Natural variation in the human sex ratio.
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Female↗
Biomedical subjects
G Bártfai
Publications and source records attributed to G Bártfai.
Emergency contraception in clinical practice: global perspectives.
Access to reliable contraception is often unavailable. Unsafe abortion yearly causes death for thousands and disabling illness for millions worldwide. Insufficient information, negligence, inappropriate contraception, poverty and poor education contribute to these serious sequelae of unintended pregnancy. Identification of those at risk, the provision of appropriate information and access to emergency contraception (EC), and male involvement are emphasized. Improved knowledge, better attitudes, enhanced practice of EC, and determined providers might meet the requirements of the next century.
Adolescent↗
Interleukin-10 receptors are expressed by basement membrane anchored, alpha(6) integrin(+) cytotrophoblast cells in early human placenta.
Cytotrophoblast cells produce interleukin (IL)-10 and express IL-10 receptor mRNA in culture. Furthermore, IL-10 dramatically reduces the synthesis of matrix metalloproteinase (MMP)-9 and the invasivity of cytotrophoblast cells in vitro, suggesting that an autocrine regulatory role in vivo is also possible. To test this hypothesis we investigated the expression of IL-10 receptor protein by first trimester cytotrophoblasts both in vitro and in situ, using flow cytometry and immunohistochemistry. Flow cytometric analyses demonstrated that 75-80% of cytotrophoblasts are able to bind labelled IL-10, suggesting that these cells possess IL-10 receptors in vitro. Serial sections of early human placentae stained for either alpha(5) and alpha(6) integrin subunits, or for IL-10 receptors respectively, revealed that placental cytotrophoblasts possess cell surface IL-10 receptors not only in vitro, but also in vivo. IL-10 receptors were present mainly on alpha(6) integrin expressing villous cytotrophoblast cells and on alpha(6)-positive cells of invasive cell columns located nearest the villous stroma. Differentiated trophoblasts (i.e. alpha(5)-positive cells and villous syncytiotrophoblasts) showed no reactivity. This differential expression of IL-10 receptors suggests that IL-10 might suppress the invasivity of undifferentiated cytotrophoblast cells, in vivo, preserving their non-invasive state in an autocrine manner. The possible involvement in cytotrophoblast proliferation and/or differentiation is also discussed.
Antigens, CD↗
Iatrogenic multiple pregnancy. Higher risk than a spontaneous one?
OBJECTIVE: To determine if spontaneous and induced multiple pregnancies have similar outcomes. STUDY DESIGN: We compared the results of antepartum and intrapartum surveillance and fetal outcome in spontaneous multiple gestations (group A) with induced multiple gestations (group B) at Albert Szent-Györgyi Medical University, Szeged, Hungary, in a six-year period. RESULTS: Between January 1, 1991, and December 31, 1996, there were 13,131 births; the number of multiple pregnancies was 307 (2.34%). There were 232 spontaneous and 48 induced twin pregnancies, 8 spontaneous and 16 induced triplet pregnancies, and 3 quadruplet pregnancies, all induced. Higher incidences of gestational diabetes and cervical insufficiency were found in group B. The incidences of prematurity in the induced and spontaneous groups were similar. The incidences of low birth weight and perinatal mortality were higher in induced triplet pregnancies than in spontaneous ones. Fetal outcome, with respect to Apgar score and umbilical cord blood pH, was much poorer in both induced groups. CONCLUSION: Iatrogenic multiple pregnancy following ovulation induction or assisted operative reproductive techniques may increase the incidence of pathologic events in the antepartum, intrapartum or postpartum period. Careful counseling before assisted reproductive techniques is of paramount importance.
Adult↗
[Ovulation induction with adjuvant antiandrogen treatment in Stein-Leventhal syndrome].
Ovulation induction with adjuvant antiandrogen treatment was carried out in 50 cycles of 24 hyperandrogenic anovulatory patients. Besides the clomiphene and gonadotrophin (pure FSH) administration on the bases of antiandrogenic effects of the drugs three treatment groups (dexamethasone, sprinolactone and cyproterone acetate) were established. In 40 cases of 50 cycles ovulation were detected and 11 pregnancies occurred. The authors achieved the highest ovulation and pregnancy rate in the group treated with cyproterone acetate. The highest progesterone and the lowest testosterone levels were measured in the same group. According to our investigations adjuvant antiandrogen treatment with cyproterone acetate advisable in the cases of hyperandrongenic conditions.
