Abstract:
:The pronounced hepatic impact of oral ethinyl estradiol has been attributed by some to its so-called first-pass effect through the liver as only some 40% of ingested ethinyl estradiol reaches the systemic circulation. Others believe that ethinyl estradiol exerts its hepatic effects because of its chemical composition, specifically its 17 alpha-ethinyl group. In an attempt to resolve this controversy, a study was undertaken to determine whether vaginal administration of ethinyl estradiol can selectively reduce the hepatic effects of oral ethinyl estradiol. To compare the effects of oral and vaginal ethinyl estradiol, a group of postmenopausal subjects received either 5 micrograms of oral and 20 micrograms of vaginal ethinyl estradiol or 10 micrograms of oral and 50 micrograms of vaginal ethinyl estradiol in either sequence, respectively. Oral ethinyl estradiol was four to five times more potent than vaginal ethinyl estradiol. The potency ratios of the oral-vaginal ethinyl estradiol doses required to suppress follicle-stimulating hormone and luteinizing hormone were 4.4 and 3.2 and those to raise sex hormone-binding globulin binding capacity, corticosteroid-binding globulin binding capacity, and high-density lipoprotein cholesterol as well as lower low-density lipoprotein cholesterol were 3.5, 5.0, 4.2, and 4.2, respectively. These essentially equal oral-vaginal route potency ratios for both central nervous system and hepatic effects indicate that vaginal administration of ethinyl estradiol does not selectively reduce its hepatic impact in relation to its central nervous system effects. The pronounced hepatic effects of ethinyl estradiol are therefore attributed to its chemical composition. :This study assessed the bioavailability of vaginally administered ethinyl estradiol (EE) and determined the effects of 2 different doses of oral and vaginal EE of comparable bioavialability on serum follicle stimulating hormone (FSH) and luteinizing hormone (LH) concentrations as well as on corticosteroid-binding globulin binding capacity (CBG-BC), sex hormone-binding globulin capacity (SHBG-BC), high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol, and triglycerides. 5 healthly, regularly menstruating volunteers aged 26-31 years who used nonhormonal means of contraception participated in the initial phase in which bioavailability was assessed of EE in intravaginal suppositories containing 120 mcg of EE. 9 healthy postmenopausal women aged 48-67 years were randomly assigned to receive larger or smaller doses of oral and vaginal EE, each given over 25 consecutive days with a 6-week estrogen-free interval between. As a results of randomization, 2 subjects were given 10 mcg of EE orally followed by 50 mcg vaginally, 1 received 50 mcg vaginally followed by 10 mcg orally, 2 received 5 mcg orally followed by 20 mcg vaginally, and 4 received 20 mcg vaginally followed by 5 mcg orally. Oral EE was found to be 4 to 5 times more potent than vaginal EE. The potency ratios of the oral-vaginal EE doses required to suppress FSH and LH were 4.4 and 3. and those to raise SHBG-BG, and HDL cholesterol as well as to lower LDL cholesterol were 3.5, 5.0, 4.2, and 4.2, respectively. The essentially equal oral-vaginal route potency ratios for hepatic effects and central nervous system effects indicate that vaginal administration of EE is not associated with a lower hepatocellular effect of EE. It is therefore concluded that the pronounced hepatic effects or oral EE are attributable to its chemical composition, specifically its 17 alpha-ethinyl group, rather than to the 1st-pass effect through the liver.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Goebelsmann U,Mashchak CA,Mishell DR Jrdoi
10.1016/0002-9378(85)90664-7subject
Has Abstractpub_date
1985-04-01 00:00:00pages
868-77issue
7eissn
0002-9378issn
1097-6868pii
0002-9378(85)90664-7journal_volume
151pub_type
杂志文章abstract:OBJECTIVE:The purpose of this study was to assess whether endometrial polyps (EMPs) represent cancer precursors. STUDY DESIGN:Age standardized incidence ratios (SIRs) of histologically verified endometrial cancers (EmCas) were estimated in women with EMPs and in women with uterine leiomyomata, which is a condition tha...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.03.036
更新日期:2010-09-01 00:00:00
abstract::Available information suggests that some instances of preterm birth or premature rupture of membranes are associated with clinically unrecognized infection and inflammation of the lower uterine segment, decidua, and fetal membranes. Various cervicovaginal microorganisms have been recovered from these sites. Many of th...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(90)90632-h
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare longitudinally sampled maternal angiogenic proteins between singleton and twin pregnancies. STUDY DESIGN:Placental growth factor (PlGF), soluble feline McDonough sarcoma (fms)-like tyrosine kinase (sFlt)-1, and soluble endoglin from healthy pregnant women were quantif...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.11.035
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:This study investigated the possible roles of interleukin 6 and soluble interleukin 6 receptor in the growth of endometrial and endometriotic cells. STUDY DESIGN:Endometrial and endometriotic stromal cells were collected from the uterus or from ovarian chocolate cysts. We examined the effects of interleukin ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70599-5
