摘要:

Forty-three women who had undergone a natural or surgical menopause were randomized to receive either 0.625 mg of conjugated estrogens or an intramuscular injection of 150 mg of depo-medroxyprogesterone acetate (DMPA) for 25 days each month. Vasomotor symptoms were recorded before treatment for three weeks and weekly thereafter for three months. Serum estradiol (E2) and estrone (El) were measured before and during the second month of treatment, as were urinary calcium, hydroxyproline, and creatinine levels. Vasomotor symptoms decreased significantly in both groups, and this reduction was of a similar magnitude with either treatment. Whereas 18% of patients in both groups did not have a reduction in vasomotor symptoms, of those women who did benefit, vasomotor symptoms decreased 61.5 ± 7.5% with conjugated estrogens and 69.4 ± 7.7% with DMPA. Eighteen percent of patients treated with conjugated estrogens reported no vasomotor symptoms whatsoever, as compared with 33% among those treated with DMPA. Serum estrone and estradiol increased in patients receiving conjugated estrogens, but were lower in women treated with depo-medroxyprogesterone acetate. Urinary calcium/creatinine and hydroxyproline/creatinine ratios were significantly lowered to the premenopausal range in women treated with conjugated estrogens and DMPA. There were no differences in these ratios when the two treatments were compared. Adverse side effects such as vulvovaginal complaints and weight gain were negligible in both groups and the complaints of dyspareunia were similar. The data from this short-term study suggest that depo-medroxyprogesterone acetate affords a suitable alternative to estrogen therapy for reducing vasomotor symptoms and may prevent bone resorption as well.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Five infertile patients with polycystic ovarian disease were treated to induce ovulation with pure human urinary follicle-stimulating hormone and human menopausal gonadotropin consisting of follicle-stimulating hormone and luteinizing hormone in 1:1 ratio. No substantial differences were seen between the two types of treatment regarding plasma values of follicle-stimulating hormone, prolactin, testosterone, dihydrotestosterone, progesterone, and 17-hydroxypro-gesterone. Estrone, estradiol, and androstenedione values were higher during human urinary follicle-stimulating hormone treatments. Luteinizing hormone levels dropped in both treatments, but the fall was greater during human urinary follicle-stimulating hormone. No real differences were observed concerning number of ovulations, length of treatments, and follicle-stimulating hormone amounts administered; no hyperstimulations were observed. These data do not confirm the observation that more controlled responses of the ovaries can be elicited when low luteinizing hormone gonadotropin preparations are used.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Seven women with hirsutism (five with polycystic ovarian disease, two with eumenorrheic hirsutism) were studied before and during the fourth and sixth cycles of oral contraceptive treatment (norethindrone/mestranol, 1 mg/0.05 mg). Plasma testosterone, androstenedione, and dehydroepiandrosterone sulfate were measured before and during treatment. Testosterone was reduced 72%, androstenedione was reduced 68.5%, and dehydroepiandrosterone sulfate was reduced 41.25% during therapy. Plasma dehydroepiandrosterone sulfate normalized in all patients with pretreatment elevation of this steroid. Norethindrone/mestranol, 1 mg/0.05 mg is capable of suppressing both ovarian and adrenal androgens in hirsute women with modest elevation of these steroids.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The responses of plasma prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and thyroid-stimulating hormone were measured in ten women with Sheehan's syndrome after intravenous administration of the appropriate releasing hormones. Growth hormone and cortisol responses to insulin-induced hypoglycemia were also measured. It was found that two patients were biochemically borderline euthyroid and eight were probably hypothyroid in the face of thyroid-stimulating hormone values in the reference range; in two patients thyroid-stimulating hormone response to thyrotropin-releasing hormone was appropriate. In no patient were the minimum prolactin levels achieved, in response to thyroid-releasing hormone as established in reference subjects. Growth hormone response to hypoglycemia was inadequate in all patients and only one patient achieved reference range values of cortisol during hypoglycemia. In six patients fasting LH and FSH were in the reference range and the response to gonadotropin-releasing hormone was adequate and appropriate in eight patients. In light of these findings it is suggested that prolactin response to thyrotropin-releasing hormone administration would be a reliable and simple screening procedure for suspected Sheehan's syndrome.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Total plasma cholesterol, cholesterol in high-density lipoproteins, unesterified cholesterol, total plasma triglycerides, and plasma cholesterol esterification rate were measured in three groups of subjects, including 176 pregnant, 22 non-pregnant, and 22 postpartum women. Total cholesterol levels showed a 497c increase during pregnancy, reaching a maximum at 33 to 36 weeks. Triglycerides showed a threefold increase over the levels in nonpregnant women by 37 to 40 weeks' gestation. However, unesterified cholesterol percentage and high-density lipoprotein cholesterol were hardly affected by pregnancy. The hyperlipidemia of pregnancy is accompanied by an increase in the plasma cholesterol esterification rate for the first half of gestation. During the second half of gestation there is little change in the plasma cholesterol esterification rate, in the presence of a continuing increase in plasma lipid levels.