SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Further to the investigation of the possible mode of action of the intra-uterine contraceptive device (IUCD), an assay for the beta-specific subunit of human chorionic gonadotrophin (HCG) has detected endogenous chorionic activity 21 days after menstruation. In 22 proven ovulatory cycles, 7 patients wearing an IUCD had demonstrable serum HCG levels in 45% of these cycles. Abnormal menstruation was associated with the majority of cycles in which there was HCG in the serum. Subsequent luteolysis occurred in all cases. The results of this study may support the hypothesis that IUCD exerts its effect on the fertilized, implanted blastocyst, thus causing possible 'micro-abortion'. Caution should be exercised in the interpretation of HCG values in the follow-up of patients with hydatidiform mole or choriocarcinoma who are bearing IUCDs, since positive HCG levels may be due to an early, fertilized and implanted blastocyst and not to invasive tissue.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Factors V, VII and VIII (each determined by biological assay), fibrinogen, platelet count and adhesiveness, and fibrinolytic activity were measured in 234 white pre-menopausal women, of whom 57 (24%) were on oral contraceptives and 177 (76%) were not. Cholesterol, triglyceride and blood pressure levels were also recorded. In 20 of the women on oral contraceptives, and in an age-matched group of 20 who were not, prothrombin, factor X, antithrombin III and alpha 2-macroglobulin levels were determined, and factors VII and VIII were also measured immunologically. For the majority of the variables studied, the differences between those using and not using oral contraceptives were greater in younger than older women; in the case of factor VII (biological assay) and fibrinogen, the differences between the regression slopes on age were statistically significant, and mean values were substantially higher in those on oral contraceptives. There was also a significant difference between regression slopes on age for cholesterol. Mean levels of prothrombin, factors VII (immunological assay) and X, triglycerides and blood pressure were significantly higher, and mean levels of antithrombin III significantly lower, in those on oral contraceptives compared with those not. Overall, fibrinolytic activity was significantly higher in the women on oral contraceptives; this difference was, however, almost entirely due to the greatly increased fibrinolytic activity of the non-smokers on oral contraceptives, activity in the smokers on oral contraceptives being similar to that of the women not on these preparations. There were no significant differences in mean platelet count or adhesiveness, or in haemoglobin, packed cell volume, uric acid and blood sugar levels. Among the women on oral contraceptives, there was a significant negative correlation between factor VIII and fibrinolytic activity; this was largely due to five women all of blood groups A and B, in whom, besides high factor-VIII levels and poor fibrinolytic activity, other variables (e.g. fibrinogen) were raised in a direction that might be expected to favour thrombogenesis. It is possible that it is those women whose fibrinolytic activity does not increase in order to compensate for the effects of oral contraceptives on clotting factors, lipids and blood pressure, who are at special risk of thromboembolic episodes. The differential effects of oral contraceptives by age must be borne in mind in evaluating the effects of these preparations on the haemostatic and lipid systems.
The authors have tried to classify the oral contraceptives at present in use throughout the world by their respective levels of oestrogenic and progestogenic components, taking into consideration also the relative strength of each product in use. They have based this classification on their personal experience of the several oral contraceptive products and on a profound study of the international literature. In this way it is possible to define a place for each oral contraceptive so that it can be chosen for the best possible use of a particular product for the hormonal background of the person using the contraceptive. It is true that changes have to be made to work out the oral contraceptives used for masses of people, but on the other hand in countries where there is sufficient medical personnel and education so that it is possible to think out and to prescribe for an individual, it seems to us useful that the doctor who is prescribing should try to adjust the oral contraceptive to the hormonal climate of the woman seeking it. This is true not only for the first time a prescription is made but in cases where by the accident of failure to tolerate the product something must be done to correct the troubles that are so often found in the first months after starting to use contraceptive products. This study includes a general picture of all oral contraceptives in which the products have been classified according to the total dose of oestrogens administered and according to the proportions of progesterone to oestrogens which make up the hormonal climate of the product. On the other hand this study also includes a list of the observations to make in order to adapt the oral contraceptive to the side-effects shown after the first prescription. The authors have come to the conclusion that by adapting the choice of a particular oral contraceptive to the woman who is to receive it interruptions in taking the contraceptive because of side-effects should be avoided. So unwanted pregnancies will be avoided and also the termination of these unwanted pregnancies.