Menorrhagia associated with the wearing of IUD--the results of treatment with clomiphene citrate.

The influence of clomiphene citrate was tested in 206 women suffering from menorrhagia following the insertion of an intrauterine device (IUD). Eighty-three percent felt relief during the therapy, 10% did not benefit and 7% complained of a worsening of their symptoms. Among the women who felt an improvement, 85% responded to the 250 mg/cycle dosage, and 15% required the 350 mg/cycle dosage. Women with shortened menstrual cycles required the higher dose treatment, i.e. 350 mg, compared with women with normal cycles (36% vs. 28%, respectively). The influence of placebo was 6%. The hypothesis is raised that the mechanism of action of clomiphene citrate is the correction of the hormonal disturbances in the luteal phase of the cycle following insertion of the IUD.

PIP: The influence of clomiphene citrate was tested in 206 women suffering from menorrhagia following IUD insertion. 83% felt relief during the therapy, 10% did not benefit, and 7% complained of a worsening of their symptoms. Among the women who felt improvement, 85% responded to the 250 mg/cycle dosage and 15% required the 350 mg/cycle dosage. Women with shortened menstrual cycles required higher dosage as compared to those women with normal cycles (36% vs 28%). The influence of the placebo was 6%. The hypothesis is raised that the mechanism of action of clomiphene citrate is the correction of the hormonal disturbances in the luteal phase of the cycle following IUD insertion.

Tococardiography in pregnancy during extracorporeal bypass for mitral valve replacement.

A 23-year-old pregnant woman with class III rheumatic heart disease, with mitral stenosis, underwent mitral valve replacement with cardiopulmonary bypass during the 32nd week of gestation. Fetal heart rate and uterine activity were recorded during the operation. Transient fetal heart rate decelerations and loss of variability, as well as uterine contractions, were observed during surgery and subsided spontaneously afterward. The pregnancy was carried to term and resulted in a normal infant. Problems associated with maternal extracorporeal circulation during pregnancy are discussed. Long-term effects on the fetus are presently unknown.