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  • 1
    Electronic Resource
    Electronic Resource
    The role of trophoblast dysfunction in the aetiology of miscarriage (1993)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 100 (1993), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To investigate the endocrine changes associated with spontaneous miscarriage after fetal heart activity has been demonstrated.Design Prospective study during the first trimester of pregnancy comparing the circulating levels of human chorionic gonadotrophin (hCG), Schwangerschaft protein 1 (SP-1), pregnancy-associated plasma protein A (PAPP-A), oestradiol (E2), and progesterone (P), and fetal growth (crown-rump length [CRL] and gestational sac volume [GSV]) in women who miscarried after the identification of fetal heart activity with those of normal singleton and twin pregnancies achieved following in vitro fertilisation (IVF) and embryo transfer (ET).Setting The Assisted Conception Unit of King's College Hospital, London.Subjects Nine women who miscarried after demonstration of fetal heart activity, 52 normal singleton and 22 normal twin pregnancies.Interventions Weekly blood tests and ultrasound assessments of CRL and GSV.Results Four fetuses (all singleton) died between 9 and 12 weeks gestation (Group 1), and seven (three singleton and two twin) died between 16 and 20 weeks gestation (Group 2). In Group 1, both fetal growth and placental function, as assessed by serial measurements of CRL and GSV, and of serum levels of PAPP-A, SP-1 and hCG respectively, were reduced before fetal death. In Group 2, while fetal growth was maintained in all but one case, placental function was reduced in 4 of 5 women.Conclusion These findings suggest that there may be a relationship between trophoblast dysfunction and some forms of miscarriage. Furthermore, the pattern of the reduction in the circulating levels of the placental proteins in later miscarriages suggests that the function of specific cell types may be impaired.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1993.tb12979.x
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  • 2
    Electronic Resource
    Electronic Resource
    Effects of subcutaneous oestradiol implants on ovarian activity (1987)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 94 (1987), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. The effects of subcutaneous oestradiol implants on ovarian activity were investigated in 14 ovulating premenopausal women. Treatment with either 100 mg or 150 mg oestradiol was combined with cyclical oral norethisterone from days 20 to 26 of the cycle to ensure regular withdrawal periods and prevent endometrial hyperplasia. Ovarian function was monitored by regular pelvic ultrasonography and urinalysis over a period of nine cycles. During the first three cycles after hormone implantation, follicular development continued in almost half the study group, but only one of the women in each treatment group showed signs of follicular rupture and luteinization. By the sixth cycle, over half the women given the lower dose of oestradiol were developing follicles, including a large functional cyst in one, but none of them ovulated. A further implant given early in the seventh cycle was associated with ovarian suppression in all cases. Both doses of implant elevated the excretion of oestrone-3-glucuronide compared to pretreatment. The contraceptive and therapeutic implications of these results are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1987.tb02321.x
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  • 3
    Electronic Resource
    Electronic Resource
    Ovarian size in postmenopausal women (1988)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 95 (1988), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Ovarian volumes have been determined by pelvic ultrasonography in 2246 apparently healthy postmenopausal women of whom 2221 were included in the statistical analysis. Factors associated with gonadal size have been identified, and reference ranges for derived indices have been determined for use (in association with criteria for abnormal morphology) in a screening programme for ovarian carcinoma. The right ovary was present in 98·9% of subjects and the left in 99 · 1 %. The mean (SD; range) of right and left ovarian volumes were 3·58 (1·40; 1·00–14.01) and 3·57 (1·37; 0·88–10·9) ml respectively. Significant predictors of ovarian volume were years since the menopause, weight, parity, age at menopause, a history of hormone replacement therapy, and previously diagnosed breast cancer. Abnormal ovarian volumes were assessed from a score equal to the (observed mean log volume (MLV) minus the predicted MLV)/0·327. A simplified nomogram has been prepared for routine clinical use. The relative abnormality of one ovary was assessed from a ratio score equal to loge (larger ovarian volume/smaller ovarian volume)/0·211 compared with the 99th centile for the Gaussian distribution.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1988.tb06554.x
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  • 4
    Electronic Resource
    Electronic Resource
