RESUMO
No differences in the clinical effects on climacteric complaints of an unopposed oestrogen and two oestrogen-progestogen regimens were observed in a double-blind cross-over study. Only 4 out of 18 women with an intact uterus had withdrawal bleeding during oestradiol valerate (2 mg/day) treatment alone, but 14 out of 18 had regular bleeding during the two oestrogen-progestogen regimens (oestradiol/medroxyprogesterone acetate and oestradiol/levonorgestrel (LNG], each of which prevented the development of endometrial hyperplasia. High-density-lipoprotein cholesterol (HDL-CH) concentration remained 6% above the initial level and the atherogenic index (low-density-lipoprotein (LDL) cholesterol to HDL-CH ratio) improved significantly during the oestradiol/medroxyprogesterone acetate regimen, while the HDL-CH concentration fell by 20% in relation to the initial level and there was a deterioration in the atherogenic index during the oestradiol/LNG regimen. The data suggest that both of these oestradiol/progestogen combinations are clinically as effective and well-tolerated as oestradiol alone, but that combined oestradiol/medroxyprogesterone acetate causes fewer adverse lipid metabolic effects than the oestradiol/LNG combination.
Assuntos
Estradiol/análogos & derivados , Lipídeos/sangue , Medroxiprogesterona/análogos & derivados , Menopausa/efeitos dos fármacos , Norgestrel/administração & dosagem , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Quimioterapia Combinada , Estradiol/administração & dosagem , Feminino , Humanos , Levanogestrel , Medroxiprogesterona/administração & dosagem , Acetato de Medroxiprogesterona , Menopausa/sangue , Pessoa de Meia-Idade , Triglicerídeos/sangueRESUMO
The clinical and autopsy findings in all stillbirths during the years 1974-1979 at the Helsinki University Central Hospital were analysed. There were 243 stillborn infants of whom 200 died before labour. According to the autopsy findings asphyxia accounted for 38% and major malformations for 17% of the deaths, but because of fetal maceration no diagnosis could be made at autopsy in 43%. The cause of death suggested by the clinical findings was placental failure in 57%, cord complication in 12% and major malformations in 17%. The cause of death remained unsolved in 9%. The importance of routine ultrasound and alpha-fetoprotein screening for the detection of unrecognized risk patients is emphasized.
