Abstract:
:Epidemiological data have demonstrated, that the progestogen component of oral contraceptives is involved in the development of hypertension, ischaemic heart diseases and stroke. It had been suggested, that atherosclerotic lesions due to the unfavourable effect on lipid metabolism of progestogens with androgenic properties, play a causal role. It has, however, been shown, that there is no development of atherosclerosis despite reduced HDL and elevated LDL, presumably because of the induction of hepatic LDL- and remnant-receptors by the strong effect of ethinyl-oestradiol upon the liver. A series of experimental and clinical findings indicates that vasospasms caused by the vasoconstrictory effect of progestogens are involved in the development of arterial thromboses. In postmenopausal women, the additional administration of progestogens to the oestrogen treatment may trigger ischaemic diseases, particularly in the presence of vascular lesions. Oestrogens exercise a pronounced vasodilatory effect and stabilize the vascular tonus--through changes in the responsiveness of endothelium and smooth muscle cells to vasoactive compounds, through modulation of neurotransmitter release from nerve endings, and through direct blocking of calcium channels. The effects depend essentially on an intact endothelium. By a direct action on the vascular wall, progestogens increase the sensitivity of arteries to vasoconstrictory compounds and reduce blood flow. As aldosterone increases the number of beta-adrenergic receptors in the arterial smooth muscle cells and thus act vasodilatorily, it cannot be excluded, that progestogens with high affinity to the aldosterone receptor and antimineralocorticoid properties, may exert a strong vasoconstrictory effect.(ABSTRACT TRUNCATED AT 400 WORDS) :Epidemiological data have revealed that the progestogen in oral contraceptives (OCs) is involved in hypertension, ischemic heart diseases, and stroke. Atherosclerotic lesions were implicated owing to the androgenic properties of progestogens. However, atherosclerosis did not develop despite reduced high density lipoprotein (HDL) and elevated low density lipoprotein (LDL), presumably because of the strong effect of ethinyl estradiol (EE) upon induction of hepatic LDL- and remnant-receptors. A series of findings indicate that vasospasms caused by the effect of progestogens are involved in arterial thromboses. In postmenopausal women, the addition of progestogens to the estrogen treatment may trigger ischemic diseases. Estrogens exert a vasodilatory effect and stabilize the vascular tonus through the responsiveness of the endothelium, neurotransmitter release, and direct blocking of calcium channels. Progestogens increase the sensitivity of arteries to vasoconstrictory compounds and reduce blood flow. In women treated with ovulation inhibitors, and EE-induced activation of the renin-angiotensin-aldosterone system was observed. Aldosterone acts vasodilatorily, while progestogens with high affinity to the aldosterone receptor may exert a strong vasoconstrictory effect. If vascular lesions are present, the vasoconstrictory action of progestogens may cause acute ischemic attacks. Therefore, the lowest effective dose of the progestogen has to be used for replacement therapy. In hysterectomized women, the extra administration of progestogens should be avoided and in women with arterial diseases they should be prescribed with discretion. Additional progestogens given for 14 days 3 months apart may suffice for the prevention of endometrial hyperplasia. Both the EE and progestogen doses in OCs should be reduced. Progestogen-dominant ovulation inhibitors should be restricted to cases with an additional indication.
