)
selektiver Östrogen-Rezeptor-Modulator

- anti-östrogene Wirkung
- vermehrten FSH/LH-Freisetzung mit künstlichem FSH/LH-Peak führt. Die hohen Spiegel können bei intakter Hypothalamus-Hypophysen-Ovar-Achse eine Follikelreifung und eine Ovulation bewirken
Abortivei (#R: 1; #F: 1)
Molenschwangerschaft

- intakter Trophoblast und Eihüllen
- Entwicklungsstörung der Plazentazotten
- konsekutiver Fruchttod (Absterben der Embryonalanlage).
Risikoschwangerschaft (#R: 1; #F: 1)
Alter bei Erstschwangerschaft 35 Jahre
Familiäre Belastungen: U.a. Fehlbildungen, genetische Erkrankungen, Hypertonie, Diabetes mellitus, Häufung von Schwangerschafts- und Geburtskomplikationen
Vorerkrankungen der Mutter: U.a. Hypertonie, Diabetes mellitus, Malignome, Infektionen, neurologische Erkrankungen
Uterusanomalien: Myome, Z.n. nach Uterusoperation, Z.n Sectio
Schwangerschaftsanamnese
>5 Geburten
>2 Aborte oder Abruptios
Z.n. Frühgeburt, Totgeburt oder Geburt eines geschädigten Kindes
Z.n. Geburt eines hyper- oder hypotrophen Kindes
Z.n. Mehrlingsschwangerschaft
Z.n. Geburtskomplikationen
Z.n. Sectio caesarea oder anderen Uterusoperationen
Z.n. Sterilitätsbehandlung
Z.n. Rhesusinkompatibilität
Rasche Schwangerschaftsfolge (
Präeklampsieprophylaxe (#R: 1; #F: 1)
ASS
I. Stellung (#R: 1; #F: 1)
- Die kleine Fontanelle, die sich am kindlichen Hinterkopf befindet, liegt zur linken Seite der Mutter hingewandt.

- Der kindliche Rücken liegt (von der Mutter aus betrachtet) links

-> Vordere Hinterhauptslage
II. Stellung (#R: 0; #F: 1)
- kleine Fontanelle rechts
- Rücken rechts

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Pap 0 (#R: 0; #F: 0)
Abstrich unbrauchbar
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Physiologisches Zellbild

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Anormale und entzündliche, aber keine schwerwiegend veränderten Zellen nachweisbar

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Unklarer Befund: Schwere entzündliche Veränderungen, die aber nicht sicher beurteilt werden können

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As if the historic point spread wasn’t embarrassing enough, the Broncos, via the team’s official Twitter page, pointed out that the 51 points the team scored in Sunday’s win was more than the Jaguars have scored all season.
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The weak pace of second-quarter growth will reflect a sharp slowdown in consumer spending caused by higher taxes at the start of the year and an unwinding of utilities spending, which was boosted by unusually cold weather in the first three months of the year.
Wertheim-Meigs-Operation (#R: 0; #F: 0)
Radikale Hysterektomie zumeist unter Mitnahme des oberen Scheidendrittels und der Parametrien
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CA 72-4, CA 125
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Endometriumkarzinom - Tumormarker - Verlauf (#R: 1; #F: 0)
CEA
Glandulär-zystische Endometriumhyperplasie (#R: 0; #F: 0)
Karzinomrisiko von ca. 1%

ektatisch geweitete Schleimhautdrüsen (Schweizer-Käse-Muster)
Morbus Bowen (#R: 0; #F: 0)
Präkanzerose des Plattenepithels; im Bereich der Vulva entspräche das der Erythroplasie Querat. Hier müssten sich in der histologischen Aufarbeitung der Gewebeprobe Zelldysplasien und Atypien finden.
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- Methotrexat i.v.