更新日期:1999-05-01 00:00:00
abstract::A sensitive and specific double antibody radioimmunoassay for gonadotropin-releasing hormone (GnRH) has been developed for measurement in ethanol extracts of human plasma. Iodinated hormone was prepared with the use of the chloramine-T method, and antibodies were developed in rabbits over a six-month period with a GnR...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90090-9
更新日期:1976-02-15 00:00:00
abstract::Thirteen healthy postmenopausal volunteers were studied under basal conditions and at intervals (days 1, 5, 10, and 30) after intravaginal placement of a polysiloxane ring impregnated with 400 mg of estradiol. Mean serum estradiol concentrations rose 26-fold with a twofold increase in serum estrone concentrations. Ser...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(86)90821-5
更新日期:1986-08-01 00:00:00
abstract::Five nonstress tests were interpreted by a national sample of obstetricians blinded to specific patient clinical data. The 169 questionnaires suitable for analysis showed that the reliability of the test interpretation, as measured by the kappa statistic, decreased with increasing number of categories of interpretatio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90459-4
更新日期:1985-11-01 00:00:00
abstract::The National Institutes of Health funding for reproductive sciences research, specifically in academic departments of obstetrics and gynecology, is disproportionately low. Research is one of the most important pillars in advancing healthcare. Despite US Congress' vision in providing increased funding to the National I...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.03.022
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the feasibility and efficacy of laparoscopic radiofrequency ablation of uterine fibroids. STUDY DESIGN:Eighteen women with symptomatic intramural uterine myomas underwent radiofrequency ablation under laparoscopic guidance. Postoperative sonographic evaluations of th...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.10.591
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:We sought to determine the reasons for obstetric and gynecologic patients' acceptance or refusal of medical student participation in their outpatient care. STUDY DESIGN:A descriptive and analytic cross-sectional study of 180 patients at the University of California, San Francisco, was done to identify factor...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.106133
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:Our purpose was to determine what factors occurring after digital separation of the chorionic membranes from the lower uterine segment (membrane stripping) are involved in observed clinical changes compared with patients not so treated. STUDY DESIGN:Thirty patients were randomly divided among a study populat...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9378(93)90134-5
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine whether indomethacin is associated with an increased incidence of constriction of the human fetal ductus arteriosus with advancing gestational age. STUDY DESIGN:A retrospective analysis of fetal echocardiograms performed in 44 patients with premature labor or hydr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)90763-7
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:Circulating adrenomedullin is increased in pregnancy, and placental and fetal membranes participate significantly in its secretion. Recent studies have suggested a potential role for this peptide in the regulation of fetoplacental circulation and placental hormonal secretion. Because adrenomedullin acts also ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.117189
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:Our purpose was to study the effects of the progestomimetic compound nomegestrol acetate on spontaneous and sulprostone-induced uterine contractility in pregnant cynomolgus monkeys. STUDY DESIGN:Intrauterine pressure was continuously monitored with use of an implanted intraamniotic catheter and a telemetric ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70643-x
更新日期:1998-01-01 00:00:00
abstract::Invasive cervical squamous cell carcinoma was diagnosed in 45 patients less than 35 years old from 1980 to 1985. Thirty-two cases were Stage IB; 10, Stage IIB; and three, Stage IIIB. Twenty-two patients developed persistent or recurrent disease. Only one of these is now alive with no evidence of tumor. The mean interv...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90144-5
更新日期:1988-02-01 00:00:00
abstract::Ocular malignant melanoma, similar to the cutaneous variety, may metastasize to the placenta, almost always in the presence of widespread disease. The prognosis is poor, and there is a 25% risk of spread to the fetus. All women with a history of this disease should be informed of the risks when they are contemplating ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70626-9
更新日期:1996-05-01 00:00:00
abstract::SAA and SIA were assayed in the sera of 172 infertile couples and in the CM of the women and 18 control subjects. Complete infertility evaluation was performed in all subjects except the controls. Results of these studies were correlated with PCT's. Sperm antibodies were detected in the CM of 25.6% of infertile women ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