journal_name
Geburtshilfe Frauenheilkdjournal_title
Geburtshilfe und Frauenheilkundeauthors
Kuhl Hdoi
10.1055/s-2007-1026140keywords:
subject
Has Abstractpub_date
1992-11-01 00:00:00pages
653-62issue
11eissn
0016-5751issn
1438-8804journal_volume
52pub_type
杂志文章,评审abstract::In four cases of one twin pregnancy and three triplet pregnancies, efforts were made to prolong the pregnancy after the death of one foetus between 15th and 26th weeks of gestation. Two patients had a history of spontaneous abortion, three patients had undergone infertility treatment. In a further three cases the memb...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1022944
更新日期:1992-01-01 00:00:00
abstract::A woman, born in 1923, suffered since menarche of pain of the vertebra and has had a headache during menstrual periods. 1963 she developed a transverse lesion of the cord with an incomplete paraplegia because of an endometriosis externa of spinal canal. After a 12 years symptomless interval, she complained again of a ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1977-09-01 00:00:00
abstract::A study of the side effects of epidural anesthesia for painless delivery in 100 patients showed that 90% of the post partum patients were very satisfied with the analgesia and did not consider symptoms post partum to be very debilitating and did not blame the epidural anesthesia for the symptoms. Severe pain in the oc...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 临床试验,杂志文章
doi:10.1055/s-2008-1036870
更新日期:1984-03-01 00:00:00
abstract::In estradiol micro-crystalline suspension was injected into the ovary containing the corpus luteum in women who underwent hysterectomy. The same complete luteaolysis is in women who did not have hysterectomies was obtained. The conclusion is drawn that the prostaglandins which are formed in the uterus have no influenc...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-11-01 00:00:00
abstract::Diet and exercise before and during pregnancy affect the course of the pregnancy, the child's development and the short- and long-term health of mother and child. The Healthy Start - Young Family Network has updated the recommendations on nutrition in pregnancy that first appeared in 2012 and supplemented them with re...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-0713-1058
更新日期:2018-12-01 00:00:00
abstract::Aim: Nodal status remains one of the most important prognostic factors in breast cancer. The cellular and molecular reasons for the spread of tumor cells to the lymph nodes are not well understood and there are only few predictors in addition to tumor size and multifocality that give an insight into additional mechani...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0032-1328291
更新日期:2013-02-01 00:00:00
abstract::In spite of the development of various techniques for the formation of a neovagina, the longterm results are often disappointing, especially if the simpler methods (dilation, ectopic pouch formation, epithelium transfer) have been applied. The more complex surgical techniques such as musculo/fasciocutaneous and colon ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023312
更新日期:1995-05-01 00:00:00
abstract::Within the framework of a retrospective analysis, 96 patients who had undergone sterilisation at the Department of Gynaecology at the University of Cologne between 1988 and 1991, had been questioned as to whether they were content about their former decision in favour of a definitive contraception. At present, 94% of ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1022791
更新日期:1995-03-01 00:00:00
abstract::Foetal cardiac measurements performed in the four-chamber-view plane were performed in uncomplicated pregnancies between the 20th and the 40th week of gestation. Using cine-loop- and zoom-techniques, the heart length, width, area, and width/length ratio (n = 143) were measured. Including the thoracic diameter and the ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023560
更新日期:1994-02-01 00:00:00
abstract::According to a judgement by the German Federal Court of 17 December 1991 the surgeon is legally bound to inform the patient before hand of the risk of a possible homologous blood transfusion during surgery. If the transfusion probability exceeds 5%, this obligation is really relevant, 228 patients with primary breast ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023526
更新日期:1995-10-01 00:00:00
abstract::The pre-operative and post-operative findings in 56 patients with urinary stress incontinence are compared amongst each other and with the result of 24 continent control patients. The 56 patients were selected prospectively. The urethral closure pressure with stress and the stress quotient in urethral cystometry are s...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036786
更新日期:1982-05-01 00:00:00
abstract::Cystometry and simultaneous cystometry and urethrometry were conducted in 81 incontinent female patients (46 Grade I, 35 Grade II, according to the Ingelman-Sundberg Scale). The tonometric criteria for stress incontinence were presented and discussed by statistically comparing the pressure parameters for continent and...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-11-01 00:00:00
abstract::The concentration of hCG was measured in serum and peritoneal fluid (PF) of women with normal intrauterine pregnancy (34), extrauterine pregnancy (21), and intrauterine abortion (12) by two different methods. A new rapid, quantitative method (Spot-Test; ICON-QSR) which provides the results within 10 minutes was compar...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1026529
更新日期:1988-07-01 00:00:00
abstract::Optimal cytoreductive surgery of ovarian cancer is based on the preoperative diagnosis and assessment of tumour spread. Of 147 patients who underwent staging laparotomy at the Department of Gynaecology of the University of Tübingen, intraoperative staging was compared retrospectively with the results of sonography, co...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035841
更新日期:1989-06-01 00:00:00
abstract::We investigated the clinical course in 35 healthy newborn with premature beats and studied the literature with regard to their frequency, pathogenesis, and therapy with the following results: Investigations with continuous monitoring or long-term ECG registration show a frequency of 7-25%. In literature, almost one-fo...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036652
