Effect of head-out water immersion on serum sodium transport inhibitor and urinary nonadrenaline excretion in pre-menopausal women.

The effect of head out water immersion on the excretion of catecholamines and serum sodium transport inhibitor (STI) was studied in healthy young women during the follicular and leuteal phases. Two way ANOVA showed that menstrual cycle had no effect on the excretion of noradrenaline (NA), dopamine (DA) or serum STI. Analysis of pooled data from follicular and leuteal phases showed that immersion caused a significant increase in sodium excretion and serum STI and a significant decrease in urinary NA excretion in healthy young women. After immersion, sodium excretion, DA excretion and serum STI decreased and NA increased.

The Pipelle endometrial suction curette: how useful is it in clinical practice?

The Pipelle endometrial sampler is gaining popularity as an alternative to formal dilatation and curettage (D&C). This study demonstrates that the Pipelle reduces the number of D&Cs required to assess the endometrium by 65%. This has significant benefits in terms of patient safety and cost. If an inadequate sample is obtained, which occurs most commonly in the postmenopausal patient, there may be a temptation to ascribe this to the presence of an atrophic endometrium. This study, however, finds a significant chance of an underlying carcinoma in these cases. Thus whereas the Pipelle sampler has clinical usefulness when a sample sufficient for histological analysis is obtained, an equivocal result must lead to further investigation.

Renal sodium retention does not occur during the luteal phase of the menstrual cycle in normal women.

OBJECTIVE: To determine whether weight gain due to renal sodium and water retention occurs in the luteal phase of the normal menstrual cycle. DESIGN: Prospective observational study. SETTING: Research laboratory installed with modified spa bath. SUBJECTS: Ten normal healthy women. INTERVENTION: Each subject underwent two experiments, one in each phase of the menstrual cycle, involving 3 h head-out water immersion and a pre- and post immersion control hour. 25 ml blood samples were obtained every hour before, during and after water immersion. MAIN OUTCOME MEASURES: Renal and hormonal responses to water immersion during the luteal and proliferative phases of the cycle. RESULTS: There was no change in weight, creatinine clearance, basal sodium excretion or plasma atrial natriuretic peptide between the two phases of the cycle. There was a significant rise in basal progesterone, plasma aldosterone and plasma renin activity in the luteal phase of the ovulatory cycles. Renal and hormonal responses to immersion including sodium and calcium excretion, elevation of atrial natriuretic peptide (ANP) and suppression of plasma aldosterone and plasma renin activity were identical in the two phases of the menstrual cycle. CONCLUSION: We found no evidence to support the hypothesis that renal sodium and water retention occurs in the luteal phase of the normal menstrual cycle.

Episiotomy: who gets one and why.

Data was collected about the mother, the infant and the pregnancy in women who had an episiotomy performed at delivery, and those who did not, in one district hospital and two community hospitals. Factors predisposing mothers to episiotomy were sought and compared in the different hospitals. Traditional indications for episiotomy, such as a large baby and a small mother, were found to be less important than the occurrence of fetal distress, prolongation of the second stage of labour and the presence of pupil midwives at delivery. Current practice in the use of episiotomy is discussed.