In vitro interaction of prostaglandin F2alpha and oxytocin in placental vessels.

The interaction of prostaglandin F2alpha and synthetic oxytocin on placental vessels was studied in vitro. Resistance was measured near the placental margin after spontaneous term delivery. In seven experiments reactions to norepinephrine and oxytocin were PGF2alpha. PGF2alpha produced significantly increased vasoconstriction after a single administration of oxytocin. In eight experiments the perfusion medium contained oxytocin. There was no change after a single dose of PGF2alpha. The reaction after norepinephrine remained the same in both groups of experiments. There is thus an "enhancement effect" of PGF2alpha upon the reaction of placental vessels to oxytocin in vitro.

[Which stage of the menstrual cycle in best suited for the insertion of IUD?]. / Které období menstruacního cyklu je nejvhodnejsí pro inzerci IUD?

PIP: Some clinicians feel that the best time for inserting an IUD is during a woman's menstrual period. At that time the cervix is dilated, the chance of introducing an IUD into a pregnant uterus is slight, and the menstrual bleeding masks bleeding due to insertion. There is evidence that inserting the IUD during the menstrual period lowers the incidence of infection, spontaneous expulsion, and removal due to method failure and patient dissatisfaction. But there are clinicians who freely insert the IUD at other times in the cycle. This may be particularly advantageous in developing countries, where a woman who has had to travel a great distance to the family planning clinic but arrives when she is not menstruating might not return at another time. The IUD may also be inserted after unprotected coitus as a "morning after" contraceptive. The International Planned Parenthood Federation conducted a world-wide study to determine what stage of the cycle IUDs are being inserted. 33% of the 240 respondents insert the IUD only during the woman's period, and 70% of them do so only because their clinic requires it. 49% of the respondents from Africa and the Middle East, 30% of the respondents from Europe and the U.S., and 13% of the respondents from Asia restrict insertion to this time. Of the 67% of respondents who said they insert the IUD when the woman is not menstruating, most restrict insertions to 10 days after the last menstrual period. Most cite the possibility of pregnancy as the reason for this practice. The percentage of clinicians willing to insert the IUD at any point in the cycle varies with the contraceptive method the patient is using. Only 7% are willing to do this for women who use no contraception, 18% for women who use non-hormonal contraception, and 36% for women who were using oral contraceptives.^ieng

[Abortion law in Italy]. / Potratový zákon v Itálii.

PIP: On May 28, 1978, the Italian senate passed a law legalizing abortions. The law, passed against the will of the Christian Democrat party and the Vatican, is the most liberal in Western Europe. Any woman 18 or older is free to seek an abortion at a private or public institution during the first 90 days of pregnancy. Abortions can be sought on health, economic, social, family, or psychological grounds. A woman requests an abortion at a hospital or clinic, or from a physician. If termination is deemed urgent, the procedure may be performed immediately. If a request is denied, a woman may make another request 7 days later. Second trimester abortions are permitted only if grave danger to the woman or deformation of the fetus is suspected. Women under 18 meed the permission of their parents or legal guardians; a court may also grant permission. Passage of the law has facilitated open debate on the legal and medical aspects of abortion. It has also guaranteed women access to abortions. Physicians, who on grounds of conscience feel they can't perform abortions, may register to be exempt from having to perform them. They may not, however, deny a woman care before and after her abortion, and if they perform the procedure even once, their name is removed from the exempt register. Additionally, all physicians are bound to attempt to preserve the life of all women as well as any fetus which shows life outside the womb.^ieng

[Fertility and possibilities of anticonception in adolescence]. / Fertilita a moznosti antikoncepce v adolescenci.

PIP: The age at menarche has been decreasing worldwide. In 1845, the median age at menarche was 15; in 1962 it was 12. The age at menarche seems to depend on a threshold weight and body fat level. In the U.S. this has been determined to be 47+/- .5 kg. and 23.5% body fat. For about 2 years after the onset of menstruation there is a period of adolescent subfecundity, until the ovulatory cycle is established. Nevertheless, more adolescents are exposed to the risk of pregnancy than ever before. Adolescents need to be made fully aware to the negative consequences of pregnancy, abortion, or giving birth, which may result in the interruption of career or educational plans and the formation of unstable marriages. Pregnant adolescents are more vulnerable than adults to such complications as pre-eclamps and anemia. Their children are more likely to be of low birth weight and have birth defects. Adolescents are more vulnerable to injury during therapeutic abortion than are adults, especially if the procedure is carried out late in the pregnancy and by the traditional rather than the suction method. Unfortunately, adolescents, as a group, are not conscientious contraceptive users. From the medical standpoint, the condom is the safest method for adolescents to use. It is free from side effects and provides protection against venereal diseases. Diaphragms are effective and medically safe, but adolescents tend not to use them faithfully. Hormonal contraceptives are objectionable for sue in very young girls, especially those who have not stopped growing. IUDs may be used, but they expose the young woman to an increased risk of pelvic infections, which may have a negative effect on later fertility. Contraceptive education by the age of 15 appears to be the best hope for achieving higher rates of contraceptive use among adolescents.^ieng

[Review of induced-abortion technics in Czechoslovakia]. / Prehled o technice umelého prerusení tehotenství v CSSR