更新日期:1985-11-01 00:00:00
abstract::The problems of the development and treatment of lymphocysts following radical abdominal surgery with lymphadenectomy are described with reference to a case. Where intervention is necessary, incision with drainage is the treatment of choice. ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035810
更新日期:1987-03-01 00:00:00
abstract::A case of squamous cell carcinoma infiltrating the stroma of cystosarcoma phylloides malignum is reported. A short review of prognosis and therapy is given on comparable cases. It is not uncommon to find squamous cell metaplasias in the dilated ducts of cystosarcoma phylloides. The combination of squamous cell carcino...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036322
更新日期:1984-10-01 00:00:00
abstract::Since the publication of the updated German guideline in 2015, the recommendations for performing pelvic lymphadenectomy (LAE) in patients with vulvar cancer (VSCC) have changed considerably. The guideline recommends surgical lymph node staging in all patients with a higher risk of pelvic lymph node involvement. Howev...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-1120-0138
更新日期:2020-12-01 00:00:00
abstract::Seasonal fluctuations in the sex ratio of new borns are investigated. The largest predominance of male deliveries over female deliveries was found to be during the conception months May-June with an almost constant number of deliveries. The highest value was in June. Seasonal maximum of the male to female sex ratio is...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract::Aim: Endometriosis is a chronic gynaecological disorder with manifold symptoms and psychosocial effects on the lives of affected women. The prevalence of endometriosis is estimated to be up to ten percent of women of reproductive age. As a result of its unclear aetiology, only limited treatment options are available. ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0035-1546052
更新日期:2015-05-01 00:00:00
abstract::The therapy for patients with breast cancer has developed markedly in the past ten years. Our understanding of the molecular biology of tumours and the characteristics of the patients has shaped the recent advances. In this review we present the latest knowledge about the therapy for breast cancer. There are new tests...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0035-1545704
更新日期:2015-02-01 00:00:00
abstract::Oncolytic viruses are replication competent "live" viruses. They infect tumor cells, replicate highly selective inside and thereby destroy them. Because of the enormous advances in the field of genetic engineering and biotechnology during the last decade, virotherapy is increasingly used within clinical trials and pro...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0031-1298281
更新日期:2012-02-01 00:00:00
abstract::Obstetrical management in case of foetal third-degree AV block has been to date mainly via primary abdominal section, the indication being partly the foetal condition and partly also unsatisfactory childbirth monitoring. The article describes a childbirth associated with AV block, monitoring being effected by continuo...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1026469
更新日期:1990-03-01 00:00:00
abstract::The foetal intravillous blood volume was approximately determined in 90 cases, using placental histiometry post partum. This was compared with the Doppler sonographic flow patterns in the umbilical arteries determined during the last week ante partum. A direct dependence was seen: The larger the peripheral vascular tr...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1026513
更新日期:1990-08-01 00:00:00
abstract::In the present study the combination of tamoxifen and bromocriptine was tried for the suppression of prolactin in prolactin secreting adenomas which were resistant to suppression with bromoergocriptine alone. 10 women under treatment with 2.5-10 mg of parlodel (bromocriptine) for pituitary tumours of various sizes wer...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1037161
更新日期:1982-11-01 00:00:00
abstract::In a study comprising 172 patients who had been abdominally or vaginally hysterectomised, the effectivity of short-term prophylaxis with cefotaxim on various infection parameters was examined. The 100 patients of the prophylaxis group showed a significant reduction (p less than 0.01) of postoperative fever and of pelv...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036203
更新日期:1985-01-01 00:00:00
abstract::We report a case of non-ruptured tubal pregnancy at 38 weeks of pregnancy with the survival of mother and baby. Following salpingotomy a 1860 gr and 43 cm normal healthy male infant was delivered. The fallopian tube with placental tissue was removed by salpingectomy. Fetal development post partum and recovery of the m...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035995
更新日期:1988-05-01 00:00:00
abstract::Clinical reports on successful hormonal treatment of climacteric or menopausal sexual dysfunctions are in contradiction with the lack of oestrous phenomena in humans as well as with the results of double-blind studies finding no objective proof for the alleged hormonal influence. A review of recent studies on the topi...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2007-1023732
更新日期:1993-11-01 00:00:00
abstract::The confusion of terms between the radiological literature and the gynaecological and anatomical literature regarding the definitions of the infantile and the hypoplastic uterus are described. The history of this confusion is traced. The two types of uterus were clearly defined by K. Menge and K.v. Oettingen in 1930. ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1975-11-01 00:00:00
abstract::Permanent disturbances of bladder function are the most unpleasant and least tolerated side effects in patients, who underwent Wertheim hysterectomy because of cervical cancer. The cause of this problem with respect to the radical nature of the operation in relation to the possibly and responsible anatomical structure...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1022927
更新日期:1993-08-01 00:00:00