Pattern of bone loss in surgical menopause: a preliminary report.

The objective of our study was to assess bone mineral density between surgical menopausal women without hormonal replacement and perimenopausal women. This randomized study group included fifty surgical menopausal women and fifty perimenopausal women. Both groups were assessed in body height, body weight and body mass index. The bone mineral density of the distal radius, midradius, femoral neck, lumbar spine and total body in both groups was determined by dual energy X-ray absorptiometry (DEXA). Data analysis was used ANOVA test and rate of bone loss equation. Both groups were similar with respect to body height, body weight and body mass index. As compared with the values in perimenopausal group, bone mineral density of the surgical menopausal group was significantly lower at distal radius, midradius, femoral neck, lumbar spine, and total body (0.267 vs 0.312 g/cm2, 0.609 vs 0.692 g/cm2, 0.762 vs 0.930 g/cm2, 0.980 vs 1.153 g/cm2, and 1.029 vs 1.141 g/cm2). In the postmenopausal period less than 9 years, the estimated rate of bone loss at the lumbar spine and the distal radius were higher than the other sites (3.05, 2.70 per cent/year). While the postmenopausal period more than 9 years, the estimated rate of bone loss at the femoral neck was higher than the other sites (2.70 per cent/year). Pattern of bone loss in the surgical menopause is responsible for type I osteoporosis in the first 9 years postmenopause and type II osteoporosis in the after 9 years postmenopause. Prevention of bone loss in the surgical menopausal women should be instituted immediately after surgery.

Fetal outcome in term frank breech primipara delivered vaginally and by elective cesarean section.

A retrospective study was carried out over a 3-year period comparing the fetal outcome of primiparous term frank breech delivered vaginally with those by elective cesarean section. There were 87 patients delivered by vaginal route and 176 by abdominal route. The staff delivered 13 per cent by vaginal route against 57 per cent by residents. There were no statistical differences in apgar score at 1 and 5 minutes with regard to the routes of delivery, different fetal birthweights and obstetrical experience of the accoucheur. There were no perinatal deaths. The concept of elective cesarean section in all primiparous term frank breech should be reconsidered.