[Norwegian Society of Gynecology and Obstetrics--guidelines in obstetrics. Structure, process, results and evaluation]. / Norsk gynekologisk forening--veileder i fødselshjelp. Struktur, prosess, resultat og evaluering.

This paper describes structure, process, results, and evaluation of the Norwegian Society of Gynaecology and Obstetrics' Guidelines in obstetrics. This work, which lasted for 2 1/2 years, involved almost all obstetrical departments in Norway and 1/4 of all members of the Norwegian Society of Gynaecology and Obstetrics. All members of the Norwegian Society of Gynaecology and Obstetrics were invited to answer 24 questions. Of the 63% who replied to the questionnaire, 44% and 48% respectively stated that the Guidelines in obstetrics were very good or good. The introduction of the Guidelines in obstetrics led to changes in routines in more than 70% of the hospitals, and the different categories of hospital physicians changed their routines as well (55-65%). 83% of the heads of the departments stated that the Guidelines in obstetrics served partly or totally as the model for the obstetrical management guidelines. The evaluation and the experience of this quality assessment handbook serve as perspectives for future work.

[Transdermal estrogen treatment. A placebo controlled study]. / Transdermal østrogenbehandling. En placebokontrollert studie.

A double blind, crossover study was used to test the effect of transdermal oestrogen therapy (Estraderm) in 22 women with climacteric complaints. The number and intensity of hot flushes were both reduced by approximately 80% (p less than 0.0025). Some improvement was also seen as regards general wellbeing, disturbed sleep and tiredness. We noted a significant increase in serum oestradiol to premenopausal follicular phase levels, and a decrease in FSH values. Systolic blood pressure was lowered during active treatment (p less than 0.025), a smaller reduction of diastolic pressure was not significant. Body weight remained unchanged. Some patients reported tender breasts, and some reported slight irritation of the skin. Neither condition necessitated withdrawal of treatment. It is concluded that Estraderm is effective and suitable for treatment of climacteric complaints.

A comparative evaluation of the Multiload 250 and Multiload 375 intra-uterine devices.

The experience of 1254 women who had Multiload 250s (MLCu250) and 754 women who had Multiload 375s (MLCu375) inserted by the author was evaluated. The performance of the two Multiload models was similar over 4 years of use, except for a significantly lower (p less than 0.05) pregnancy rate for the MLCu375 (4-year cumulative life table rates: 3.0 vs 5.4 per 100 women). Use of the MLCu250 and MLCu375 provided women with a very safe method of contraception. Many of the removals for medical reasons other than bleeding, pain or pelvic inflammatory disease (PID) appeared to be unrelated to IUD use. Thirty-nine women had their IUDs removed for suspected PID, but the diagnosis of PID was confirmed in only 44% of these cases. The overall rate of confirmed cases of PID was 0.3 per 100 woman-years. Except for a higher rate of PID during the first few months of Multiload use, the results of the study did not indicate that IUD use is associated with an increased risk of PID. Multiload use did not impair future pregnancy or affect the outcomes of these pregnancies.