Clinical and ultrasonographic parameters in assessment of labor induction success in nulliparous women.

Purpose: Evaluation of simplified Bishop score and ultrasound cervicometry in the assessment of labor induction success in nulliparous women.Methods: Prospective cohort study included 146 nulliparous women with singleton pregnancy and indications for labor induction. Prior to labor induction, cervicometry and Bishop score were determined. Upon delivery, patients were classified as those delivered vaginally and by cesarean section (CS) after unsuccessful labor induction.Results: Bishop score >5 was found in 47.95% of vaginally delivered women and 12.33% of patients delivered by CS (p < .01). Cervicometry had appropriate findings in 34.2% of vaginally delivered women and 75.3% of those delivered by CS (p < .01). Bishop score (>5 versus ≤5) had lower sensitivity (52.05%) and specificity (12.33%) than cervicometry (good versus unfavorable findings) (sensitivity 65.75%, specificity 75.34%) for prediction of labor induction success. If Bishop score was ≤5, cervicometry had 50.0% sensitivity and 78.13% specificity, while if Bishop score was >5, 82.86% sensitivity and 55.56% specificity. Obtained model for predicting labor induction outcome in nulliparous women based on their clinical and ultrasonographical characteristics identified the Bishop score as the most important predictor.Conclusions: Study confirmed the usefulness of simplified Bishop score and ultrasound cervicometry in the assessment of labor induction success in nulliparous women.

The most frequent hormone dysfunctions in juvenile bleeding.

The main goal of this study was to investigate the precise hormone dysfunction that leads to dysfunctional uterine bleeding (DUB) in adolescent girls so that, with the appropriate therapy, the occurrence of organic dysfunctions of their reproductive function can be prevented. This study included 70 adolescents with DUB aged 14.70 +/- 1.70 and 30 healthy adolescents aged 13.7 +/- 1.83. Hormone examinations indicated the presence of three typical endocrinological findings of the adolescents with DUB: the first group with FSH values within the normal range, but low LH values, the lower value of estradiol and absence of hyperandrogenism; the second group with higher LH values and normal FSH values but one third with hyperandrogenism; and the third group with normal FSH and LH values, but with hyperinsulinemia and hyperandrogenism. Comparing the hormone values obtained in the control group and the group with DUB, we have concluded that hyperandrogenism, hyperinsulinemia, lower values of progesterone, and dysfunctions in secretion of gonadotropin are statistically important factors for the origin of juvenile bleeding.

Influence of adiposity on leptin, LH and androgen levels in lean, overweight and obese PCOS patients.

BACKGROUND: Leptin modulates hypothalamic-pituitary-gohadal axis functions. OBJECTIVE: To assess the influence of leptin on LH, and to investigate the potential association of leptin with body mass index (BMI) and androgen concentrations in women with polycystic ovary syndrome (PCOS). DESIGN: Levels of leptin, LH, FSH, E2, testosterone, and androstenedione were measured. PATIENTS: 91 patients with PCOS were included in this study. METHODS: Patients were stratified into three groups according to BMI: normal weight (NW group, N=31), overweight patients (OW group N=30) and obese PCOS patients (Ob group, N=30). Results-Hyperandrogenemia was present in the studied group. A significant correlation was observed between BMI and androgens (both P < 0.01), and between leptin levels and androgens (respectfully for androstenendione P < 0.01 and for testosterone P < 0.05). A positive correlation between the LH and leptin levels in NW (P < 0.05) and OW (P < 0.001) patients was noticed, while negative correlation is seen in the Ob group (P < 0.01). In OW patients the significant positive correlation between leptin levels and androstenendione was found (P < 0.001), after correction for BMI. A linear regression model indicated that leptin concentrations and BMI contributed negatively and significantly (P < 0.001) to LH concentrations. CONCLUSION: LH secretion in PCOS patients can be viewed as a consequence of the activity of different adipocyte and neuroendocrine factors. The attenuation in basal LH levels in obese PCOS women might be related to a leptin-resistant state.

Endometriosis in a woman with mosaic Turner's syndrome: case report.

The coexistence of endometriosis and Turner's syndrome is extremely rare, and therefore poses certain questions on the mechanisms of endometriosis. We present a case of a 27-year-old woman with Turner's syndrome [(46, X(x) (q10); 45X], primary amenorrhea and menopausal hormonal profile in which peritoneal endometriosis was revealed laparoscopically.

Inhibin B: a potential marker of gonadal activity in patients with anorexia nervosa during weight recovery.

Inhibin B is a product of the gonads and a marker for ovarian follicular development. This was a cross-sectional study designed to assess awakening of the reproductive function by studying secretion pattern of inhibin B during the weight restoration in patients with anorexia nervosa (AN). Twenty patients with AN participated at low weight [body mass index (BMI) 14.3 +/- 0.3 kg/m(2))], 22 partially weight recovered AN (BMI 17.4 +/- 0.1 kg/m(2)), 16 reached goal weight but did not restore menstrual cycles (BMI 19.5 +/- 0.1 kg/m(2)), and 13 reached goal weight and had at least six consecutive menstrual cycles (BMI 19.3 +/- 1.0 kg/m(2)). Nineteen eumenorrheic females with BMI 19.8 +/- 0.4 kg/m(2) served as controls. At low weight, patients had low basal leptin, inhibin B detectable in only 15% of samples, and LH significantly lower than in controls (P < 0.01). At weight gain, basal leptin increased, median inhibin B increased (detectable in 66.7% of samples), and LH remained low, all significantly lower than in controls (P < 0.01). Weight-recovered/amenorrheic patients further increased basal leptin, inhibin B was detectable in all samples, and LH remained low, all significantly lower than in controls (P < 0.01). In weight-recovered/cycling patients, basal leptin, median inhibin B, and LH, as expected, were not different from healthy volunteers. Inhibin B values correlated significantly with leptin (P = 0.000) and BMI (P = 0.000). In summary, gonads in patients with AN who gain weight are not entirely quiescent but have a low level of activity. Inhibin B is an early marker of gonadal activity, and with weight gain, awakening of the reproductive function is gradual, whereas factors triggering the onset of menstrual cycles still remain unknown (nutritional fat intake, psychological).