摘要:

The effect of breast stimulation on the prostaglandin secretion was tested in 13 patients at 38–40 weeks of gestation. Uterine contractions following breast stimulation were documented in all cases. There was an increase in prostaglandin metabolite levels 10 min after breast stimulation.

ISSN:0378-7346    

DOI:10.1159/000293317

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Premature rupture of the membranes (PROM) in otherwise uncomplicated full-term single pregnancies was studied in a prospective randomized study. Ninety-three women were randomized to either induction with oxytocin infusion (n = 43) or expectant management (n = 50). Twenty-four and 26 respectively were nulliparas. In the induction group, all but 3 were delivered within 24 h from PROM. There were 3 vacuum extractions (VE), all in nulliparous women. No cesarean section (CS) was performed. In the expectancy group, 23 of 50 were delivered within 24 h. There were 5 VE and 3 CS in nulliparas and 1 VE and 1 CS in paras. The instrumental actions were mainly due to arrest of 1 st or 2nd stage labor. The only clinical infections occurred in nulliparas in the expectancy group. Our conclusion is that parous women with PROM can be treated by either induction or expectancy while in nulliparas, induction after some hours’ expectation seems preferable.

ISSN:0378-7346    

DOI:10.1159/000293318

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Pharmacological hypogonadotropism was induced in 167 women using the gonadotropin-releasing hormone agonists (GnRH-A) buserelin acetate or triptorelin acetate. 84 patients (group 1) began treatment using 1.2 mg/ day buserelin acetate intranasally during the follicular phase (days 1–3); 41 patients (group II) began the same treatment, supported by 10 mg medroxyprogesterone acetate for 10 days, during the early luteal phase; 42 patients (group 3) received triptorelin acetate as an intramuscular depot injection, supported by 10 mg medroxyprogesterone acetate for 10 days, during the early luteal phase. Serum luteinizing hormone, follicle-stimulating hormone, oestradiol (E2), prolactin, and testosterone levels were monitored. Pituitary function was assessed by (1) measurement of endogenous luteinizing hormone fluctuation; (2) response to luteinizing hormone releasing hormone administration, and (3) response to oestradiol benzoate (E2 test). Complete pituitary desensitization was only assumed, if all three tests were negative. The LH-RH test and the E2 test were shown to be the most reliable indicator of pituitary function. E2 administration led to further reduction of gonadotropin secretion after pituitary desensitization. The desensitization time was 41.1 ± 11.7 days in group 1 and was significantly reduced to 20.7 ± 10.5 days in group 2 (p < 0.01); a further, non-significant shortening to 15.1 ± 3.0 days was observed in group 3. Changes in endocrine parameters demonstrated hypogonadotropic hypo-oestrogenism after initial pituitary stimulation.

ISSN:0378-7346    

DOI:10.1159/000293319

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Ovarian stimulation cycles were initiated using human menopausal gonadotropin (HMG) in 318 women (643 cycles) without pretreatment and in 341 women (525 cycles) after pituitary desensitization by pretreating with the gonadotropin-releasing hormone agonists (GnRH-A) buserelin acetate or triptorelin acetate. Significantly higher pregnancy rates were observed in the GnRH-A/HMG group (15%) as compared to the HMG group (7%) following in vitro (p < 0.05) but not in vivo fertilization therapy (14 vs. 9%, respectively). After in vitro fertilization, the rates increased with increasing length of the active phase of follicular maturation. Gamete intrafallopian transfer, performed only in the GnRH-A/HMG group, led to a pregnancy rate of 34%. Overall, there was a clear trend to higher pregnancy rates in the GnRH-A/HMG group (16%) as compared to the HMG group (8%). Abortion rates were comparable in both groups (24 vs. 19%). The higher pregnancy rates in the GnRH-A/HMG group were attributable to enhanced follicular maturation and optimized ovarian stimulation produced by the hypogonadotropic state. However, an increased risk of the ovarian hyperstimulation syndrome was observed in these patients.