Adult↗
Reproductive health in the formerly socialist economies in Europe.
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Delivery of Health Care↗
[Risk of premature rupture of the fetal membranes in cases of fetal maturity].
In this study data of labour, delivery and neonatal outcome were compared in term pregnancies in 100 patients with premature rupture of the membranes (PROM) amniotomy. According to the data in cases of PROM there are more unfavourable cervix findings at the beginning of labour (54%), more pathologic cardiotocograms in the first stage (14% vs. 12%), more prolonged first stages (21.5 vs 14.5 hours) more caesarean section (9% vs 7%) and more newborns were born with a 5 minute Apgar score below 8 than in the control group. Intrauterine infection was detected in 1% of all cases. The authors conclude, that careful monitoring of the fetal state and with no signs of intrauterine infection expectant management of delivery is advisable to improve to improve perinatal mortality and morbidity.
Adult↗
[Pulsatile gonadotropin releasing hormone treatment following previous ovarian hyperstimulation].
Physiological follicular maturation was achieved by pulsatile gonadotrophin releasing hormone treatment in ovarian hyperstimulatory cases induced previously by other ovulation induction methods (clomiphene, clomiphene + hCG, clomiphene + hMG + hCG). The follicular development was detected by vaginal ultrasound examination (Hitachi-3000, 6.5 MHz) in 8 cycles treated with gonadotrophin releasing hormone. During the pulsatile gonadotrophin releasing hormone treatment ovulation was found in all cases and 2 pregnancies occurred. Ovarian hyperstimulation was not noticed. Physiological follicular maturation can be induced with the pulsatile administration of gonadotrophin releasing hormone after previous ovarian hyperstimulation because using this method the hypophyseal-ovarian steroid feed back mechanism remains unchanged.
Adult↗
[Changes in melatonin blood levels during gonadotropin releasing hormone loading tests in women with anovulatory disorders].
The results of seven gonadotropin releasing hormone (GnRH) loading tests are presented with special respect to the changes of melatonin level. The tests were carried out after a withdrawal bleeding triggered by progesterone (100 mg for 5 days) and plasma FSH, LH, prolactin and melatonin level were determined. The initial melatonin values were between 3.9 and 35.7 pg/ml and were in inverse ratio with the basal gonadotropin levels. In the case of reactive hypophyseal response the melatonin level decreased in every case in inverse ratio with the increase of gonadotropins. In one case, after the GnRH administration there was no increase in gonadotropin production and at the same time the melatonin secretion remained unchanged. According to our examinations the melatonin secretion during the GnRH loading test showed a good correlation with the changes of gonadotropins.
Anovulation↗
[Gonadotropin releasing hormone loading test with bromocryptin therapy: a new possibility in the differential diagnosis of normo-prolactinaemic anovulation].
An anovulation group with normal basal prolactin level (less than 600 mU/l) was found during GnRH loading tests. After GnRH administration there was a definite increase in prolactin value together with an insufficient hypophyseal response. Bromocriptine treatment was commenced on the 10th day (daily 2.5 mg) before carrying out the GnRH loading tests again. During the repeated tests prolactin levels remained normal, basal FSH and LH values increased and reactive hypophyseal responses occurred. On the basis of the examination a group ("latens hyperprolactinemia") responding with increased prolactin production during GnRH administration was found. This higher prolactin level inhibits gonadotropin release from hypophysis. In these cases ovulation induction with bromocriptine is adviseable in spite of basal prolactin level is normal.
Anovulation↗
[Pulsatile gonadotropin-releasing hormone substitution following excision of a craniopharyngioma with suprasellar invasion].
Craniopharyngeoma growing suprasellary attacks the medio-basal region of hypothalamus, that leads to the stopping of the production of gonadotropin releasing hormone. In connection with the case of a 15-year-old girl who had partial extirpation of craniopharyngeoma the authors write about the favourable endocrine effect of pulsatile gonadotropin releasing hormone treatment. Through giving gonadotropin releasing hormone every 90 minutes in 20 micrograms doses menstruation cycle and ovulation was performed. Beside surgical treatment hormonal substitution plays an important role in the treatment of additional endocrine symptoms.
