The impact of six-month tibolone postmenopausal treatment on cell adhesion molecules levels.

PURPOSE: The aim of the present study was to evaluate the effects of tibolone on inter-cellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), inter-cellular adhesion molecule-2 (ICAM-2) and P-selectin levels in healthy postmenopausal women. METHODS: This prospective study included 25 postmenopausal women, complaining of hot flashes, assigned in two groups. Fifteen women received tibolone (dosage of 2.5 mg per day for six months) and ten women did not receive any therapy, according to their personal preference. Basal control included complete medical history, anthropometrics, clinical examination, and blood sampling to perform hormonal, biochemical, hematological testing and ICAM-1, ICAM-2, VCAM-1 and P-selectin measurements. Evaluation was repeated in three and six months. RESULTS: There was no significant difference in ICAM-1, VCAM-1, ICAM-2, P-selectin, homocysteine, total cholesterol, HDL, LDL, and triglyceride concentrations between the women of the two groups after either three or six months of treatment. However, a significant reduction in the frequency and intensity of hot flashes was noted in both groups. CONCLUSIONS: Tibolone does not have any adverse effects on cell adhesion molecule levels which primarily affect atherosclerotic processes or on triglyceride and homocysteine concentrations. These results may support the view that tibolone could be considered a safe treatment, regarding its impact on the endothelium, in healthy postmenopausal women.

Previous cesarean section increases the risk for breech presentation at term pregnancy.

PURPOSE OF INVESTIGATION: The aim of the present study was to estimate the risk for breech presentation in women with singleton pregnancies at-term who had had at least one previous cesarean section (CS) versus at least one previous vaginal delivery. METHODS: Out of 4269 singleton pregnancies during the study period, 2008 met the inclusion criteria. The history, the number of previous CSs, as well as maternal age, parity, birth weight, gestational age, neonatal sex and placenta previa were used to estimate the risk for breech at term. RESULTS: The overall incidence of breech presentation was 3.2%, while 20% of the women had a history of at least one previous CS. The rate of breech presentation at term in singleton pregnancies after CS increased two-fold (5.3%) when compared to those with at least one previous vaginal delivery (2.6%), (p = 0.01) [OR 2.08 (95% CI, 1.23-3.52)], while the number of the previous CSs did not correlate with breech presentation (p = NS) [OR 0.86 (95% CI, 0.31-2.4)]. CONCLUSION: According to the present study, women with a history of at least one cesarean delivery have an increased risk for breech presentation in the subsequent singleton pregnancy at-term.