PIP: Gynecological clinics in Czechoslovakia were sent questionnaires with the following questions: What methods are used for artificial abortions? How many were performed in 1974? How many of these were by vacuum aspiration (VA)? How many vacuum aspirations take place weekly? Also, whether abortions by curettage should be revised, and how many injuries occurred. It was found that clinics used either only dilatation and curettage, only (VA), or a combination of both. The reason for the latter approach is the VA should be used only up to the 8th or 10th week of pregnancy, or that only a few of the physicians are qualified to perform this operation. Comprehensive data showed that only 23% of the entire Republic used VA. Lack of proper equipment was also a reason given. VA is considered the most effective and economical method, but is only considered safe up to the 9th week of pregnancy. As it is considered that VA should be used in all cases of artificial abortion, it is encouraged that all should be performed within the first trimester.^ieng

[Laminariae redivivae--are laminaria an old fashioned and abandoned part of gynecologic instruments?]. / Laminariae redivivae--jsou laminárie zastaralá a opustená soucást gynekologického instrumentária

PIP: Much discussions have been held on the safety and utility of laminaria in gynecological practice, primarily for the dilation of the cervix. The device was abandoned in the U.S. completely during the 1920s because of the difficulty and uncertainty in sterilizing it. But some positive references to it appeared in 1971 in regard to Japanese experience with new methods of sterilizing the device. Currently, laminaria are used primarily in cervical dilation for artificial abortion. The ends are an average of 5-7 cm in length and vary in width from 1-5 mm to 8-10 mm. The dilatory effect is normally 9-12 cm and is normally used in later pregnancies. The frequency of complications varies between 2-3%. Blood losses are low, as a rule, below 100 ml. It is considered a technique worthy of experimental application.^ieng

[Experiences with the insertion of IUD after artifical abortion]. / Nase zkusenosti s inzercí IUD po umelém potratu.

PIP: 2 kinds of IUD (Dana 2 and Dana Super 3) were used to determine whether an IUD inserted immediately after an abortion would increase the percentage of complications and lower effectiveness. In cases of primigravidae and primipara which had not had an interruption of pregnancy, Dana 2 was applied; for women with more births or more interruptions of pregnancies, Dana Super 3 was used. The 2 types did not differ in terms of hospitalization, infections, and bleeding complications. However, use of Dana 2 resulted in a rate of pregnancies 3 times that of Dana Super 3. At the end of 1 year, 42.4% discontinued using Dana 2 some because of bleeding, expulsion or medical extraction, others for personal reasons. The results in the Dana type 3 group were basically the same as for the control group.^ieng

[Postcoital contraceptives in clinical practice]. / Postkoitální antikoncepce v praxi

PIP: 55 women were administered a series of postcoital contraceptives, 35 of whom received only a single application and 20 received the preparations for more than 1 cycle (more than 2 but less than 13). 34 women of the 1st group (48 hours after unprotected coitus) and 7 women from the 2nd group were administered diethylstilbestrol (DES) for 5 days for a total of 250 mg. The remaining subjects were given norethisterone Spofa for 3 days at 30 mg/day. Results from this administration in the sense of a general contraceptive were not considered favorable, primarily due to contraindications in regard to physiological side effects, particularly with DES. DES proved to be the most successful in preventing pregnancy.^ieng

[Level of serum proteins, mainly ceruloplasmin, in fertile women after prolonged use of Biogest]. / Hladina sérových bílkovin, zvláste ceruloplazminu, u fertilních zen po dlouhodobém uzívání Biogestu.

PIP: 20 healthy women, approximately 26 years of age, who had used a preparation of Biogest as a contraceptive, were examined. A significant drop of albuminaemia was observed, while the fractions of globulin (mainly alpha-globulin) increased considerably. The total proteinemia did not change to any remarkable degree. The cerulplasmin rose more than twofold and this increase was evident even in the check-up carried out after 1 year.^ieng

[Intrauterine contraception in nuligravidae]. / Nitrodelozní antikoncepce u nuligravid.

PIP: Detailed study of the uses of IUDs by a sufficient number of young women (aged 17-29) and nulligravidae shows the levels of toleration for and effectiveness of this method of contraception. Long-tested IUDs as well as new models (Cor, Ecu) were used. 2.6% of the women being tested experienced extreme pain immediately after insertion. However, only 3% of them had to have the IUD immediately removed. The frequent use of IUDs in young women is not recommended but it is possible to use it when the physician finds it more effective than other means of contraception.^ieng

[Experience with contraceptive effect of Depo-Provera, 300mg and 450mg, administered in 6-month intervals]. / Zkusenosti s antikoncepcní úcinností Depo-Provery v dávce 300 mg a 450 mg podaných v intervalech 6 mesícu.

PIP: The application of Depo-Provera in doses of 300 mg over a 6.7-month period and 450 mg over a 4.7-month period was studied. No failures were observed. The major complication was bleeding, although amenorrhea and weight gain were also noted. The percentage of discontinuation was 4.4% for 300 mg and 8.9% for 450 mg. 75% experienced irregularities and difficulties in bleeding.^ieng

[On the mechanism of the contraceptive action of oestrogens administered after ovulation (author's transl)]. / K mechanismu antikoncepcního úcinku estrogenu podaných po ovulaci.

PIP: The antifertility effects of estrogens in animals has long been known, but it was not until 1966 that the effects of estrogen in man became known as well. The estrogen effects during the time of the transport of the egg through the fallopian tubes to the uterine cavity was studied. 50 mg of diethylstilbestrol (DES) was administered daily during the 5-day postovulatory period. The results were a shortening of the cycle, a lowering of plasmic progesterone, and a decrease in the secretion of pregnanediol. The development of the endometrium stopped. These results indicate that DES, when given at this time, shortens the function of yellow corpuscles and affects the further development of the endometrium. Either of these mechanisms could explain the contraceptive effects of the estrogen.^ieng