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Biomedical subjects

M R van Santen

Publications and source records attributed to M R van Santen.

5 recordsLinked to original sources
PubMed1988

Interfering with implantation by postcoital estrogen administration. II. Endometrium epithelial cell ultrastructure.

Secretory human endometrium was studied by electron microscopy after high-dose ethinylestradiol administration, a method used for interception (morning-after pill). Medicated (experimental) cycles were compared to non-medicated (control) cycles in the same volunteers. The nucleolar channel system typically present in the nucleus of the epithelial cell in secretory phase of the human endometrium disappears completely as a result of this treatment, resulting in a nucleolar basket structure. Glycogen deposits were prominent at the basal membrane and in the apex of the cell during the experimental cycle. Giant mitochondria were observed to occur to similar extent during control and treatment cycles. This study confirms the morphological delay found in light microscopic studies, published earlier with diethylstilbestrol and with ethinylestradiol.

Administration, Oral↗
PubMed1987

Postcoital interception with steroids.

At present there is a high demand for PCI. The psychological distress experienced by women after unprotected intercourse while awaiting the onset of her next menses could be avoided with effective postcoital treatment. As demonstrated in countries with good health services, the availability of PCI leads to low abortion rates. PCI is designed for use as an emergency method after unprotected intercourse as an isolated incident. Women who have frequent intercourse however, do better to use a regular, very effective, method of contraception such as a combined oral contraceptive. Postcoital progestagens can well be used in infrequent intercourse since they are to be taken after each coitus, if applicable several times a month. Such use however leads to menstrual cycle disturbances and irregular bleedings. The estrogen-only and the estrogen-progestin combination are recommended, but need to be given within 2 or 3 days after the event of unprotected intercourse, preferably periovulatory. The latest development of the anti-progestins as a morning-after pill is promising. Taken from day 27 through 30 of the menstrual cycle it induces menstruation at the expected day. Side effects are minimal and the efficacy is good. Because of the imperfectness of PCI to prevent all pregnancies, sofar this regimen cannot be recommended for monthly use and does not replace regular oral contraceptives. PCI has a definite place in family-planning and fertility regulation. Since different methods are available today careful assessment of individual needs can help to decide for the best suitable method for the individual person.

Contraceptives, Postcoital↗
PubMed1987

Interception. III: Postcoital luteal contragestion by an antiprogestin (mifepristone, RU 486) in 62 women.

The new antiprogestin mifepristone (RU 486) was studied as an emergency postcoital contragestive. An actual pregnancy rate of 1.6% was observed and was related to the actual conception rate. The follow-up rate was 100%. The patterns of onset and duration of the induced menstruation after mifepristone treatment are described. This method provides a good new interceptive technique when the time for use of postcoital steroids or for a postcoital IUD insertion has lapsed.

Contraceptives, Postcoital↗
PubMed1984

[Postcoital IUD insertion, a review].

Following the development of hormonal interception after coitus the post-coital insertion of an intrauterine contraceptive device was proposed by Tatum . The advantage of this treatment is the avoidance of the ingestion of large doses of estrogen which causes much nausea and vomiting although it is a very effective post-coital method of contraception. The recently proposed alternative administration of 200 micrograms Ethynol Estradiol combined with 2 mg of DL norgesterol in 2 equal doses at 12 hour intervals has the same disadvantage of a high percentage of side effects. The post-coital insertion of an intrauterine contraceptive device is the first method which is effective up to five days following unprotected intercourse which is three days longer than treatment by estrogen. In addition the method can be offered to women who would want to continue to wear the intrauterine contraceptive device for long term contraception. The disadvantage of the post-coital insertion of an intrauterine contraceptive device is the ability of serious complications if the patient has a vaginal or venereal infection or an asymptomatic cervicitis or salpingitis. Following appropriate physical examination women who present themselves for post-coital treatment are selected. Cases of rape are usually not suitable for treatment with intrauterine contraceptives devices. However, when cases of rape are seen early enough the appropriate investigations may be done and the treatment with the intrauterine device started within five days. The potential risk of future infertility must be considered since salpingitis is 7 times more common in nulliparous wearers of intrauterine devices than in nulliparous non-wearers. Young sexually active nulliparous women especially of lower socio economic background are patients with a high risk. Over 70% of the women who present themselves for interception treatment are nulliparous.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