    Monitoring gonadotrophin therapy by real-time ultrasonic scanning of ovarian follicles (1982)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 89 (1982), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary. Real-time ultrasound scanning of ovarian follicles was performed during 61 cycles in 22 infertile patients being treated with sequential injections of human menopausal gonadotrophin (hMG) and human chorionic gonadotrophin (hCG). Total 24-h urinary oestrogens were estimated (and in 13 cycles plasma oestradiol) but the amount of gonadotrophin given was based mainly on the ultrasound findings. A retrospective analysis of the results showed that there was a poor statistical correlation between the diameter of the largest follicle and the total urinary oestrogens (r= 0.39) and with the level of plasma oestradiol (r= 0.56), although similar clinical information was obtained by all methods. Ovulation was induced in 58 cycles when the leading follicle had a mean diameter of 20–25 mm (mean 21.3 mm); follicular rupture was observed in 57 cycles and in these cases there was biochemical evidence of luteinization (plasma progesterone 〉15 nmol/1; total urinary pregnanediol 〉8 μmol/24h). Three patients (three cycles) were not given hCG; one developed micropolycystic ovaries and two showed evidence of hyperstimulation (one follicle 〉25 mm diameter, three or more follicles 20–25 mm diameter). Twelve patients became pregnant, all with single fetuses. Subsequently one aborted, one had an ectopic pregnancy, three gave birth to normal babies at term and seven pregnancies are continuing. Real-time ultrasound scanning of ovarian follicles is a simple, practical method for monitoring follicular growth during the administration of hMG and predicting the response to hCG.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1982.tb04684.x
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  • 5
    Electronic Resource
    Electronic Resource
    OESTRADIOL: THE PREDOMINANT INTRANUCLEAR OESTROGEN IN THE ENDOMETRIUM OF OESTROGEN-TREATED POSTMENOPAUSAL WOMEN (1981)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 88 (1981), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Intracellular oestrogen metabolism has been investigated in endometrial tissue from postmenopausal women receiving oestrogen therapy either alone or in combination with a progestogen. During oestrogen therapy alone, there was a 3·2 fold predominance of oestradiol over oestrone within the endometrial cell nucleus and the mean nuclear oestrogen receptor content was 1·40 pmol/mg DNA. The addition of norethisterone decreased the nuclear oestradiol/oestrone ratio to 1–4:1 by lowering the oestradiol mass. A concurrent reduction in the mean level of the nuclear oestrogen receptor to 0·58 pmol/mg DNA indicated a decrease in oestro-genic stimulation. The activity of oestradiol-17β dehydrogenase was significantly increased. There was a plasma excess of oestrone over oestradiol during oestrogen therapy alone and the oestrone/oestradiol ratio was not significantly altered following norethisterone administration. The ability of the endometrium to incorporate oestradiol selectively into the nucleus is discussed in relation to the risk of endometrial hyperplasia with unopposed oestrogen therapy. The profound biochemical changes induced by norethisterone help elucidate mechanisms whereby progestogens lower oestrogenic potency and thereby protect the endometrium against excessive stimulation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1981.tb02228.x
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  • 6
    Electronic Resource
    Electronic Resource
    THE ABSORPTION AND METABOLISM OF ORAL OESTRADIOL, OESTRONE AND OESTRIOL (1981)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 88 (1981), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The absorption, metabolism and clearance of oestradiol, oestrone and oestriol from the peripheral circulation were investigated in five postmenopausal women after the oral administration of Hormonin (oestradiol 600 μg, oestrone 1400 μg, oestriol 270 μg) daily for five consecutive days. In addition the concentrations of plasma oestrone-3-sulphate, oestrone-3-glucuronide, LH and FSH were determined in the same plasma samples. The maximum concentrations of each steroid in peripheral plasma and the time intervals during which the peak occurred after ingestion of the last tablet were:—oestrone (750 to 2116 pmol/1, 0·5 to 6·0 hours), oestradiol (246 to 813 pmol/1, 1 to 8 hours), oestriol (173 to 241 pmol/1, 5 to 12 hours), oestrone-3-glucuronide (32·2 to 78·8 nmol/1, 0·5 to 3·0 hours) and oestrone-3-sulphate (21·9 to 39·0 nmol/1, 1 to 7 hours). The mean factorial increases in the concentration of each compound during the first 12 hours post-treatment over the baseline values were:—oestrone (4·1); oestradiol (4·4); oestriol (1·7); oestrone-3-sulphate (2·6) and oestrone-3-glucuronide (8·1). After treatment, the concentration of plasma oestradiol remained significantly higher than the baseline values (p 〈0·025) for 24 hours and the values for each subject were within the normal range for premenopausal women. Moreover, there was a significant reduction (p 〈 0·025) in the level of circulating LH. It is concluded that the simultaneous administration of oestrone, oestradiol and oestriol, by mouth, to postmenopausal women is a good approach to maintaining an appropriate concentration of oestradiol in peripheral plasma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1981.tb01312.x
