The effectiveness of intracervical prostaglandin E2 (PGE2) was studied in 96 primigravidas with unfavorable cervix and need for induction of labor. Group A consisted of 49 oligohydramnios and group B of 47 cases with normal amniotic fluid volume (controls). A single dose of 0.5 mg PGE2 gel was applied intracervically and several parameters were recorded during the next hours. The mean number of uterine contractions increased during the first 2 h in both groups, decreased during the next one and did not change significantly afterwards. The mean fetal heart rate (FHR) in group A decreased during the first 2 h and then increased, staying always within normal limits. The mean FHR in group B increased for 2 h, decreased during the next hour and did not change significantly afterwards. No significant differences were found between the two groups regarding mode of delivery, Apgar score and neonatal acidosis. Intracervical PGE2 appeared to effectively stimulate cervical ripening and labor induction in oligohydramnios, without causing side effects to the uterus and fetus.
The purpose of this study was to evaluate the effect of tamoxifen therapy on the endometrium by transvaginal color Doppler sonography and on lipid profile focusing on lipoprotein (a) [Lp(a)] levels. Seventy-five postmenopausal breast cancer patients were examined by transvaginal color Doppler sonography and serum Lp(a) levels. Lipid parameters were measured after overnight fasting. Forty of the patients were treated with tamoxifen (20-30 mg/day) for at least 1 year. The remaining 35 patients did not receive tamoxifen and were used as controls. Statistical analysis was performed using t-test and Mann-Whitney U-test (Systat version 5.0). The patients receiving tamoxifen had significantly thicker endometrium (7.9 +/- 3.6 mm) compared to the control group (4.5 +/- 1.8 mm) (p < or = 0.001). The mean pulsatility index and resistance index of the uterine arteries in the tamoxifen group were 2.063 +/- 0.49 and 0.83 +/- 0.07, respectively, and were significantly lower than those of the control group (2.69 +/- 0.16 and 0.88 +/- 0.02) (p < 0.001). In addition, tamoxifen decreased total cholesterol (p < 0.001) and low-density lipoprotein cholesterol (p <0.001) and apolipoprotein B (p < 0.05) significantly. Tamoxifen also increased high density lipoprotein cholesterol (p < 0.05) and apolipoprotein A-I (p < 0.05). These results indicate that tamoxifen stimulates the endometrium and acts as an anti-atherogenic agent in postmenopausal women.
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