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Doxorubicin (#R: 1; #F: 0)
= Topoisomerase-Hemmstoff
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Indikation
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Cyclophosphamid (#R: 1; #F: 0)
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Indikation
- Leukämien
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Nebenwirkung
- Hämorrhagische Zystitis: Prophylaktische Gabe von Mesna
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An envelope http://xnxx-xxnxx.in.net/ xxnx It would be unfair to portray the Business Secretary as a covert opponent of the Government in which he serves. In the Liberal Democrats’ post-election discussions, he lined up behind coalition. But his decision was formed by his head, not his heart. Gordon Brown was discredited with the voters. Mr Cameron had the numbers in the Commons. The logic of events pointed to a blue-yellow deal. Furthermore, Mr Cable was, at least at that point, a deficit reduction hawk. And although he is a critic of the Chancellor on some points, he has never challenged him on getting the deficit down. (#R: 0; #F: 0)
An envelope http://xnxx-xxnxx.in.net/ xxnx It would be unfair to portray the Business Secretary as a covert opponent of the Government in which he serves. In the Liberal Democrats’ post-election discussions, he lined up behind coalition. But his decision was formed by his head, not his heart. Gordon Brown was discredited with the voters. Mr Cameron had the numbers in the Commons. The logic of events pointed to a blue-yellow deal. Furthermore, Mr Cable was, at least at that point, a deficit reduction hawk. And although he is a critic of the Chancellor on some points, he has never challenged him on getting the deficit down.
Uterus bicornis unicollis (#R: 0; #F: 0)
Bicornis und unicollis leiten sich von den lateinischen Begriffen cornu (Horn) und collum (Hals) ab. Der Uterus bicornis beschreibt die Erhaltung der paarigen Anlage aufgrund unvollständiger Verschmelzung der Müller-Gänge (auch bei anderen Säugetieren), während unicollis eine bereits verschmolzene Zervix bezeichnet.
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Sorry, you must have the wrong number http://xnxx-xxn.in.net/ vina garut xnxx Nicky (Steven Louis Grush) is an ex-con with a major debt. Antonio (Luis Antonio Ramos) has three kids and isn’t even sure he can kick in for the ticket. Denise (Lorraine Bruce) has marital issues apparently tied to her weight.
Uterus arcuatus (#R: 0; #F: 0)
Der lateinische Begriff arcuatus leitet sich vom Wort arcus (Bogen) ab. Uterus arcuatus bezeichnet demnach einen Uterus, der durch unvollständige Verschmelzung der Müller-Gänge eine Furchung am Fundus uteri aufweist und daher mit zwei Bögen imponiert.
Hermaphroditismus verus (#R: 0; #F: 0)
gleichzeitige Vorhandensein von Ovar- und Hodengewebe
Swyer-Syndrom (#R: 1; #F: 0)
Gendefekt in der geschlechtsdeterminierenden Region des Y-Chromosoms (SRY) vor.

Weiblicher Phänotyp.
Testosteronspiegel im Normbereich.

Weniger entwickelte Brust
komplett fehlende Schambehaarung.
Schwangerschaftsabbruch bis zur 12. SSW p.c. (#R: 1; #F: 0)
zwar rechtswidrig, bleibt aber straffrei
- wenn die Schwangere sich nach § 219 hat beraten lassen und der Eingriff von einem Arzt vorgenommen wird.

nicht rechtswidrig
- wenn die Schwangerschaft Folge einer rechtswidrigen Tat ist.
Primäre Sterilität (#R: 1; #F: 0)
Trotz regelmäßigen ungeschützten Geschlechtsverkehrs tritt innerhalb eines Jahres bei einer Frau, die noch nie schwanger war, keine Schwangerschaft ein
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Sekundäre Sterilität (#R: 1; #F: 0)
Nach mindestens einer vorausgegangenen Schwangerschaft tritt trotz regelmäßigen ungeschützten Geschlechtsverkehrs keine Schwangerschaft ein
Can I call you back? http://trannytube.fun/ trannytube He’s also starting to develop better chemistry with Geno Smith, who has spread the ball around. Only 53% of Smith’s completions have been to receivers. Cumberland is tied for the most catches (seven) and has the most receiving yards (138) in the past two games. “I look at him as another receiver,” Smith said. “He’s fast enough where he’ll run by you.” (#R: 0; #F: 0)
Can I call you back? http://trannytube.fun/ trannytube He’s also starting to develop better chemistry with Geno Smith, who has spread the ball around. Only 53% of Smith’s completions have been to receivers. Cumberland is tied for the most catches (seven) and has the most receiving yards (138) in the past two games. “I look at him as another receiver,” Smith said. “He’s fast enough where he’ll run by you.”
Infertilität (#R: 1; #F: 0)
Unvermögen eine Schwangerschaft bis zur Lebensreife des Kindes auszutragen, obwohl eine Konzeption prinzipiell möglich ist.
Kallmann-Syndrom (#R: 1; #F: 0)
Aplasie des Bulbus olfactorius

- Anosmie
- hypogonadotroper Hypogonadismus
Postkoitaltest (#R: 2; #F: 0)
Beurteilung der Funktionsfähigkeit von Spermien und Zervixschleim

- Zeitpunkt: Periovulatorisch
- Test positiv: Nachweis von >7 sich vorwärts bewegenden Spermien im Zervikalschleim nach Kohabitation
Kurzrok-Miller-Test (#R: 1; #F: 0)
Beurteilung der Funktionsfähigkeit von Spermien und Zervixschleim

