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M Vejtorp

Publications and source records attributed to M Vejtorp.

At least 19 recordsLinked to original sources
PubMed1996

[Extrauterine pregnancy: diagnosis and treatment].

The incidence of ectopic pregnancy in Denmark has doubled since the beginning of the 1980's. A total of 2400 cases per year are identified corresponding to an ectopic localization in one of 40 pregnancies. An early diagnosis of ectopic pregnancy depends on the use of vaginal ultrasound examination and serial determination of the concentration of serum-HCG. By this information the diagnosis of an ectopic pregnancy can usually be established without the use of laparoscopy. In approximately 20% of the women the ectopic pregnancy regresses without treatment. Laparoscopic salpingotomy compared to treatment by laparotomy reduces the hospital stay and the convalescence period. The fertility is preserved in 60-80% of the women, if the contralateral salpinx has not previously been damaged. The possibility of making the diagnosis of ectopic pregnancy without laparoscopy has resulted in an increased interest in medical treatment. Repeated administration of methotrexate leads to regression of the ectopic pregnancy in approximately 95% of the treated women, however, 20% have temporary unpleasant side-effects. After treatment with a single dose of methotrexate, the side effects are avoided. The effectiveness, however, seems severely reduced. There is a need for a continued development of non-invasive methods for the treatment of ectopic pregnancy.

Denmark↗
PubMed1995

[Fertilization in vitro in the presence of hydrosalpinx and in advanced age].

The purpose of the study was to determine the effect of the presence of a hydrosalpinx and of increasing age on the pregnancy rate after in vitro fertilization (IVF). The presence or absence of a hydrosalpinx was determined by transvaginal ultrasonography before hormonal stimulation of the follicles. The study included 741 women treated in 1090 consecutive cycles in which at least one oocyte was aspirated. The pregnancy rate in 104 cycles in women who had a hydrosalpinx was 6%. In 813 cycles in women with tubal infertility, but without a hydrosalpinx, the rate was 21% (p < 0.0005). A similar pregnancy rate was found in women with unexplained infertility after treatment in 257 cycles. The pregnancy rate in women without a hydrosalpinx decreased from 25% among the women who were 22-29 years old to 11% in the women who were 40-44 years old. In conclusion, the presence of a hydrosalpinx decreases the pregnancy rate after IVF. As tubostomy to improve fertility generally carries a poor prognosis, a salpingectomy prior to IVF may be preferable. Owing to the age-related reduction of the pregnancy rate, IVF should not be put off when indicated for treatment of infertility.

Adult↗
PubMed1994

[Laparoscopically treated extrauterine pregnancy].

During a period of 12 months 55 women were treated for 56 ectopic pregnancies. Forty of the 56 (71%) procedures were performed laparoscopically. The duration of operation was 74 minutes when a conservative procedure was used, and 83 minutes where a salpingectomy was performed. The median duration of a diagnostic laparoscopy followed by laparotomy in 12 women was 83 minutes. Four women (13%) had persistent trophoblast, which necessitated a second operation. Two patients had a second laparoscopy because of lower abdominal pain, but did not need further treatment. Median hospitalization time (including diagnosis and second procedures) for the laparoscopically treated women was three days (range one to 16 days).

Female↗
PubMed1993

Function of the corpus luteum, the endometrium and the trophoblast after treatment of tubal pregnancy by prostaglandin F2 alpha.

The activity of the corpus luteum, the endometrium and the trophoblast was studied after local medical treatment of 31 women with tubal pregnancy. We measured the serum concentration of progesterone, the secretory endometrial protein placental protein 14 (PP14), and human chorionic gonadotrophin (HCG) before and after treatment by injection of prostaglandin F2 alpha into the site of the gestation and into the corpus luteum. There was no significant difference in the pre-treatment serum progesterone and serum PP14 concentrations of 26 women who were treated successfully and of five women, who were operated on after failure of the treatment. After the prostaglandin treatment the serum progesterone and PP14 concentrations decreased simultaneously with the serum HCG concentration or remained at a low, constant concentration. We conclude that measurement of serum progesterone and PP14 cannot be used for selection of patients for treatment by prostaglandin F2 alpha or for monitoring the effect of the treatment. The injection of prostaglandin into the ovary has either no effect on the activity of the corpus luteum or induces only a partial luteolysis.

Adult↗
PubMed1992

[New therapeutic methods in tubal pregnancy].

A world-wide increase in the incidence of extrauterine pregnancy has increased interest in new forms of treatment of this condition. In Denmark, the number of cases of diagnosed tubal pregnancies has doubled from 1980 til 1989. Experience with the spontaneous course of tubal pregnancies is reviewed. In addition, various forms of laparoscopic treatment and systemic and local treatment with methotrexate are described. In Denmark, local treatment with prostaglandin has been employed with good effect. Whether conservative surgical treatment or treatment with methotrexate or prostaglandin are to be employed depends upon the patience of the treating physician as regards control examinations with ultrasonic scanning and measurement of serum human chorion gonadotropin. Repeated tubal pregnancy in the salpinx involved, persisting trophoblastic tissue after treatment and long periods of observation are unintentional side effects of treatment. After conservative treatment of tubal pregnancy, it is important that the patient is given meticulous information.

Female↗
PubMed1992

The secretory endometrial protein, placental protein 14, in women with ectopic gestation.

