[Prevention of hypotonic hemorrhage in the placental and early puerperal period with prostenone]. / Profilaktika gipotonicheskikh krovotechenii v poslerodovom i rannem poslerodovom periodakh prostenonom.

To prevent afterbirth and early postpartum hemorrhages the authors used prostenone in 46 (the main group) and oxytocin in 20 females (control group). Intraplacental blood pressure and coagulation parameters were studied. With prostenone, the mean amount of the blood loss turned to be significantly lower (137 +/- 13 ml) than with oxytocin (208 +/- 17 ml). Administration of prostenone led to a significant elevation of prothrombin index alone and tolerance to heparine. As there was an insignificant difference between the parameters in the main and control groups, the mechanism of prostenone's effect on the myometrium required further studies.

[Pregnancy and diabetes mellitus]. / Beremennost' i sakharnyi diabet.

The dynamics of the placental lactogenic hormone level, insulin requirements, and glycaemia during pregnancy was studied in diabetes I and II patients and diabetic pregnancies. Fructose amine and C-peptide levels in maternal and neonatal blood were measured in different diabetes types. The risk of diabetes I development in relation to the incidence of the HLA-system antigens was assessed. The need for a functional insulin therapy prior to and during pregnancy was substantiated.

[Prolonged-action contraceptives]. / Kontratsevtivy prolongirovannogo deistviia.

PIP: Various aspects of injectable prolonged-action steroid contraceptives are reviewed with special emphasis on the effectiveness of depo- medroxyprogesterone (depo-provera) and norethisterone enanthate (NE). Both preparations have progestogen activity. Depo-provera was 1st used for the treatment of endometriosis and threatened abortion. As a contraceptive, 150 mg depo-provera is given every 90 days (once every 3 months). NE is also given 200 mg during the 1st 5 days of a cycle; injections are repeated 2 months later and then every 3 months. The incidence of pregnancy following depo-provera use did not exceed 1/100 women-years. Clinical trials of NE indicated the incidence of pregnancy ranging from 1-3.6/100 women-years (depending upon drug administration schedule). The contraceptive effect of both depo-provera and NE was shown to be associated with inhibition of ovulation. The majority of women treated with depo-provera or NE developed various disorders of the menstrual cycle. Amenorrhea development was found to depend upon duration of administration, and was more frequent after depo-provera than after NE. Metabolic effects of depo-provera and NE included decrease in the blood level of cholesterol in high-density lipoproteins, and an increase in the fasting levels of glucose and insulin. Depo- provera did not affect liver function. Epidemiological studies did not show an increase in cancer incidence following the use of depo-provera. Restoration of fertility occurred about 5.5 months after termination of depo-provera administration. Injectable contraception recommended primarily in young women who want to increase the intervals between childbirths. Women older than 40 years should use other methods of contraception.^ieng

[Topical contraceptives]. / Mestnye kontratseptivy.

PIP: Recently there has been little interest in topical contraceptives. The most popular are the cervical cap and the diaphragm. Other types of mechanical contraceptive devices are being investigated. Standley and Kessler have developed a device for introduction into the cervical canal with a reservoir of spermatocide, it does not block the flow of blood during menstruation. New models of vaginal rings are also being developed which are simple enough for self-insertion and also contain a reservoir of spermatocide. Work is being done on spermatocide-containing sponges in many countries. Another project being investigated is the possibility of using natural proteins, collagens, and other substances which absorb spermatozoids. The ancients used various vaginal suppositories to kill spermatozoids; in the late 19th century quinine sulfate was used for this, and a variety of substances have been used recently. These spermicidal creams also have the advantage of acting as anti-infectious agents in many cases. But they do have some negative effects. They are about 85% effective, are local irritants, and some cause discomfort during intercourse. And it is possible that some are resorbed by the body and act on the liver and other organs. Vaginal globules and suppositories are also popular. The "Kontraceptin-T" brand contains quinosol, boric acid, and tannin. There are also foaming tablets which are mixed with water and then introduced. New locally-active chemical substances are being developed in Japan, West Germany, and the USSR. Kontraceptin-E contains paranonyl-phenoxypolyethylene glycol and sodium dioctylsulfosuccinate. The "Norforks" and other preparations contain mercurial compounds which may turn out to be harmful. The future promises the development of products which will act to prevent fertilization by acting on the hyaluronidase and the acrosine of the spermatozoid, thus preventing it from penetrating the ovum. It would be best to find enzyme inhibitors which are specific for the spermatozoids, thus reducing the possibility of side effects.^ieng