Objective To assess lipid peroxidation and antioxidant function in hypertensive complications of pregnancy. Design Cross sectional study comparing pre‐eclamptic and control patients. Setting Tampere University Hospital, Finland. Subjects Twenty healthy women with normal, uncomplicated pregnancy; 23 women with severe pre‐eclampsia; 20 women with mild pre‐eclampsia; and 13 women with pregnancy‐induced hypertension. Main outcome measures Conjugated dienes; tiobarbituric acid—reactive material or malondialdehyde (MDA); fluorescent chromolipids (FCL); glutathione peroxidase (GSHPx); selenium; uric acid; and vitamin E. Results Lipid peroxidation assessed by the appearance of conjugated dienes and malondialdehyde was significantly increased in the hypertensive patients as compared with control patients. Lipid peroxidation products also showed high correlation to the level of blood pressure, but failed to show significant relation to the outcome of the fetus. The activities of erythrocyte and plasma glutathione preoxidase were increased in severe pre‐eclampsia, and high levels of plasma or platelet glutathione peroxidase were found to have some association with fetal growth retardation or asphyxia. Conclusions Our findings give support to those few studies considering lipid peroxidation as an important factor in the pathogenesis of pre‐eclampsia. The rise in antioxidants is probably of compensatory nature responding to the increased peroxide load in pre‐eclampsia and may reflect the severity of the disease.

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This paper reports the results of two trials using midwifery students and a small pilot trial using laywomen as support persons during labor and the feasibility and experiences in organizing such support. In the trials with students, healthy mothers with single, full-term infants not expected to have immediate delivery were randomly allocated to support (12 = 122) and control ( n = I 18) groups; most mothers had the father of the baby with thcm. In the support group, a student stayed with the mother constantly. Many students and midwives did not consider constant support by professionals important or requiring special skills. Mothers were vcry satisfied with having a midwifery student stay with them. The length of hospital stay before birth W A S shorter and the number of women whose contractions stopped after randomization was smaller. Otherwise, the progress of labor, interventions and the mother's and infant's health were similar in the two groups. In the trial with laywomcn, nine out of the ten mothers Corrcspondmce to: Elina Hemminki, MI), 1)eyartnient of Public Health, University of Helsinki. Haartmaniiikatii 3. 00290 Hclsinki, Fiiiland. 239 Downloaded by [McMaster University] at 13:36 26 March 2016 240 Hcmminki et al.were very satisfied with their presence. Our study suggests that constant support may be important for successful birth.

Ospemifene, at the dose of 90 mg/day, was more estrogenic than raloxifene, as shown by changes in serum follicle-stimulating hormone and sex hormone-binding globulin levels. Neither agent stimulated endometrium, but in contrast to raloxifene, ospemifene had a clear estrogenic effect in the vagina. Further studies with ospemifene are needed in subjects with vaginal atrophy.

Areal bone mineral density (BMD, g/cm(2)) of five healthy women (aged 26-30 years) was measured at the lumbar spine, right femoral neck and dominant distal radius with dual-energy X-ray absorptiometry before pregnancy, immediately after delivery, 1 month after the resumption of menses and 1 year thereafter. Because of the small number of subjects, only individual changes in BMD that were greater than 2 radical2 times the short-term in vivo precision were considered as significant changes. To obtain a further perspective, the reproduction-related BMD changes were compared with twice the standard deviation (SD) of the BMD changes in healthy premenopausal women (about +/- 5%), and with the SD of the BMD in a cross-sectional sample of young healthy women. The duration of postpartum amenorrhea (PPA) and of lactation in our subjects ranged from about 2 months to 1 year and from 5 months to almost 2 years, respectively. No clear association between PPA and lactation could be seen. The magnitudes of reproduction-related BMD changes in general seemed not to differ substantially from about +/- 5% variability in BMD changes in healthy nonpregnant and nonlactating women. There was, however, some tendency toward systematic bone loss at the lumbar spine (about -3%) during pregnancy and at the femoral neck during PPA (about -5% as compared with prepregnancy data). Some individuals can yet show large, systematic bone losses comparable to 1 SD in magnitude. The site-specific reproduction-induced bone loss and consequent recovery are apparently multifactorial phenomena that may be related not only to duration and magnitude of lactation and/or duration of postpartum amenorrhea, but also to prevailing biomechanical and dietary factors, and other yet unknown individually modulated factors.