The possible effect on the infant of dopamine antagonists used to promote lactation is cause for concern. Domperidone (Motilium) may be safer than other drugs in this group as it does not cross the blood-brain barrier. The mean serum level of prolactin 2 h after treatment with 20 mg of domperidone in the puerperium was 255 ng/ml compared with 150 ng/ml after a placebo. The mean domperidone level in all breast milk samples during treatment with IOmg, three times daily, was 2.6 ng/ml. This was significantly more than levels after a single 20 mg dose sampled at 2 h (0.24 ng/ml) and at 4 h (1.1 ng/ml), and considerably less than values available for metoclopramide and sulpiride, relative to the therapeutic dosage. The effectiveness of domperidone to augment lactation requires further study.

SUMMARY. The content of cytoplasmic 17~oestradiol and progesterone receptors in human uterine leiomyoma and normal myometrium in the Negroid population was determined. Eighteen women of reproductive age. at various stages of the menstrual cycle. were included in the study. The serum oestrogen and progesterone concentrations were also measured. This is the first report in the literature in which oestrogen and progesterone receptors in leiomyoma are significantly higher than in normal myometrium (P=().()002). The steroid dependence of the growth of leiomyomas may be related to the steroid receptor level. The presence of persistently high concentrations of oestrogen and progesterone receptors in leiomyoma should be helpful in the treatment of this benign tumour.Leiomyoma of the uterus is the most common solid pelvic benign tumour in the female and occurs in nearly 20'Yo of all women during reproductive life.' The tumour increases in size during pregnancy or in response to exogenous oestro~en and regresses following menopause. -I For unknown reasons the incidence is much higher in the Negroid population than in Caucasians. I. 5. h Sufficient data are not available at present to suggest any conclusion regarding the aetiology of uterine leiomyomas. Nevertheless. it seems that leiomyomas arise from a single neoplastic parent cell derived from the smooth muscle elements of the myometrium and the growth of cells is influenced by various factors in the cellular environment. including the effect of steroid borrnones.""The concentration of oestrogen and progesterone receptors in human uterine leiomyoma and normal myometrium were measured in an attempt to clarify the relation of receptors to tumour growth in the Negroid population. We have also studied the concentrations of serum 17~oestradiol and progesterone with respect to steroid receptor concentrations in leiomyoma and normal myometrium at different phases of the menstrual cycle. Materials and methods PATIENTSEighteen women were included in the study. Each of these women had a hysterectomy for leiomyoma at Baragwanath Hospital. Criteria for patient selection included reproductive age, history of regular menstrual cycles and no history of exogenous hormone usage.The menstrual cycle dating was done by last menstrual period. by histologic evaluation of the endometrial specimen and serum progesterone levels. On the day of the operation a venous blood sample was obtained, allowed to clot and centrifuged. Serum was separated and frozen at -20°C. REAGENTSThe radioligands (2. 4, 6, 7 3H(N)) 17~oestra-diol, specific activity 95 Ci/rnmol. and 171~ methyl-3(lI)prornogesterone .263

No abstract

No abstract

Objective To determine the distribution of platelet volumes and numbers through pregnancy, and to compare these to changes in platelet volumes and numbers in women with pre‐eclampsia. Subjects Four hundred twenty‐eight women with normal pregnancy from whom four or more platelet measurements were available were identified. 74 women with pre‐eclampsia (blood pressure 140/90 mmHg, at least 0.5g protein/24 h urine collection) from whom platelet measurements were available between 27 and 30 weeks of gestation were identified. Results Mean platelet volume and platelet number remained constant in normal pregnancies between the first trimester and the end of pregnancy. A persistent increase of 0.8 fl ( 90th centile) in mean platelet volume was found in 14 out of 15 pre‐eclamptic patients between 24 weeks and 38 weeks of gestation and in only 13 of 428 normal pregnant individuals. Platelet numbers were decreased by 50 × 109/l (i.e. to less than the 10th centile) in 12 of the 15 patients with pre‐eclampsia. 10% of the normal pregnant population showed a similar decline in platelet numbers showing that changes in platelet numbers may be a less accurate assessment of the development of pre‐eclampsia. Conclusion We suggest that longitudinal determination of platelet volumes may be of use in identifying those women at risk of pre‐eclampsia.