Durchführung: Periovulatorische Entnahme von Zervikalsekret der Patientin, Aufbringen auf einen Objektträger gemeinsam mit Spermien des Partners → mikroskopische Beurteilung
Test positiv: Gute Vorwärtsbeweglichkeit der Spermien im Zervixschleim
Gestagen-Test (#R: 0; #F: 0)
Prüfung, ob die Ovarien ausreichend Östrogen produzieren

Test positiv: Ca. eine Woche nach Absetzen des Gestagens tritt eine Abbruchblutung auf → Östrogenmangel und anatomische Fehlanlage der Uterusschleimhaut unwahrscheinlich
Clomifen-Test (#R: 1; #F: 0)
Prüfung der Funktion der Hypothalamus-Hypophysen-Achse

Durchführung: Fünftägige Gabe des Antiöstrogens Clomifen
Test positiv: Anstieg von LH und Östradiol
Until August http://xnxxx.in.net/ xnxx. The squad is massively motivated to go and create history. It is not very often you get a chance to put a mark on the game and if we manage to win four successive series it will be the first time since the 19th century an England team have managed to do that. It would be an amazing achievement. But that is only the end goal, the big dream. (#R: 0; #F: 0)
Until August http://xnxxx.in.net/ xnxx. The squad is massively motivated to go and create history. It is not very often you get a chance to put a mark on the game and if we manage to win four successive series it will be the first time since the 19th century an England team have managed to do that. It would be an amazing achievement. But that is only the end goal, the big dream.
Ovarielles Überstimulationssyndrom (#R: 1; #F: 0)
Iatrogener, potenziell lebensbedrohlicher Zustand
- Folge einer hormonellen Follikelstimulation

Risikofaktor: Polyzystisches Ovarialsyndrom
Have you read any good books lately? http://sextube.in.net/ sex video "She will go from being a virtual prisoner in a hospital bed to running around and playing with her sister and enjoying a normal life, which is a beautiful thing," Macchiarini said after the surgery. (#R: 0; #F: 0)
Have you read any good books lately? http://sextube.in.net/ sex video "She will go from being a virtual prisoner in a hospital bed to running around and playing with her sister and enjoying a normal life, which is a beautiful thing," Macchiarini said after the surgery.
I was born in Australia but grew up in England http://cam4.in.net/ cam4 uk Gates was the one who rather recently appointed Ray Ozzie as Microsoft CTO. The decision, it is said, was largely due to one nostalgic conversation where they enjoyed reminiscing over antiquated CP/M programming. It was just the same old Bill Gates whim and whimsy that had nothing to do with the company’s real strategic needs, the same mindset that has hobbled its chances since he tried to take over the Internet and then quickly lost interest. (#R: 0; #F: 0)
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Hydrosalpinx (#R: 1; #F: 0)
Rezidivierende Salpingitiden (v.a. bei Chlamydien-Infektionen) können zu einer chronischen Eiter- und Flüssigkeitsansammlung in den Tuben führen, was als Hydrosalpinx bezeichnet wird. Diese Ansammlung kann sich fibrotisch organisieren und zeigt sich in der Sonographie als septierte, zystische Struktur. Die Folge kann ein Tubenverschluss mit konsekutiver Infertilität sein.
In-vitro-Fertilisation (#R: 0; #F: 0)
kommt bei Paaren zur Anwendung, die aufgrund einer tubaren Sterilität der Frau keine Kinder bekommen können. Zunächst erhält die Frau eine Hormonbehandlung, um die Follikelreifung zu stimulieren und mittels ultraschallgesteuerter Punktion reife Eizellen gewinnen zu können. Die Eizellen werden dann in einer Petrischale mit den Spermien des Partners zusammengebracht. Anschließend erfolgt der Transfer von maximal 3 Embryonen (in Deutschland) in das Uteruskavum.
In-Vitro-Fertilisation mit intrazytoplasmatischer Spermieninjektion (#R: 2; #F: 0)
erfolgt bei unbeweglichen Spermatozoen. Davon muss auch im beschriebenen Fall ausgegangen werden. Bei Azoospermie werden die Spermien in der Regel durch eine testikuläre Spermienaspiration gewonnen. Auf die ICSI folgt ein Embryotransfer in den Uterus.
Pearl-Index (#R: 1; #F: 0)
Anzahl an Schwangerschaften im Verhältnis zu 100 Frauenjahren
Kalendermethode (#R: 1; #F: 0)
PI 6-40
Basaltemperaturmethode (#R: 1; #F: 0)
Bestimmung des Temperaturanstiegs im Rahmen des Eisprungs

PI 0,8-6
Billings-Methode (#R: 0; #F: 0)
Zum Zeitpunkt der Ovulation ist der Zervixschleim am flüssigsten und hat die größte Spinnbarkeit. Durch Beobachtung sowie Verzicht auf Geschlechtsverkehr in dieser Zeit ist eine Befruchtung unwahrscheinlich.

