Ectopic pregnancy following tubal sterilization.
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Adult↗
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Monitoring perinatal mortality by birth weight specific mortality rates.
The perinatal mortality at University Central Hospital of Turku, Finland decreased significantly from 15.7/1000 in years 1970-75 to 8.9/1000 in years 1976-78. The main decrease has occurred in weight groups of 1000 g and more. In years 1976-78 the perinatal mortality of non-malformed babies in the weight group 1500-1999 g was 93/1000, in the group 2000-2499 g 21/1000 and in the group of 2500 g and over 1.7/1000. The early neonatal mortality of non-malformed infants has decreased significantly only in the weight group of 1500-1999 g. The 1-week survival rate has been 48% in the weight group 500-999 g, but 77% in the weight group 1000-1499 g. The birth weight specific mortality rates are greatly required when the quality of obstetrical care is assessed. Birth weight specific neonatal mortality rates are essential when guidelines for elective termination of third trimester pregnancy are designed.
Birth Weight↗
The effect of an oral contraceptive containing ethinylestradiol and desogestrel on hair growth and hormonal parameters of hirsute women.
A group of 22 hirsute women was treated with a combination of 0.030 mg of ethinylestradiol and 0.150 mg of desogestrel (EE-DG) for 6 or 12 months. After 6 months the hair growth was decreased in 17 patients. There was a significant decrease in testosterone/sex hormone binding globulin (T/SHBG) ratio and serum dehydroepiandrosterone sulphate (DHEAS) levels. The changes in the hirsutism and the T/SHBG ratio showed correlation (rho 0.36, P less than 0.05). The patient groups with the best and the poorest clinical response differed in terms of summed changes in the T/SHBG ratio and DHEAS. These findings suggest that the therapeutic effect of the EE-DG is based on combined changes in the related hormone levels.
Adolescent↗
Different effects of two progestins on plasma high density lipoprotein (HDL2) and postheparin plasma hepatic lipase activity.
Two progestins with different androgenic activity were compared for their effects on plasma high density lipoproteins and postheparin plasma lipase activities in premenopausal women. Levonorgestrel, a nortestosterone-derived steroid with androgenic activity reduced plasma HDL cholesterol by 17% (P less than 0.05) and HDL2 cholesterol by 30% (P less than 0.05), without changing the HDL3 cholesterol concentration. At the same time the postheparin plasma hepatic lipase activity was increased by 56% (P less than 0.01) whereas the lipoprotein lipase was not changed. None of these effects was reproduced during administration of medroxyprogesterone acetate, a progestin with low androgenic activity. The results suggest, first, that the decrease of HDL cholesterol observed during treatment with progestins is related to the androgenic activity of the steroid used, and, second, that the change in HDL (HDL2) is caused by androgen-induced increase of hepatic lipase activity.
Adult↗
Personality and sexuality in relation to an index of gonadal steroid hormone balance in a 70-year old population.
Relationships between an index of gonadal steroid hormone function and personality as well as sexual activity were studied in a sample representative for 70-year-olds in Gotenburg, Sweden. Personality was described by means of inventories, sexual activity through a systematic interview and the balance between androgen and oestrogen activity by the quotient between lecithin and lysolecithin in plasma. Men with a relative dominance of oestrogen activity reported a lower frequency of sexual intercourse than other men. Women with a relative dominance of oestrogen activity described themselves as more resourceful, active, confident, unconcerned with the opinion of others, and able to take care of themselves than other women. There were no associations in women between the hormonal balance and the frequency of sexual intercourse.
Aged↗
Pharmacokinetics of the antiprogesterone RU 486 in women during multiple dose administration.
Serum levels of RU 486 were measured by high performance liquid chromatography (HPLC) following oral intake of 12.5, 25, 50 and 100 mg twice daily (b.i.d.) for 4 days, 50 mg b.i.d. for 7 days, as well as a single dose of 200 mg of RU 486. The pharmacokinetics of RU 486 were not linear: when the daily dose of RU 486 was 100 mg or more, the serum levels were similar. The pharmacokinetic behaviour of RU 486 during the treatment period was similar between the study subjects, whereas the elimination phase pharmacokinetics showed wide individual variation. Also the mean elimination phase half-lifes (t 12) of RU 486 varied from 25.5 to 47.8 h in the groups of different regimen, yet the variation between different groups was not statistically significant. The areas under the concentration curves (AUC) were calculated. In the multiple dose study (mds) the AUC0----12h:s decreased when the administered dose of RU 486 was increased. The AUC0----12h seen after administration of 100 mg b.i.d. x 4d. (mean +/- SEM = 0.43 +/- 0.04 mumol/l x h/mg) was significantly (P less than 0.05) lower than the AUC0----12h:s obtained with administration of 12.5 mg b.i.d. x 4d. (1.49 +/- 0.37 mumol/l x h/mg), 25 mg b.i.d. x 4d. (1.09 +/- 0.15 mumol/l x h/mg), and 50 mg b.i.d. x 7d. (0.72 +/- 0.11 mumol/l x h/mg). The AUC0----infinity obtained by administration of a single dose of 200 mg of RU 486 (sds) was 0.67 +/- 0.21 mumol/l x h/mg. It is concluded that if multiple dose administration of RU 486 is preferred, daily administration of relatively small doses of RU 486 over several days seem to be advantageous.