abstract:OBJECTIVE:Our purpose was to evaluate effects of multifetal pregnancy reduction on pregnancy complications and birth weights of remaining twin fetuses compared with expectantly managed triplets and nonreduced twins. STUDY DESIGN:Medical records of 54 triplet pregnancies, 59 twin pregnancies resulting from multifetal p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)80017-2
更新日期:1996-10-01 00:00:00
abstract::We report the effect of high glucose infusion on vascular resistance in isolated human placental cotyledons perfused with Krebs-Ringer-bicarbonate solution containing 80 mg/dl (4.4 mmol/L), 160 mg/dl (8.8 mmol/L), or 320 mg/dl (17.6 mmol/L) D-glucose (n = 6). Placental vascular resistance remained constant during 25-m...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90758-y
更新日期:1990-12-01 00:00:00
abstract::We have studied the effects of magnesium sulfate (MgSO4) administration in chronically instrumented normotensive and hypertensive pregnant sheep. Animals of 90 to 144 days' gestation were divided in two groups; those with normotensive arterial pressure and those in which renovascular hypertension had been produced. Ou...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90255-1
更新日期:1977-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate vascular reactivity in heterozygous and homozygous offspring with a genetic predisposition for hypertension after postnatal cross-fostering to mothers with the opposite genetic inheritance of the NOS3 knockout allele. STUDY DESIGN:Homozygous NOS3 knockout (C57BL/6...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.01.031
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVES:Our purpose was to determine whether birth weight discordance is a risk factor for preterm birth of twins, and to further characterize the relationships involved. STUDY DESIGN:Maternally linked 1978-1990 Missouri birth certificates were used to analyze gestations resulting in live twins. We used contingency...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.105346
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVES:We analyzed the safety and patient acceptance of amniotic fluid insulin measurements by third-trimester amniocentesis in women with gestational diabetes mellitus. STUDY DESIGN:We studied the rate of early uterine contractions, need for tocolysis, premature rupture of membranes, mode of delivery, length of g...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70221-2
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:We estimated the risk of complications at birth of extremely large babies (≥5000 g). STUDY DESIGN:This was a cohort study including all births of extremely large babies in 1996 through 2005 and comparison cohort with normal birthweight (1:2) identified in the national birth registration. RESULTS:There were ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.12.036
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the risk of cumulative cervical intraepithelial neoplasia (CIN) grade 2 or 3 according to initial colposcopy and directed biopsy results among women with low-grade squamous intraepithelial lesions (LSIL) or human papillomavirus (HPV) DNA positive atypical squamous ce...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.461
更新日期:2003-06-01 00:00:00
abstract::Ritodrine hydrochloride was administered parenterally to pregnant ewes during spontaneous or oxytocin-induced uterine activity. The effects of ritodrine on the uterus and cardiovasculature were assessed both with and without simultaneous administration of either alpha or beta blockade. Ritodrine was found to be an eff...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90692-x
更新日期:1976-12-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the fetal response to submaximal maternal exercise at 22 to 26 weeks in pregnancies with abnormal uterine artery Doppler. STUDY DESIGN:This was a prospective comparison of singleton pregnancies with uteroplacental vascular insufficiency (UPVI) (mean uterine pulsatil...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.06.035
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to review the population incidence of congenital gastroschisis in Western Australia over the past 2 decades. STUDY DESIGN:A population-based incidence study of congenital gastroschisis from 1980 to 2001. Maternal and perinatal outcome data were collected to ascertain incidence, ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/s0002-9378(03)00819-6
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to test the hypothesis that cocaine alters placental prostaglandin production in vitro. STUDY DESIGN:Placentas were obtained from healthy women (n = 6) after normal vaginal delivery at term. Placental explants (300 mg) were incubated in duplicate at 37 degrees C in the presenc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(94)90015-9
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:Neurotrophins are proteins that promote neuronal growth and differentiation. In this pilot study we determined whether the neurotrophins nerve growth factor, brain-derived neurotrophic factor, and neurotrophin-3 were present in amniotic fluid specimens to begin to elucidate their developmental regulation. We ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70113-4
更新日期:1999-11-01 00:00:00