OBJECTIVE: To determine the serum level of the secretory endometrial protein, placental protein 14 (PP14) and progesterone (P) in women with ectopic gestation. DESIGN: Blood samples were collected prospectively and preoperatively. Reference range was determined from a prospective population of 98 women with uncomplicated pregnancies and normal outcome. SETTING: The women were admitted to a university hospital. PATIENTS: Fifty-nine women with laparoscopically verified ectopic pregnancy entered the study. INTERVENTION: At the time of diagnosis PP14 and P were measured. MAIN OUTCOME MEASURE: After observing the low serum levels of PP14 and P, a correlation analysis was made and compared with the findings in normally pregnant women. RESULTS: A significant positive correlation was found between the level of PP14 and P (P less than 0.00002), not found in normal intrauterine pregnancies. CONCLUSIONS: These findings suggest that the regulation of the PP14 production involves either a control mechanism from the ovary or is mediated by paracrine secretion.

Adult↗
PubMed1991

Treatment of tubal pregnancy by local injection of prostaglandin: selection of patients and evaluation of subsequent tubal patency.

Thirty women who had a small unruptured tubal pregnancy were treated by laparoscopically guided injection of prostaglandin F2 alpha into the oviduct and into the corpus luteum. They had no side effects. The serum human chorionic gonadotropin (S-HCG) concentration decreased in 25 women to less than 20 IU/l in a median time of 8 days (range 1-45). Five women were operated on because of increasing S-HCG concentration. The median diameter of the oviduct at the site of the gestation, the tubal localisation and the gestational age was similar in the women treated by prostaglandin and those, who were operated on after failure of the procedure. Four of the 6 women, with S-HCG concentrations of more than 2000 IU/l, needed subsequent operative treatment, compared to only one of 24 with a lower concentration. The median duration of the hospital stay after treatment was 2 days for the group of women with a S-HCG concentration of less than 2000 IU/l. Hysterosalpingography 3 months after treatment showed patency on the side of the pregnancy in 12 of 14 women. Prostaglandin injection seems to be an appealing option for the treatment of selected ectopic pregnancies.

Animals↗
PubMed1990

[Diagnosis and treatment of women with urinary incontinence at Danish gynecologic departments].

The routine practice in the diagnosis and treatment of urinary incontinence was investigated by means of a questionnaire to which all 32 departments replied. Miction charts were employed routinely in 17 departments and for selected patients in eight departments. Weighing of diapers was employed in 13 departments for all patients investigated for incontinence, but only for selected patients in ten departments. Cystometry was employed in cases of stress-incontinence in 23 departments and in cases of urge-incontinence in 30 departments. As regards the choice of operative treatment, 22 departments stated that they would employ abdominal intervention in cases of anterior suspension defect and vaginal operation in posterior suspension defects. Other departments perferred an abdominal or vaginal approach without employment of guiding miction cysto-urethrography. It is concluded that there are great differences in the routine practices in Danish gynaecological departments in the diagnosis and treatment of utinary incontinence. This appears to be a suitable field for so called reference programmes.

Denmark↗
PubMed1989

Local prostaglandin treatment of ectopic pregnancy.

Eleven women with small unruptured tubal pregnancies were treated by laparoscopically guided injection of prostaglandin F2 alpha in the oviduct and in the ovary which contained the corpus luteum. They had no side effects of the treatment and were discharged from hospital 1-3 days later. In 10 women the serum concentration of human chorionic gonadotrophin (HCG) decreased to less than 20 IU/l in a median time of 7.5 days, the range being 1-46 days. One woman required an operation 6 days after the treatment as her serum HCG level was stationary and she continued to have abdominal pain. Hysterosalpingography 3 months after the treatment showed patency of the oviduct on the side of the pregnancy in seven of the eight women who have been examined. We conclude that the injection of prostaglandin F2 alpha seems to promote the resolution of selected tubal pregnancies.

Chorionic Gonadotropin↗
PubMed1988

Bacterial vaginosis: a double-blind randomized trial of the effect of treatment of the sexual partner.

In a double-blind randomized controlled trial we assessed the effect of metronidazole treatment of the male partner on the recurrence rate of bacterial vaginosis. Women who fulfilled the diagnostic criteria for bacterial vaginosis were treated with metronidazole given in single doses of 2 g on days 1 and 3. The sexual partners were randomized to receive either the same dosage of metronidazole or a placebo. A total of 107 pairs completed the study. One week after the start of treatment 89% of the women considered themselves improved or cured and 93% no longer had the diagnostic criteria for bacterial vaginosis. At assessment 5 weeks after the treatment, 75% reported that they were cured or improved and the diagnostic criteria were not present in 73%. Treatment of the male partner did not affect subjective symptoms, clinical signs and isolation rates of Gardnerella vaginalis at 1 and 5 weeks after treatment.

Adolescent↗
PubMed1986

Serum lipoprotein changes in climacteric women induced by sequential therapy with natural estrogens and medroxy-progesterone acetate or norgestrel.

Thirty perimenopausal women were randomized to sequential therapy with either estradiol-valerate and norgestrel (Cyclo-Progynon), or estradiol and medroxy-progesterone acetate (EM 627). Blood samples were drawn before treatment and in the third treatment cycle during estrogen and progestogen phases respectively. The clinical effects of the two treatments were without significant difference. Ovulation was not suppressed by the treatments, which induced similar increases in serum estradiol and estrone concentrations. The medium serum high density lipoprotein-(HDL)-cholesterol concentration expressed as a percentage of the pretreatment level decreased in the postmenopausal women treated with Cyclo-Progynon to 90% compared with 104% (p less than 0.01) in the EM 627 group. However, the concentrations expressed in mmol/l did not differ significantly, probably owing to non-significant differences in the pretreatment levels. Low density lipoprotein-(LDL)-cholesterol concentrations decreased by approximately 10% in the postmenopausal women during both treatments. Cyclic addition of medroxy-progesterone acetate to estrogen replacement therapy does not adversely affect the serum lipoprotein pattern, and may be preferable to norgestrel.

Adult↗