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Biomedical subjects

J Studd

Publications and source records attributed to J Studd.

80 records · Page 5Linked to original sources
PubMed1973

Partograms and nomograms of cervical dilatation in management of primigravid labour.

Philpott's graphic labour has been modified and used in 15,000 labours; it has been unanimously accepted by the staff. A nomogram has been constructed to show the normal progressive dilatation of the cervix for primigravidae admitted at different stages of cervical dilatation. Retrospective evaluation of the nomogram showed that it can separate normal labour from labour destined to result in an abnormal outcome, such as longer first and second stages, a greater incidence of instrumental delivery, and babies with low Apgar scores.It is suggested that the use of a stencil representing normal labour progress, together with Philpott's partogram, will be of considerable use, both in specialist and in general-practitioner units.

Apgar Score↗
PubMedDate not supplied

Progestogen intolerance and compliance with hormone replacement therapy in menopausal women.

It is vital that we maximize compliance if patients are to receive the full benefits from hormone replacement therapy (HRT). One of the main factors for reduced compliance is that of progestogen intolerance. Progestogens have a variety of effects apart from the one for which their use was intended, that of secretory transformation of the endometrium. Endometrial effects vary between individuals and between different progestogens, leading to bleeding problems. Symptoms of fluid retention are produced by the sodium-retaining effect on the renin-aldosterone system. The nor-testosterone-derived progestogens can have adverse effects on skin, lipids, vasculature and insulin resistance. Negative mood effects are produced by most progestogens due to the effect on neurotransmitters via central nervous system progesterone receptors. Manipulation of the dosage and duration of progestogen, continuous administration of a low dose of progestogen and a reduction in the number of progestogenic episodes can be used to improve compliance. The progestogen and progesterone releasing coils and vaginal progesterone gel minimize systemic side effects and bleeding. Adverse effects can also be avoided by making use of the progesterone receptor-specific progestogens such as the pregnanes (e.g. cyproterone), nor-pregnanes (e.g. nomegestrol) and progesterone itself. Hysterectomy remains an option for the severely progestogen-intolerant woman. In the future, progestogen intolerance may not be an issue if selective oestrogen receptor modulators provide a complete alternative to HRT.

Affect↗