PI 15-35
Symptothermale Methode (#R: 2; #F: 0)
Kombination aus Basaltemperaturmethode und Billings-Methode

PI 0,8-2
hormonelle Kontrazeption (#R: 0; #F: 0)
PI 0,1-3
Intrauterinpessar (#R: 1; #F: 0)
Ohne Gestagenbeschichtung: PI 1,5-3
Mit Gestagenbeschichtung: PI 0,1-3
primäre, akute nichtinfektiöse Vulvitis (#R: 1; #F: 0)
allergischer oder mechanischer Genese. Zum Beispiel Wasch- und Reinigungsmittel, Textilfasern, Binden/Slipeinlagen können als Allergene ausgemacht werden und im Bereich der Vulva zu Juckreiz, Rötung, Schwellung und Hitzegefühl führen.
submuköses Myom (#R: 0; #F: 0)
Submukös und intramural gelegene Myome verursachen häufig Blutungsstörungen, die sogar Hb-wirksam werden können.
Chorionkarzinom (#R: 0; #F: 0)
Trophoblastentumor

- entwickelt sich zumeist aus Resten einer Blasenmole.
- kann nur nach einer erfolgten Befruchtung und Einnistung der Eizelle entstehen

- Entstehung meist schon Tage oder Wochen nach Schwangerschaftsvorgängen
- in Einzelfällen auch noch Jahre danach

- Hochmaligner Tumor mit Bildung mehrkerniger Riesenzellen
- Tumormarker: β-HCG

- Therapie mit Methotrexat + Actinomycin D
Blasenmole (#R: 0; #F: 0)
Trophoblastentumor
- von der befruchteten Eizelle ausgeht
- beruht auf chromosomalem Defekt
- - komplette Blasenmole: uniparentalen paternalen Disomie
- - partielle Blasenmole: Triploidie

- Ovariale Luteinzysten
- hoher β-hCG-Wert (>500000IU/l)
- sonographisch fehlende Fruchtanlage
- sonographisches Schneegestöber
Sertoli-Leydig-Zelltumor (#R: 1; #F: 0)
Androblastom
- sehr seltener Keimstrang-Stroma-Tumor des Ovars
- Androgene produzierend
- Virilisierungserscheinungen verursacht.

Bei ca. 20% kommt es beim Androblastom zu einer malignen Entartung. Es tritt zumeist um das 30.-40. Lebensjahr auf.
seröses Kystom (#R: 0; #F: 0)
Gutartige, epitheliale Ovarialtumoren werden auch als Kystome oder Kystadenome bezeichnet. Bei einem serösen Kystom handelt es sich um einen benignen Ovarialtumor, der mit seröser Flüssigkeit gefüllt
Brenner-Tumor (#R: 1; #F: 0)
Der Brenner-Tumor ist meist benigne und leitet sich vom embryonalen Zölomepithel ab. Er gehört zu den epithelialen Tumoren, die ca. 65-75% der Ovarialtumoren ausmachen. Seine häufige Gutartigkeit ist eine Ausnahme, da epitheliale Ovarialtumoren ca. 90% der ovariellen Malignome ausmachen.
Dysgerminom (#R: 1; #F: 0)
Dysgerminome gehören zu den Keimzelltumoren des Ovars.
- jungen Frauen (zw. dem 20. und 30 LJ)

Sie zählen zu den am häufigsten maligne entarteten Ovarialtumoren und fallen zumeist erst spät durch unspezifische Schmerzen im Abdominalbereich auf.
Struma ovarii (#R: 0; #F: 0)
Sonderform des Teratom

- Differenzierung zu Schilddrüsengewebe
- Thryoxin-produzierend
- evtl. Hyperthyreose-Symptome verursachen.

Sehr selten kommt es zu einer Entartung des Schilddrüsenkarzinoms.
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vorzeitige Plazentalösung (#R: 0; #F: 0)
Teilweise oder vollständige Ablösung der Plazenta von ihrer Haftfläche vor der Geburt des Kindes. Die Blutung erfolgt aus mütterlichen und kindlichen Gefäßen.

- Schmerzen im Unterbauch
- brettharter Uterus
- akute Plazentainsuffizienz mit fetaler Hypoxie
- abgeschwächten Kindsbewegungen.
- evtl. vaginale Blutungen (evtl. Retroplazentäres Hämatom)
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Granulosazelltumor (#R: 1; #F: 0)
Bis zu 25% der Granulosazelltumoren besitzen eine überaktive Aromatase und bilden Östrogene. Hohe Östrogenspiegel führen zu einer übermäßigen Proliferation des Endometriums, was als glandulär-zystische Hyperplasie bezeichnet wird.