ISSN:0378-7346    

DOI:10.1159/000293320

出版商:S. Karger AG    

年代:1990

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000288450

出版商:S. Karger AG    

年代:1909

数据来源: Karger

摘要:

A total of 205 female infertility patients were investigated for hormonal causes of infertility after other factors such as tubal dysfunction or andrologic disorders had been ruled out. Increased androgen serum levels were found in 72/205 (35.1%) of females. In 28/205 (13.7%), elevated prolactin serum levels were noted. 119/205 (58%) of patients suffered from primary infertility versus 86/205 (42%) with secondary infertility. The incidence of hyperandrogenemia was higher in the primary infertility group (p < 0.0015). No differences relative to hyperprolactinemia were noted between the two groups. Computerized tomography and sonographic methods did not reveal tumors in any of the subjects where serum concentrations of testosterone and dehydroepiandrosterone sulfate were greater than 2 ng/ml and 7 μg/ml, respectively. Present data combine to suggest that the determination of androgen serum levels is of major importance when investigating infertile patients.

ISSN:0378-7346    

DOI:10.1159/000293321

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Nineteen women with polycystic ovarian disease (PCO; 9 obese) and 15 normal ovulatory women (7 obese) were studied at their follicular phase. All patients had an oral glucose tolerance test (OGTT) before and after treatment with gonadotropin-releasing hormone (GnRH) agonist (Buserelin 400 µg/die s.c. for 8 weeks) to investigate the relationship between ovarian steroidogenesis and insulin and growth hormone (GH) and insulin-like growth factor (SmC) secretion. Luteinizing hormone, follicle-stimulating, estradiol, androstenedione, testosterone, dehydroepiandrosterone sulfate, cortisol, insulin, GH and SmC were measured basally at the time of OGTT. PCO patients showed higher androgen basal levels than control patients. All subjects showed a normal glycemic response to OGTT. The mean fasting level and area under the curve of plasma insulin were also significantly greater in PCO than in control patients (p < 0.05), while GH and SmC plasma concentrations did not differ between the groups. Despite a considerable decrease in androgens and the similar levels in both PCO and control women, buserelin treatment did not determine any significant changes of insulin and GH-SmC secretion. GH and SmC did not correlate with ideal body weight (IBW), insulin or androgens, whereas insulin correlated with both testosterone and androstenedione levels (p < 0.05) and with IBW (p < 0.01); after the buserelin regimen only IBW remained related to plasma insulin (p < 0.01). In conclusion results of this study confirm that hyperinsulinism is a characteristic picture of PCO and is related in an unclear way with hyperandrogenism and obesity. The similar plasma values of GH and SmC in PCO and control patients suggest that the possible mechanism of insulin and insulin-like peptides in this syndrome may be of intraovarian origin

ISSN:0378-7346    

DOI:10.1159/000293322

出版商:S. Karger AG    

年代:1990

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000288451

出版商:S. Karger AG    

年代:1909

数据来源: Karger

摘要:

In a prospective study, serum concentrations of squamous cell carcinoma (SCC) antigen were determined by radioimmunoassay from 74 healthy volunteers and 54 patients with cervical carcinoma who underwent irradiation therapy. 5.4% of the controls had SCC levels > 3.0 ng/ml, which was considered as upper limit of the normal range. 31/54 (57.4%) patients and 60% of the patients with SCC had elevated pretreatment levels. In all patients with pretreatment serum levels above 3.0 ng/ml, SCC serum levels decreased during irradiation therapy. 4/5 patients with posttreatment levels > 0.5 ng/ml developed recurrence or persistence of tumor, 1 patient could not be followed up. Good conformity was found between SCC antigen serum levels and therapy response. SCC antigen determinations during and after therapy provide a useful tool in detecting progression and persistence of tumor.

ISSN:0378-7346    

DOI:10.1159/000293323

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The study describes Kock’s continent ileostomy in 2 females, both of whom were suffering from tubal infertility. Appropriate placement of the abdominal pouch, permitting in vitro fertilization embryo transfer treatment, was present in 1 patient. In the other patient, an ultrasonographic examination demonstrated the pouch covering the entire surface area of both ovaries. Oocyte aspiration was thus precluded for fear of penetrating the pouch. Ovum pickup in the presence of a Kock continent ileostomy can be conducted safely and without risk, if the pouch is correctly positioned above the small pelvis. Ultrasonography facilitated the ability to locate the patients’ ovaries and precise position of the pouch.

ISSN:0378-7346    

DOI:10.1159/000293324

出版商:S. Karger AG    

年代:1990

数据来源: Karger