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Female↗
Biomedical subjects
J H Strathy
Publications and source records attributed to J H Strathy.
Risk factors for ectopic pregnancy. A population-based study.
To evaluate the association between ectopic pregnancy and 22 potential risk factors, we conducted a population-based case-control study. The investigation included 274 cases diagnosed from 1935 through 1982 in residents of Rochester, Minn, and 548 matched controls selected from live-birth deliveries. Risk factor information documented prior to the last index menstrual period was obtained via medical record abstract. Univariate matched analyses revealed nine variables associated with a significantly elevated relative risk of ectopic pregnancy. Following conditional logistic regression, four variables remained as strong and independent risk factors for ectopic pregnancy: current intrauterine device use (relative risk, 13.7; 95% confidence interval, 1.6 to 120.6), a history of infertility (relative risk, 2.6; 95% confidence interval, 1.6 to 4.2), a history of pelvic inflammatory disease (relative risk, 3.3; 95% confidence interval, 1.6 to 6.6), and prior tubal surgery (relative risk, 4.5; 95% confidence interval, 1.5 to 13.9). Theoretically, any condition that prevents or retards migration of the fertilized ovum to the uterus could predispose a woman to ectopic gestation. Further research is needed to clarify the impact of other potential risk factors in the etiology of ectopic pregnancy.
Adolescent↗
Incidence of ectopic pregnancy in Rochester, Minnesota, 1950-1981.
Trends in the occurrence of ectopic pregnancy from 1950 through 1981 were evaluated in the defined population of Rochester, Minnesota. The average ratio of ectopic pregnancies to live births was 1:171. The ratio declined from 1:141 to 1:217 from 1955-1959 to 1970-1974 and increased sharply to 1:122 by 1975-1980. Similarly, the average age-adjusted incidence rate of ectopic pregnancies per 100,000 women of childbearing age was 49 over the period studied. A peak rate of 79 per 100,000 was reached in 1955 to 1959, and a trough of 30 per 100,000 occurred in 1970 to 1974; this was followed by a sharp increase to 49 per 100,000 in 1975 to 1981. Methods of measuring ectopic pregnancy are contrasted, and possible risk factors are suggested.
Abortion, Induced↗
Comparison of estrogen receptors in human premenopausal and postmenopausal uteri: indication of biologically inactive receptor in postmenopausal uteri.
Analysis of the estrogen receptor (ER) from uteri of premenopausal and postmenopausal patients has largely been limited to quantitation. The present study examined the biologic activity of the receptors with regard to their nuclear binding capacities. A Scatchard analysis of myometrial cytosol indicated high-affinity and low-capacity estradiol binding (Kd = 10(-10 M). A 35% ammonium sulfate fraction of cytosol was characterized for steroid specificity, receptor concentration, isoelectric focusing patterns, and capacity of the ER to bind to nuclear acceptor sites in a cell-free assay. The ER from premenopausal uteri displayed an extensive but saturable binding to the nuclear acceptor sites. In contrast, the postmenopausal ER displayed minimal binding. These cell-free binding differences were supported by tissue culture studies. This difference may be accentuated by the fact that much of the receptor is bound by endogenous estrogen in the premenopausal uterine preparation, which would decrease the subsequent binding of the [3H]ER to nuclear sites. This receptor in the postmenopausal uterus is largely unbound and thus would not compete for nuclear sites. These studies suggest that a significant fraction of the ER in postmenopausal uteri is biologically inactive; for example, it cannot translocate and bind to nuclear acceptor sites. This loss in nuclear binding may represent a change in the ER occurring at menopause as a result of changing endocrine states.
Adult↗
Endometriosis and infertility: a laparoscopic study of endometriosis among fertile and infertile women.
To test the widely accepted--but not well-supported--impression that endometriosis and infertility are associated, we compared the prevalence of endometriosis visualized at laparoscopy in 100 patients being evaluated for infertility and in 200 fertile control subjects (two age-matched to each patient) undergoing tubal ligation. The extent of endometriosis and adhesions noted in the operative reports was classified according to the system proposed by The American Fertility Society. Endometriosis was found in 21 of the 100 infertile patients--mild in 11, moderate in 8, severe in 2. It was found in 4 (2%) of the 200 controls and was mild in all 4. Thus, endometriosis is more often present, and more often severe, among infertile patients. The risk of infertility was estimated to be almost 20 times greater with endometriosis than without. These data support the clinical impression that an association exists.
Adult↗