- Erhöhtes Östrogen bei supprimiertem FSH

Granulosazelltumoren können benigne oder maligne sein. Von der glandulär-zystischen Hyperplasie wiederum geht ein Endometriumkarzinomrisiko von ca. 1% aus.
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I like watching TV http://iwank.in.net/ iwan.com "The wonderful thing about Glastonbury is that I feel so safe here and it is great for families," said Nancy Laws, 35, at the festival with her 3-year-old son Joshua and 10-month-old daughter Amelie. "There is a really relaxed vibe."
Indian files (#R: 0; #F: 0)
histologische Merkmal invasiver lobulärer Mammakarzinome sind kettenförmig formierte, monomorphe Tumorzellen
PAP III D (#R: 1; #F: 0)
leichte (CIN I) und mäßige (CIN II) Dysplasien nachweisbar.

- Kontrolle in 3 Monaten (evtl. mit Biopsie)
Follikelpersistenz (#R: 1; #F: 0)
Eine mangelnde Ausreifung des Follikels und das Ausbleiben des Eisprungs bewirken bei einer Follikelpersistenz eine dauerhafte Östrogenproduktion. Der erhöhte Hormonspiegel führt zu einer verlängerten Proliferationsphase sowie zu einer glandulär-zystischen Endometriumhyperplasie, was sich klinisch als Dauerblutung nach blutungsfreiem Intervall präsentieren kann. Eine Follikelpersistenz kommt gehäuft in Phasen der hormonellen Umstellung vor.
Danazol (#R: 0; #F: 0)
Testosteronpräparat
Kapazitation (#R: 1; #F: 0)
Reifungsprozess des Spermiums, der unter Östrogeneinfluss im weiblichen Genitaltrakt stattfindet und das Spermium dazu befähigt, in eine Eizelle einzudringen
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Triple-Test (#R: 1; #F: 0)
Risikos einer fetalen Chromosomenaberration (insbesondere einer Trisomie 21)

- HCG
- AFP
- freies Östriol
Stellung (#R: 1; #F: 0)
Verhältnis des kindlichen Rückens zur Innenfläche des Uterus

1. Stellung
- Rücken links
- große Fontanelle rechts
- Pfeilnaht steht im 1. schrägen Durchmesser

2. Stellung
- Rücken rechts
- große Fontanelle links
- Pfeilnaht steht im 2. schrägen Durchmesser
Lage (#R: 0; #F: 0)
Verhältnis der Wirbelsäule des Kindes zur Wirbelsäule der Mutter.

Physiologisch
- Längslage

Unphysiologisch
- Querlage -> Sectio
Haltung (#R: 2; #F: 0)
Kopf des Kindes im gestreckten (Deflexion) oder gebeugten (Flexion) Zustand

Flexion
- Das Kinn liegt auf der Brust
- Physiologisch bis zum Austritt aus dem Geburtskanal

Deflexion
- Der Kopf ist gestreckt, das Kind schaut hoch
- Physiologisch beim Austritt aus dem Geburtskanal
Poleinstellung (#R: 1; #F: 0)
welches Körperteil auf dem Geburtsweg vorangeht.

Kopflage
- Kopf voran

Beckenendlage
- Becken, bzw. die Beine voran
3. Leopold-Handgriff (#R: 1; #F: 0)
Mit dem 3. Leopold-Handgriff tastet man mit einer Hand oberhalb der Symphyse nach dem vorangehenden Kindsteil. So kann zwischen einer Schädel- oder Steißlage unterschieden werden.
Austreibungsperiode (#R: 2; #F: 0)
Die Austreibungsperiode bezeichnet den Zeitraum zwischen vollständiger Eröffnung des Muttermundes und der Geburt des Kindes.