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  • 7
    Electronic Resource
    Electronic Resource
    THE RELATION BETWEEN UMBILICAL CORD TISSUE PROSTAGLANDIN E2 LEVELS, MODE OF ONSET OF LABOUR, FETAL DISTRESS AND METHOD OF DELIVERY (1977)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 84 (1977), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The tissue concentrations of prostaglandin E2 (PGE2) were measured by radioimmunoassay in components of the umbilical cord. The levels were significantly higher in the walls of arteries than in non-vascular tissue from the umbilical cord. The highest values were found after emergency Caesarean sections and the lowest after induced labour ending in normal delivery. The use of forceps and the presence of fetal distress were both associated with significantly raised tissue concentrations of PGE2.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1977.tb12662.x
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  • 8
    Electronic Resource
    Electronic Resource
    OESTRADIOL AND TESTOSTERONE IMPLANTS IN THE TREATMENT OF PSYCHOSEXUAL PROBLEMS IN THE POST-MENOPAUSAL WOMAN (1977)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 84 (1977), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1977.tb12586.x
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  • 9
    Electronic Resource
    Electronic Resource
    STUDIES IN THE INVOLVEMENT OF PROSTAGLANDINS IN UTERINE SYMPTOMATOLOGY AND PATHOLOGY (1976)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 83 (1976), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The concentrations of prostaglandins E2 and Fα were measured by radioimmunoassay in samples of endometrial tissue from 155 women. The results showed that the concentration of prostaglandin E2 (ng/100 mg of wet tissue; mean ± SD) in tissue from apparently healthy women with regular menstrual cycles was 79·3 ± 9·9 during the menstrual period. The level in the proliferative and early secretory phases fell to 11·8 ± 4·0 and 13·3± 8·3 respectively. During the late secretory phase there was a significant increase to 20·1±10·8. The corresponding values from patients with fibromyomata and without menorrhagia were similar. However, the concentration in tissue from patients with fibromyomata and menorrhagia was significantly higher (63·9 ±17·9) during the secretory phase of the uterine cycle. In addition, the amount was significantly higher in the groups with dysmenorrhoea (19 ·0 ± 4·5 proliferative; 68 · 0 ± 18 ·15 secretory) and irregular uterinbleeding (78·3 ± 59·0 proliferative; 87·4 ± 64·9 secretory). The mean concentration was higher in cases of endometriosis, and significantly elevated in endometrial carcinoma. The results for prostaglandin Fα showed a similar pattern, but the changes were less marked in patients with irregular dysfunctional bleeding. The findings are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1976.tb00839.x
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  • 10
    Electronic Resource
    Electronic Resource
    Characteristics of persistent ovarian masses in asymptomatic women (1989)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 96 (1989), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Persistent ovarian masses have been found in a substantial proportion of 5479 self-selected asymptomatic women who were screened for early ovarian neoplasia. Each woman was scheduled to undergo three ultrasound screens (consisting of 1–12 scans) to detect regressing and non-regressing masses. A total of 14,594 screens (15,977 scans) was performed. The average interval between successive screens was 595 days (range 214–1134 days). Overall, 650screens (4.4%; 10.1% of women) produced a positive result which became negative with successive scans (four times more frequently in pre-than naturally postmenopausal women), and 338 screens (2.3%; 5.9% of women) had a final positive result (at least one ovary that was grossly abnormal or contained a persistent mass). Biopsies were taken from 336 ovaries (89% of total, 271 women). Overall, 134 tumour-like conditions and 119 benign tumours were identified. The detection rate of tumour-like conditions was 1.5 times higher in premenopausal than naturally postmenopausal women, whereas the proportion of tumours to normal ovaries was similar in both groups. Overall, 51% of tumour-like conditions and 70% of all tumours were detected at screen 1. Four women had metastatic ovarian cancer (three at screen 1, one at screen 2; two were bilateral). Five women (0.1%) had a primary malignant tumour (two at screen 1, three at screen 2; four were stage la and one was stage Ib). All women are being monitored to obtain additional information about the significance of the findings.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1989.tb06299.x
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