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Notizen: Serial changes in serum uric acid concentrations have been studied in a group of healthy women before conception, at regular intervals throughout pregnancy and finally 12 weeks afterdelivery. Compared with pre-pregnancy values uric acid concentrations decreased significantly by 8 weeks gestation and this reduced level was maintained until about 24 weeks. Thereafter the concentrations increased such that by term they were greater than the pre-pregnancy values in the majority of patients and remained elevated until at least 12 weeks after delivery. If clinical management during the second half of pregnancy is to be based on increases in serum uric acid concentrations then such increases will have to be carefully interpreted against the background of rising concentrations which occur as part of the physiological response to normal pregnancy.

Notizen: Summary. Serial measurements of serum progesterone, oestradiol, prolactin, human chorionic gonadotrophin (hCG) and human placental lactogen (hPL) have been determined in 32 healthy women at regular intervals throughout pregnancy. The data confirm previous reports that levels of these hormones vary widely between individuals at each stage of gestation, but further analyses have shown two other features: first there is a clear tendency for individuals to retain their rank in the spectrum of hormone values throughout pregnancy; second when the concentrations of the individual hormones (except hCG) are transformed to logarithmic values, the trends within individuals approximate well to straight lines during the second and third trimester of pregnancy. These findings provide a relatively simple method for describing the rates of change in the concentrations of these hormones and for examining possible relations between them. They also suggest that the quality of the maternal endocrine milieu may be determined at an early stage of gestation.

Notizen: Haematological indices were studied serially in 33 healthy women, at one week before delivery, during the first six days of the puerperium, at six weeks and six months post partum. Red cell count, haemoglobin concentration and haematocrit decreased during the first four days of the puerperium; haemoglobin concentrations up to 3·5 g/dl less than pre-delivery values were recorded in the absence of clinical postpartum haemorrhage. The second puerperal day haemoglobin concentration correlates most closely with the six week postpartum value. A leucocytosis of greater than 20 × 109/1 was found on the first puerperal day in 15 per cent of the women studied.

Notizen: This study was undertaken to investigate the effect of various forms of hormone replacement therapy (HRT) upon postmenopausal women while controlling as many variables as possible. It was felt that the age, duration of amenorrhoea and the general health of the patients should be as comparable as possible and that each patient should provide her own pretherapy and posttherapy control data. In addition, it was felt that any placebo effect should be investigated and the patients were therefore randomly allocated to placebo tablets or one of six available forms of HRT. The age/sex registers of two large general practices were scrutinized and all women between 49 and 54 years of age were asked to cooperate; for a variety of reasons only 56 women were suitable and willing to take part in the project, yielding 8 women for each of the seven possible therapy groups. Blood samples were taken at 7-day intervals three times before therapy was given and the mean of the three values was used as the control value. The women returned on day 21 of each subsequent therapy cycle for six consecutive months and finally three months after discontinuing therapy. From the data the following broad conclusions can be drawn: (i) some women have classic symptoms of hot flushes and sweating despite high endogenous oestrogen concentrations; (ii) vaginal cytology is a relatively poor indicator of endogenous oestrogen status; (iii) while follicle stimulating hormone (FSH) and luteinizing hormone (LH) concentrations are reduced on HRT neither is decreased to anywhere near premenopausal values while prolactin is unaffected; (iv) plasma cholesterol levels are reduced on HRT, the pulse rate is slower and both systolic and diastolic blood pressure are reduced to a small but significant extent; (v) there is no adverse effect upon blood clotting; and (vi) most women experience significant or complete relief of symptoms on all forms of HRT as do some women taking a placebo. The combined preparations containing an oestrogen and progestogen produced vaginal bleeding in only 80 per cent of the women. Thus protection by regular endometrical shedding may not be afforded to all women. As vaginal bleeding is unacceptable to most women if they can achieve the same symptomatic relief without inducing menstruation, it is suggested that women have a low dose oestrogen preparation prescribed cyclically for 6 to 12 months. If therapy is to be maintained for a longer time, uterine curretage should be undertaken at regular intervals to exclude the possibility of endometrial carcinoma developing.

Notizen: Red cell mass, derived from plasma volume and haematocrit, was calculated serially in 45 healthy women during pregnancy and 4 to 6 months after delivery. Compared to the non-pregnant, postpartum value there was a reduction of approximately 100 ml at 12 weeks gestation. An increase in red cell mass occurred thereafter: at 36 weeks gestation values 180 ml greater than the non-pregnant were found. Iron and folic acid supplements almost doubled this increment to 349 ml of red cells.

Notizen: Forty patients have been studied over 96 menstrual cycles during which a blood sample was obtained within five days of the next menstrual period. Two features emerged: circulating concentrations of progesterone and oestradiol could be elevated on the day bleeding began and conversely the levels of these hormones could be low for some days without menstruation occurring. These data suggest there may not be any direct relation between circulating ovarian hormone levels and the onset of menstrual bleeding.

Notizen: Serial measurements of serum progesterone, oestradiol, human chorionic gonadotrophin (hCG) and human placental lactogen (hPL) have been determined in 33 women experiencing early pregnancy failure and compared with the values of the same hormones in 72 healthy women having uncomplicated pregnancies. Steroid production by the corpus luteum seemed similar in both groups up to 6 weeks gestation but thereafter placental steroidogenesis was not evident in those women in whom spontaneous pregnancy losses occurred. Placental production of the two protein hormones, hCG and hPL, did take place, and whereas the circulating levels were not as high as in normal pregnancies, levels did usually increase before clinical evidence of miscarriage occurred. hCG was not a sensitive discriminator of subsequent failure. In these women there were no significant hormone differences between those with evidence of a fetus and those without.