Abhängig von der Anzahl der bereits durchgemachter Geburten dauert die Austreibungsperiode meist zwischen 5 und 60 Minuten.
Frühgeburt (#R: 1; #F: 0)
Geburt vor der abgeschlossenen 37. SSW p.m.
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Übertragung (#R: 0; #F: 0)
Schwangerschaft geht über die abgeschlossene 42. SSW p.m. hinaus
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Naegele-Regel (#R: 2; #F: 0)
Erster Tag der letzten Regelblutung + 7 Tage + 9 Monate +/- Abweichung vom regulären 28-Tage-Menstruationszyklus
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Sichere Schwangerschaftszeichen (#R: 0; #F: 0)
Ab 5.-6. SSW p.m.:Embryonachweis in der abdominellen oder vaginalen Sonographie
Ab 12. SSW.: Auskultation fetaler Herztöne
Ab 18.-20. SSW: Wahrnehmen von Kindsbewegungen
Quantitative HCG-Bestimmung
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Unsichere Schwangerschaftszeichen (#R: 0; #F: 0)
Ausbleiben der Menstruation
Übelkeit, Erbrechen, Spannungsgefühl in den Brüsten
Hyperpigmentation der Areolae und der Linea fusca
Livide Verfärbung des Introitus vaginae
Manuelle Tastuntersuchung des Uterus
Physiologische Anpassung an die Schwangerschaft (#R: 0; #F: 0)
Herzfrequenz ↑
Herzminutenvolumen ↑
Arterieller Mitteldruck ↓
Atemminutenvolumen ↑
Plasmavolumen ↑
→ Auskultierbares Systolikum
→ Verdünnungsanämie
Hämatokrit, Hämoglobin ↓
Absolute Erythrozytenzahl ↑
Thrombozyten ↑
Leukozyten ↑
Fibrinogen ↑
Alkalische Phosphatase ↑
GFR ↑
Triglyzeride ↑
Cholesterin ↑
Amnion (#R: 0; #F: 0)
Innere Eihaut, wird vom Embryoblast gebildet, sezerniert die Amnionflüssigkeit
Chorion (#R: 0; #F: 0)
Mittlere Eihaut, wird vom Zytotrophoblast gebildet
Dezidua (#R: 0; #F: 0)
Äußere Eihaut, wird von der uterinen Decidua capsularis, die über der Implantationsstelle liegt, gebildet
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Oligohydramnion (#R: 0; #F: 0)
Fruchtwassermenge
Polyhydramnion (#R: 0; #F: 0)
Fruchtwassermenge >2000ml im 3. Trimenon

- Diabetes mellitus
- Rhesusinkompatibilität: Morbus haemolyticus fetalis
- Ösophagusatresie
- Duodenalatresie/-stenose
- Anenzephalus
- Myelomeningomyelozele
- Bei Mehrlingsschwangerschaft: Fetofetales Transfusionssyndrom
Umbilikalvene (#R: 1; #F: 0)
Mündet über den Ductus venosus Arantii in die Vena cava inferior, gibt vor dem Ductus einen Ast an die Pfortader ab, führt sauerstoff- und nährstoffreiches Blut
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durchschnittliche Gewichtszunahme liegt am Ende der Schwangerschaft (#R: 1; #F: 0)
10-12kg
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Meidung - Rohmilchprodukte, roher Fisch (#R: 0; #F: 0)
Listeriose
Meidung - Rohes Fleisch (#R: 2; #F: 0)
Toxoplasmose
1. Leopold-Handgriff (#R: 1; #F: 0)
Beidhändige Prüfung der kindlichen Lage (Längs-/Schräg-/Querlage) und des Fundusstands

SSW Fundusstand
20. Zwischen Symphyse und Bauchnabel
24. Bauchnabel
32. Zwischen Bauchnabel und Xiphoid
36. Höchststand: Am Rippenbogen
40. 2 Querfinger unter dem Rippenbogen
2. Leopold-Handgriff (#R: 0; #F: 0)
Beidhändige Prüfung der Stellung des kindlichen Rückens

1. Stellung: Rücken an der linken Seite der Mutter
2. Stellung: Rücken an der rechten Seite der Mutter
sonographische Screening-Untersuchungen (#R: 2; #F: 0)
9.-12. SSW post menstruationem
19.-22. SSW post menstruationem
29.-32. SSW post menstruationem
Scheitel-Steiß-Länge (#R: 1; #F: 0)
Parameter zur Bestimmung der Größe des Kindes und des Gestationsalters
fetale Herzfrequenz (#R: 0; #F: 0)
110-160bpm
Saltatorischer Oszillationstyp (#R: 0; #F: 0)
>25bpm
Ursachen: Fetale Hypoxie, Nabelschnurkomplikationen
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Undulatorischer Oszillationstyp (#R: 0; #F: 0)
10-25bpm
Normalbefund
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Eingeschränkt-undulatorischer Oszillationstyp (#R: 1; #F: 0)
5-10bpm
Ursachen: Kind schläft, Zentral-sedierende Medikamente, Hypoxie
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But by the early to mid-1980s, high oil prices had spurredso much new exploration and production in areas like the NorthSea and the Soviet Union, the world was left awash in excess oilproduction and prices collapsed.
Silenter Oszillationstyp (#R: 0; #F: 0)
DIP I (#R: 0; #F: 0)
Frühe Dezeleration

Beginn und Ende der Dezeleration liegen synchron zum Verlauf einer Wehe, die Dezeleration erreicht ihr Minimum, wenn die Wehenkurve ihren Gipfel erreicht

Ursachen: Kurzfristige fetale Hypoxie durch Druck auf den kindlichen Kopf im Rahmen einer Wehe
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DIP II (#R: 1; #F: 0)
Späte Dezeleration