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Fetal measurements, especially fetal foot length, were correlated with fetal age—as measured by last menstrual dates— for 1800 tissue specimens obtained after dilatation and evacuation abortion. These observations were compared with Streeter's results from 1920. Fetal ages ranged from ten through 26 completed menstrual weeks. Fetal measurements including weight, knee-to-heel length, biparietal diameter, placental weight, and amniotic fluid volume were correlated with foot length. Sonographic biparietal diameter obtained by real-time imaging was correlated with tissue measurement of biparietal diameter for various fetal ages. The difficulties of establishing valid correlations are discussed, and a table of recommended values for fetal measurements by week of fetal age is provided.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A retrospective analysis of 273 term deliveries over a four-month period in an Air Force Regional Hospital revealed an 11% incidence of patients seen at term with premature rupture of membranes (PROM) and not in active labor who required induction of labor. The incidence of primary cesarean section in this group was found to be more than twice that of the remaining group of patients, who were seen early in labor with intact membranes, or who had spontaneous rupture of the membranes after the onset of labor. Although this incidence was not statistically significant, it did represent a worrisome trend. Therefore, a randomized prospective study was performed over the next six months to determine whether or not elective antenatal pelvic examinations might contribute to this problem. A total of 349 patients were studied. In 175 patients in whom no pelvic examinations were done until term or past term, the incidence of PROM was found to be 6%. In the 174 patients in whom pelvic examinations were done weekly starting at 37 weeks' gestation, the incidence was 18%, which was a significant increase (P= .001). The primary cesarean section rate was comparable in both groups with PROM; however, the overall primary cesarean section rate when PROM occurred was found to be twice that of the remaining population. This, however, did not achieve statistical significance. The study suggests that pelvic examinations before term may be a significant contributing factor to the incidence of PROM.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Sixty-one patients with preterm rupture of membranes were studied. Transabdominal amniocentesis was performed successfully in 42 patients (68.8%). Among these 42, 26 (61.9%) had a lecithin: sphingomyelin (L:S) ratio of 1.8 or greater and 16 (38.1%) demonstrated pulmonary immaturity. Amniotic fluid obtained from vaginal pooling was compared to fluid obtained transabdominally in seven patients and did not demonstrate any significant differences in L:S values. Gram stain and subsequent culturing of amniotic fluid obtained transabdominally was accomplished in 41 patients. Seven of the 41 patients (17.0%) had bacteria on Gram stain and/or subsequent amniotic fluid growth. All patients with either bacteria on Gram stain or a positive amniotic fluid culture developed clinical amnionitis or endometritis. Review of the neonatal morbidity and mortality in relation to gestational age of infants with preterm rupture of membranes suggests that: 1) In infants at less than 32 weeks' gestation, amniocentesis need not be done for pulmonary maturity as the morbidity of prematurity in this group is too high even in the presence of pulmonary maturity. 2) In infants at 32 to 34 weeks' gestation, amniocentesis for L:S ratio, Gram stain, and culture is helpful in selecting those in whom delivery should be instituted. 3) In infants at greater than 34 weeks' gestation, the neonatal morbidity is sufficiently reduced so that delivery should be considered except in cases of suspected delayed pulmonary maturation.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The present study was undertaken to determine the influence of the time interval between birth and the clamping of the umbilical cord on the acid-base balance of the newborn. At 30 seconds after birth, arterial blood from the undamped cord showed a distinct decrease in pH and an increase in Pco2and base deficit. These changes were not observed in the venous cord blood. The arterial blood changes continue during the first minute following delivery. When the cord is clamped immediately after birth, acid-base equilibrium in arterial and venous blood at 60 seconds after birth oscillates around the values obtained at zero time. When acid-base equilibrium of arterial cord blood is used as a parameter of neonatal well-being, immediate clamping seems mandatory.

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A prospective noncomparative study was designed to test the ability of the nonstress test (NST) and the contraction stress test or oxytocin challenge test (CST/OCT) to predict neonatal morbidity or impending mortality. Two hundred nine pregnancies tested within eight days of delivery were studied. The only two perinatal deaths occurred in association with the postmaturity syndrome, and both had a preceding reactive NST. Some patients (37.57c) with a positive CST/OGT had fetal distress in labor. Ninety-six percent of infants with distress in labor had an antecedent reactive NST. In the study, 25.8% of the patients had a major antepartum, intrapartum, or postpartum complication that was not predicted by the NST. Therefore, electronic antepartum fetal heart rate surveillance was used as only one facet of the overall patient analysis. Management of patients was based upon the combination of antepartum monitoring, real-time ultrasound evaluation of amniotic fluid, and placental morphology, as well as the clinical suspicion of increased risk (using fetal activity testing, etc).

ISSN:0029-7844    

出版商:OVID    

年代:1984

数据来源: OVID