Adolescent↗
Pulsatile gonadotropin releasing hormone substitution following extirpation of suprasellar craniopharyngioma.
A craniopharyngioma growing suprasellarly attacks the medio-basal region of the hypothalamus, interrupting the production of gonadotropin-releasing hormone. In the case of a 15-year-old girl who underwent partial extirpation of craniopharyngioma, favorable endocrine effects were obtained by pulsatile gonadotropin-releasing hormone treatment. Gonadotropin-releasing hormone administered in a dose of 20 micrograms every 90 min resulted in the achievement of a menstrual cycle and ovulation. Together with surgical treatment, hormonal substitution plays an important role in the treatment of endocrine symptoms.
Adolescent↗
[Treatment of functional infertility, caused by luteal deficiency, with pulsatile perfusion of gonadotropin releasing hormone].
The prehistory of cyclical development of corpus luteum goes back to early follicular phase. Reduced secretion or defective rhythm of gonadotropin releasing hormone (GnRH) can later cause unperfect ovulation or corpus luteum insufficiency. The authors carried out a low-dose pulsatory GnRH-treatment on eight patients with luteal insufficiency, who were earlier treated unsuccessfully with other ovulation-inductive methods (clomiphene, hCG, bromocryptin). As a result of GnRH administration hypertherm period expanded, plasma progesteron level increased and three pregnancies occurred. In their opinion exogenic administration of GnRH results in an improvement of luteal function.
Corpus Luteum Hormones↗
[Reliability of diagnostic methods in extrauterine pregnancy].
Reliability of diagnostic methods in extrauterine pregnancy. The predictive value of different diagnostic methods used in the diagnosis of ectopic pregnancy was analysed on the basis of 87 cases and literary data. The best results were achieved by laparoscopy. Douglas pauch punction is appropriate only in acute cases. The immune pregnancy test, ultrasound and histological examinations showed relatively great number of false negative results. By suspicion of extrauterine gravidity laparoscopy is suggested even if other results are negative.
Female↗
[Changes in the prolactin level under the effect of pulsatile infusion of gonadotropin releasing hormone].
Plasma prolactin levels were measured in 18 GnRH loading tests and, in 24 cycles involving treatment with GnRH. During 17 GnRH loading tests the prolactin levels production remained virtually unchanged, the individual GnRH pulses not raising the prolactin level. In one case the GnRH loading test led to a considerable rise in prolactin level, which is considered to be a pathological prognostic sign as concerns subsequent GnRH treatment. During unsuccessful pulsatile GnRH treatment, the prolactin secretion in monotonous, while treatment resulting in ovulation, even in hyperprolactinaemia cases, is accompanied by higher prolactin levels in the preovulation and luteal periods than in the early follicular phase.
Adult↗
[Vaginal ultrasonography: a new testing method in obstetrics and gynecology].
Transvaginal sonography represents a new tool for the gynecological diagnosis and decision making. The authors present theoretical and practical aspects of transvaginal sonography with special emphasis on the 6.5 MHz vaginal probe. Based on one thousand one hundred and eight examinations it is obvious that this procedure is valuable in diagnostic algorithm of ectopic pregnancy and to follow follicular growth, as well as ultrasound guided oocyte retrieval.
Congenital Abnormalities↗
Ovulation induction with pulsatile administration of human menopausal gonadotropin.
Ovulation induction was performed by the pulsatile administration of subcutaneous human menopausal gonadotropin (hMG). Treatment was started with a daily dose of 75 IU hMG (in a 90% distribution), then it was increased to 150 IU depending on the oestradiol level of the plasma and on the result of folliculometry. Of 10 cycles treated ovulation was induced in 7 cases and two pregnancies occurred. In two cases, following a previous unsuccessful intramuscular hMG treatment, ovulation was induced. Hyperstimulation did not occur. The pulsatile s.c. administration of hMG seems to be an adequate ovulation-induction method in ovulatory disorders of hypothalamo-hypophyseal origin and is a good substitute for the missing, endogenous gonadotropin secretion of inadequate pace.
Adult↗
[Ovulation induction in Kallman syndrome by intravenous pulsatory infusion of gonadotropin releasing hormone].
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Adult↗