Abortifacient Agents↗
Growth rate, population entropy, and perturbation theory.
This paper is concerned with the connection between two classes of population variables: measures of population growth rate--the Malthusian parameter, the net reproduction rate, the gross reproduction rate, and the mean life expectancy; and measures of demographic heterogeneity--population entropy. It is shown that the entropy functions predict the response of the growth rate parameters to perturbations in the age-specific fecundity and mortality schedule. These results are invoked to introduce the notion of environmental intensity. The intensity function, expressed in terms of the entropy parameters, is applied to give a comparative study of the effect of environmental factors on the dynamics of Swedish and French populations.
Age Factors↗
Uterine perforation by copper intrauterine device.
Sixteen cases with uterine perforation by a copper intrauterine device (IUD) are presented. In 13 cases the IUD had been inserted within 5 months following delivery, and in 6 cases the insertion had been painful. Missing string was the first sign in most cases. Laparatomy was performed in all cases to remove the IUD. The IUD was adherent to omentum or sigmoid in 10 cases. There is an increased risk of uterine perforation if the IUD is inserted postpartum during lactation and involution of the uterus. Therefore a painful IUD insertion and a missing string demand investigation of a partial or complete perforation.
Adult↗
Menarche, menstruation, sexual relations and contraception of adolescent females with Down syndrome.
Fifteen female adolescents with Down syndrome (DS) and 33 female controls without this syndrome were surveyed on age of menarche, menstruation, sexual relations and contraception. All probands and controls were born between 1 January 1965 and 31 December 1970. The day of census was December 31, 1985. All probands and controls were living permanently in the Danish county of Aarhus on this day. Persons close to the DS patients (parents/foster-parents/permanent staff) were interviewed on the above-mentioned topics. All controls were interviewed themselves. The average age of menarche was 13.6 years for probands and 13.5 years for controls. The average duration of the bleeding was 5.5 days for probands and 5.4 days for controls. The average length of the cycle was 28.3 days for probands and 28.6 days for controls. Thirteen DS patients had not had sexual intercourse (no information was available for 2 probands). Twenty-four controls had and 9 had not had sexual intercourse. There is a significant difference between probands and controls concerning use of oral and other contraceptives.
Adolescent↗
Incarcerated Richter's hernia after laparoscopy: a case report.
An unusual case of Richter's hernia on the 5th day after laparoscopy is presented. The complaints simulated a postoperative hematoma, but they became so intense that the expansion was surgically explored: a conservative procedure on the loop of small bowel was possible. To prevent this complication after laparoscopy careful shaking of the abdominal wall at removal of the instruments is necessary.
Adult↗
Lamicel does not promote induction of labour. A randomized controlled study.
Lamicel is a synthetic tent, which, when inserted in the cervical canal, dilates the cervix by osmosis. Lamicel as an adjunct to induction of labour with intravenous oxytocin or vaginal prostaglandin E2 has been examined in a randomized controlled trial. Ninety-one pregnant women with an unripe cervix participated in the study. No improvement in efficacy was observed in the Lamicel groups compared to the control groups, neither when induction of labour was performed with oxytocin nor with vaginal prostaglandin.
Apgar Score↗
The arterial blood supply of the parametrium.
The possible influence of tubal sterilization on the ovarian function is still debated. In this study, we have investigated the course of the main arteries in the parametrium. This study concludes that it is unlikely, from an anatomical point of view, that the ovarian function can be disturbed after tubal sterilization with bipolar cautery, silicone-rings or Filshieclips due to changes in the arterial blood supply.
Adnexa Uteri↗
Smoking does affect fecundity.
