RESUMEN
Tamoxifen treatment for breast cancer may induce ovarian cysts and supraphysiological levels of serum estrogen. We report successful management with luteinizing hormone-releasing hormone (LHRH) agonist of ovarian hyperstimulation induced by tamoxifen. A 49-year-old woman was operated on for invasive ductal carcinoma of the right breast. She received breast irradiation and adjuvant tamoxifen therapy. After 2 years, she had a cystic ovarian mass, and her serum concentration of estradiol was 1280 pg/mL. She was treated with an injection of 11.25 mg leuprolide acetate, a long-acting LHRH agonist, without abandoning tamoxifen therapy. The levels of estradiol decreased to <10 pg/mL and the cystic mass disappeared 2 months later. Three-month depot treatment with LHRH agonists can be useful for patients receiving tamoxifen for breast cancer who have ovarian cysts and supraphysiological levels of estrogen.
RESUMEN
Two independent guidelines on appropriate weight gain for Japanese pregnant women have been established in 1997 and 2006. This study aimed to evaluate changes in the amount of gestational weight gain in pregnant women, the birth weight of their neonates, and the incidence of complications of pregnancy and neonatal outcome in women who delivered at Hyogo Prefectural Kaibara Hospital. Between 1988 and 2014, 6367 women delivered live singleton neonates at full term. The study period was divided into period I (1988-1996), period II (1997-2005), and period III (2006-2014). Changes in weight gain and birth weight were assessed. Complications of pregnancy and neonatal outcome were compared among the periods. Weight gain had been decreased in periods I and II, and weight gain was increased in period III. There was no difference in birth weights between the periods. The incidences of pregnancy-induced hypertension in periods II and III were higher than that in period I (p<0.01). The incidences of vacuum extraction in periods II and III were less than that in period I (p<0.01). The incidence of macrosomia in periods II was less than that in period I (p<0.01). There were no significant differences in the incidence of cesarean section, light-for-date, heavy-for-date, or low birth weight among the three periods. The establishment of guidelines for weight gain and maternity education based on the two guidelines significantly affected complications of pregnancy and neonatal outcome. Prevention of pregnancy-induced hypertension might be difficult when only reducing weight gain in pregnant women.