Abfall der FHF erst nach dem Maximum der Wehenkurve

Ursachen: Fetale Hypoxie → Insbesondere in Kombination mit einem Oszillationsverlust

Maßnahmen: Umlagerung der Mutter, Mikroblutuntersuchung zur Ermittlung des pH-Werts des Fetalbluts, intrauterine Reanimation
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Prolongierte Dezeleration (#R: 0; #F: 0)
Tiefe, lang andauernde Dezeleration (Badewanne)

Ursachen: Uterine Dauerkontraktion, Vena-cava-Kompressionssyndrom (s.u.), Periduralanästhesie, zu rasche Blutdrucksenkung bei der Mutter
Vena-cava-Kompressionssyndrom (#R: 0; #F: 0)
- Im 3. Trimenon
- Bei Rückenlage der Mutter
- Kompression der Vena cava und der Beckenvenen

- Fetale Hypoxie
- Prolongierte Dezeleration im CTG

- Nach Umlagerung in Linksseitenlage erholt sich die FHF wieder

Bei der Mutter
- Tachykardie
- Schwindel und Übelkeit
- Synkopen
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Will the Ricin end up in baby Holly’s bottle? That would certainly destroy Walt, but a show as moral as this one would never kill a baby (I hope). Walt Jnr? Too obvious. Skyler? Walt wouldn’t mind that a bit. Hank? A coughing fit and some internal bleeding is too boring an end for the man who survived The Twins. Jesse? A paranoid mess who almost used the stuff himself, he’s unlikely to fall for it. No, I think Walt will connive to end this on his own terms. He’ll take the Ricin himself, possibly after discovering that his cancer has come back with a vengeance, possibly after Hank has him cornered in his New Hampshire hideaway, possibly after confessing all to Jesse and deliberately denying him the pleasure of killing him, but most likely a combination of all three.
Amniozentese (#R: 0; #F: 0)
Transabdominelle Punktion der Amnionhöhle unter sonographischer Kontrolle zur diagnostischen Gewinnung von Fruchtwasser. Durchführung i.d.R. ab 15. SSW, in Ausnahmefällen ab 12.SSW
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Chorionzottenbiopsie (#R: 1; #F: 0)
Transzervikale oder transabdominelle Entnahme von Chorionzottengewebe unter sonographischer Kontrolle zur genetischen Diagnostik in der Frühschwangerschaft. Durchführung ab der 10. SSW
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Fetometrie (#R: 1; #F: 0)
Dickenmessung des fetalen subkutanen Fettgewebes vorgenommen. Die Messung kann im Transversalschnitt des Abdomens und im mittleren Abschnitt des Femurs durchgeführt und mit Referenzwerten abgeglichen werden.
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Gestationshypertonie (#R: 1; #F: 0)
Nach der 20. SSW erstmalig aufgetretene Blutdrücke >140/90mmHg bei fehlender Proteinurie und vorheriger Normotonie
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Präeklampsie (#R: 1; #F: 0)
Gestationshypertonie und Proteinurie von (>300mg/24 Stunden)
Eklampsie (#R: 2; #F: 0)
Tonisch-klonische Krampfanfälle, die als Komplikation einer Präeklampsie auftreten
HELLP (#R: 1; #F: 0)
- Haemolysis
- Elevated Liver enzyme levels
- Low Platelet count

Lebensbedrohliche Komplikation der Präeklampsie mit Hämolyse, Thrombozytopenie und Leberzellschäden
Geburtshilfliche Dopplersonographie (#R: 1; #F: 0)
Aa. uterinae
Aa. umbilicales
fetale Aa. cerebri media

Bilaterale Notches (Frühdiastolische Einkerbungen) des Flussprofils der Aa. uterinae zeigen ein erhöhtes Präeklampsierisiko an
Eklampsieprophylaxe (#R: 0; #F: 0)
Magnesiumsulfat
Hämolysezeichen (#R: 1; #F: 0)
Hämoglobin↓
Haptoglobin↓
LDH↑
indirektes Bilirubin↑
Uterusatonie (#R: 1; #F: 0)
Verstärkte Nachblutung nach vollständiger oder unvollständiger Plazentaausstoßung bei mangelhafter Kontraktionsfähigkeit des Myometriums

Risikofaktoren
- Hohe Dosen von Oxytocin sub partu
Kontraktionsmittel (#R: 0; #F: 0)
- Oxytocin
- Methylergometrin
- Prostaglandin
Plazenta accreta (#R: 1; #F: 0)
Plazentalösungsstörung

- Trophoblast durchwächst die Decidua basalis und erreicht das Myometrium
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Plazenta increta (#R: 0; #F: 0)
Plazentalösungsstörung

- Trophoblast wächst ins Myometrium
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Lone Star became the biggest shareholder in Tokyo Star Bankin 2011 after entities set up by Japanese private equity firmAdvantage Partners gave up the ownership of the bank due toproblems in repaying their debt.
Plazenta percreta (#R: 1; #F: 0)
Plazentalösungsstörung

- Trophoblast durchwächst das gesamte Myometrium, erreicht die Serosa und unter Umständen weitere Organe
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Insertio velamentosa (#R: 0; #F: 0)
Die Nabelschnur setzt außerhalb der Plazentafläche an. Die Gefäße können frei über die Eihäute verlaufen.

