[Contraception with the intrauterine pessary Progestasert]. / Zur Kontrazeption mit dem Intrauterinpessar Progestasert.

A prospective study was carried out from June 1973 to August 1976 in 131 women fitted with a newly developed IUD (Progestasert). The IUD's were removed as planned after 12 months with the exception of 4 cases in which they were retained for up to 17 months. The evaluation of the trial was performed according to the Life Table Analysis and the usual statistical methods. 1496 application months were evaluated. One case each of intrauterine and extrauterine pregnancies were observed. One patient experienced spontaneous expulsion of the IUD. In 9 cases medical reasons led to the removal of Progestasert at an earlier date. Duration, intensity, and interval of menstruation as well as frequency of spotting and dysmenorrhea were recorded. A slight increase in duration and interval of menstruation was seen whereas bleeding intensity was reduced. Increased spotting, especially during the first month after insertion, and a significant reduction of dysmenorrheal complaints were noted after 2 months. In addition to 8 removals due to bleeding disturbances, 6 other patients experienced spotting throughout the entire treatment period. Laboratory tests such as ESR, WBC, hemoglobin, hematocrit and cytological smear determinations were carried out. No pathological alterations of these parameters were found.

PIP: 117 women underwent 131 insertions of the Progestasert IUD. 22 patients were nulliparae; 80 of the patients had previously used oral contraceptives. Significant increases were observed in the length of menstruation (p.01) and the length of the menstrual interval (p.05), while a significant decrease in the menstrual intensity was observed (p.01). There was a significant decrease in the incidence of dysmenorrhea (p.01). The rate of spotting returned to normal after a marked increase during the first 3 months of Progestasert use. Previous oral contraceptive use could not be correlated to the incidence of the changes in the menstrual cycle. The continuation rate was 90.9%. There was one ectopic pregnancy and one normal pregnancy during the 12 month observation period following insertion. The expulsion rate was .7. The removal rate was 6.1, mainly because of bleeding. There were no significant changes in the patients' laboratory test results during IUD use.

[A contribution to the medical and organizational care of high-risk premature infants and newborn (author's transl)]. / Zur medizinischen und organisatorischen Betreuung gefährdeter Früh- und Neugeborener.

Perinatal mortality is a qualitative parameter for the obstetric and neonatologic efficiency of an obstetric center. The present study conducted at the Herford clinical center, based on 3,700 case histories from 1972 to 1976, revealed a drop of the uncorrected perinatal mortality from 35.08% to 14.23%, and a drop of the corrected perinatal mortality from 21.35% to 5.02%. Two groups with an observation period of 2.5 years each, were compared with each other to demonstrate the efficiency of modern perinatologic care and control methods. The methods of intensive care and control of high-risk pregnancy and high-risk parturition (ultrasound, cardiotocography, fetal blood analysis; tocolysis, laboratory diagnostics of placental insufficiency), practised since 1974, and the close cooperation with a newborn intensive-care ward of the infant hospital of the Herford center have brought about a definite improvement in perinatologic efficiency.

[3 months contraception with norethisteronönantate. Clinical and biochemical studies]. / Zur 3-Monats-Kontrazeption mit Norethisteronönanthat. Klinische und biochemische Untersuchungen.

PIP: Clinical experiences and biological parameters with injections of no rethisterone enanthate (200 mg) given at intervals of 84 days in 10 women aged 20-38 years are reported. Total gonadotropin excretion was decreased in 9 patients and urinary pregnanediol decreased by 50% in all patients. Basal temperature levels remained about .5 degrees C higher for 4-6 weeks after injections. Endometrial biopsies revealed proliferation and secretion phases and slight evidence of an anti-estrogenic effect, but atrophic or hyperplastic changes were not seen. The antiestrogenic effect was also observed in the vaginal epithelium. Other biological parameters were considered normal (plasma cortisol rise after ACTH, oral glucose tolerance, protein-bound iodine, serum cholesterol and total lipids, and liver tests). Side effects included cycle irregularities, spotting, breakthrough bleeding, and weight changes of less than 3 kg. No pregnancies occurred.^ieng