A total of 2198 mothers were interviewed at the 20th week of pregnancy and their smoking habits before pregnancy and the time from discontinuation of contraception to the beginning of the pregnancy were registered. This information was used to investigate whether smoking affects conception delay; i.e., fecundity and a multifactorial analysis were used. The longer the conception delay, the more significant was the deleterious effect of even light smoking, the odds ratio shifting from 1.1 at 6 months to 3.2 at 18 months. The effect of smoking on fecundity seemed to be mostly dose-dependent. In mothers becoming successfully pregnant in 12 months, both maternal and paternal smoking increased the risk of conception delay (OR 1.5 and 1.3), and the effect was potentiated by increasing age (OR 2.3 and 1.6). In addition to smoking, previous recurrent spontaneous abortions were also associated with fecundity.
Alcohol Drinking↗
Hysterectomy subsequent to laparoscopic sterilization.
The incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among the female population of the same age in Denmark. The relative risk of undergoing hysterectomy subsequent to tubal sterilization was increased compared to the control group. However, there are several other plausible explanations for this apparently increased risk.
Adult↗
Regret of laparoscopic sterilization.
A follow-up study with questionnaires was performed 4-8 years after laparoscopic sterilization. The follow-up questionnaires were answered for 90.5%. The study revealed that 7.1% of the women were dissatisfied at some stage with the decision to undergo sterilization. However, only 1.8% requested reversal of the sterilization. 40% of the dissatisfied women were between 25-29 years of age, and every fifth sterilized woman in this age group regretted the sterilization.
Adult↗
Sexual adjustment to tubal sterilization.
Sexual adjustment after laparoscopic sterilization has been investigated in a Danish population. The study comprises 659 patients who underwent laparoscopic sterilization during the 4-year period 1980-1983. The study focused on libido, coital frequency, coital enjoyment, lack of excitement, sexual life and feelings of femininity after sterilization in one group of patients satisfied with the sterilization and in another group dissatisfied with the decision to undergo tubal sterilization. There was no difference in libido, coital frequency and sexual satisfaction between the two groups. However, a significant difference was seen between the two groups concerning lack of excitement in sexual life, perception of a more relaxed sexual life, and, finally, perception of changed femininity.
Coitus↗
Is persistent pelvic pain and pelvic joint instability associated with early menarche and with oral contraceptives?
A study of 153 women with persistent pelvic pain and pelvic joint instability (PPPJI) following parturition, revealed that the women differed from the controls by a significantly lower age at menarche. Precocious puberty is associated with a fibrous dysplasia which resembles that seen in some PPPJI women patients at operations. Precocious puberty is known to be associated with hypothalamic dysfunction. Following cessation of lactation, 70 of 153 women did suffer galactorrhea and breast discomfort, suggesting a possible affection of the hypothalamic-pituitary system. Age at menarche was higher in users of oral contraceptives (OC) than in non-users, but onset of PPPJI was significantly earlier by gestation, and galactorrhea, and breast discomfort more frequent (60% affected as compared to 30% of non-users), suggesting that use of OC affects the hypothalamus in a manner similar to that associated with very early puberty. The widespread use of contraceptives is important if it truly leads to an increased proportion of PPPJI among reproducing women. Onset of puberty, controlled by the hypothalamus, coincides with the final step in brain development--elimination of some 40% of neuronal synapses. Age at puberty has declined by some 4 years in 100 years, and it is still falling. It cannot be excluded that in some very early maturers, redundancy of neuronal synapses persists, and that this is associated with hypothalamic dysfunction.
Adult↗
Mifepristone or vacuum aspiration in termination of early pregnancy.
This trial compared the termination of early pregnancy (amenorrhoea less than 43 days) by 600 mg orally of the antiprogesteron Mifepristone to the traditional method of vacuum aspiration. Fifty women were randomly assigned to either of the treatments. All the patients treated with vacuum aspiration had a complete abortion. Three of these patients developed pelvic inflammatory diseasae (PID) after the aspiration. Another patient had the uterus perforated during the procedure, and an emergency laparotomy had to be performed. The patients in the evacuation group spent more days in bed and needed longer sick leave after the treatment than the patients in the Mifepristone group. In the Mifepristone group, six patients had incomplete abortions and all were treated by evacuation. Three of the patients developed PID after the evacuation. A decrease of 40% or more in beta hCG from the initial value to the value 1 week later were invariably associated with complete abortion. In both groups the changes in hemoglobin were insignificant and no patients needed blood transfusion or emergency evacuation. The Mifepristone treatment is a simple and safe alternative to vacuum aspiration for termination of early pregnancies.
Abortion, Incomplete↗