Beim Blasensprung kann es zur Verletzung der Nabelgefäße kommen. Dies führt innerhalb kürzester Zeit zu einem für das Kind lebensbedrohlichen Blutverlust.

- Akut einsetzende Blutung ex utero
- Fetale Hypoxiezeichen im CTG
- Mütterlicher Zustand unbeeinträchtigt (ausschließlich kindlicher Blutverlust)
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And although nine in 10 members of the services said their families were proud of them, just half thought they were respected by society at large - a question that has not been asked in previous years.
Placenta praevia totalis (#R: 1; #F: 0)
Ein vollständiges Verlegen des inneren Muttermundes durch die Plazenta

- schmerzlose Blutungen
Mastitis fibrosa cystica (#R: 1; #F: 0)
fibröse Mastopathie

- Östrogenüberschuss
- Gestagenmangel
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Sarcoma botryoides (#R: 1; #F: 0)
hochmalignes Rhabdomyosarkom
- vaginalen Blutungen
- hohe Malignität
- schlechte Prognose
- Häufigkeitsgipfel: 8. Lebensjahr
PAP IVa (#R: 0; #F: 0)
schwere Dysplasie / Carcinoma in situ.

- Differentialkolposkopie mit der Entnahme von Biopsien durchgeführt werden.
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Mammakarzinom - Chemotherapie (#R: 1; #F: 0)
Nukleinanaloga: 5-FU
Anthrazykline: Adriamycin
Taxane: Paclitaxel
Tamoxifen (#R: 1; #F: 0)
Selektive-Östrogen-Rezeptor-Modulatoren

Nebenwirkungen von Tamoxifen
- Risikoerhöhung für thromboembolische Ereignisse
- Teilreversible Sehstörungen
- Hitzewallungen
- Übelkeit und Exanthem
- Schmerzen an betroffenem Gewebe und Knochen
Trastuzumab (#R: 2; #F: 0)
Her2/neu - Antagonist
Buserelin (#R: 1; #F: 0)
GnRH-Analoga
Mammakarzinom - Prognosefaktoren (#R: 1; #F: 0)
- Axillärer Lymphknotenstatus (wichtigster Prognosefaktor)
- Größe des Primärtumors (TNM-Klassifikation)
- Überexpression des HER2/neu-Rezeptors (ungünstiger Faktor)
- Negativer Hormonrezeptorstatus (ungünstiger Faktor)
- Histopathologisches Grading (G1-G3: gut, mäßig, schlecht differenziert)
- Bestimmung der S-Phase-Zellfraktion
Mammographie-Screening (#R: 0; #F: 0)
alle 2 Jahre für alle Frauen im Alter zwischen 50 und 69 Jahren
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Endometriosis genitalis interna (#R: 1; #F: 0)
Endometriosezellen im Myometrium und im Abgangsbereich der Tuben
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Orale Kontrazeptiva
antiandrogene Wirkung

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Uterusmyom - Risikofaktoren (#R: 1; #F: 0)
Nulliparae und wenige Schwangerschaften
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- Aufplatzen eines muzinösen Zystadenoms/-karzinoms
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Die muzinösen Zellen bewirken einen gallertartigen Aszites, der durch intraabdominelle Verklebungen rezidivierende Operationen nötig macht und langfristig meist zu Kachexie und Tod führt
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Condylomata acuminata (#R: 0; #F: 0)
Feigwarzen

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Condylomata plana (#R: 1; #F: 0)
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Flache, weiß-bräunliche, nur leicht erhabene, gestreute Kondylome im Anogenitalbereich mit hohem Entartungsrisiko
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Stark exophytisch wachsendes, verruköses Plattenepithelkarzinom mit lokaler Ausbreitung ohne Metastasierungstendenz
HPV - Diagnostik (#R: 0; #F: 0)
- Essigsäuretest: Infizierte Areale färben sich weißlich

- Nachweis von Koilozyten (Ballonzellen)
HPV-Impfung (#R: 0; #F: 0)
für ♀ zwischen 12 und 17 Jahren
HPV 6+11
HPV 16+18
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