Growth and obesity and its association with plasma level of steroid hormones and insulin-like growth factor-I (IGF-I) in Slovak female students.

The aim of the present study was to examine the possible role of steroid hormones and insulin-like growth factor 1 (IGF-I) in the control of human growth and obesity. We measured plasma level of progesterone, testosterone, estradiol and IGF-I in 301 young women at different stages of their ovarian cycle, and compared them to the standard morphometric indexes of their growth and obesity - body height, body weight, abdomen circumstance and waist to hip ratio (WHR). The ovarian cycle-dependent changes in plasma progesterone and estradiol, but not in testosterone and IGF-I level were found. Young women with higher body height had significantly higher plasma level of estradiol, testosterone and IGF-I, but not of progesterone, compared to subjects with lower body height in both follicular and luteal phases of the ovarian cycle. Subjects with a higher body weight had significantly higher plasma estradiol and progesterone, but not testosterone and IGF-I than subjects with lower body weight in both follicular and luteal phases of ovarian cycle. Women with a higher abdomen circumference had significantly lower plasma estradiol, but not the other hormones than the subjects with lower abdomen circumference. Women with higher WHR index had significantly higher plasma level of estradiol, but not other hormones than subjects with lower WHR index in both follicular and luteal phases of ovarian cycle. The present observations suggests: (1) that luteal phase of the women ovarian cycle is characterised by a dramatically increase in both progesterone and estradiol, but not in testosterone and IGF-I release, (2) that in human females growth can be up-regulated by testosterone, estradiol and IGF-I, but not by progesterone, (3) that body mass can be up-regulated by progesterone and estradiol, but not by testosterone or IGF-I, and (4) that women obesity (high WHR, but not abdomen circumference) can be promoted by estradiol, but not by other steroid hormones or IGF-I (Tab. 1, Fig. 4, Ref. 45).

[Peripartum hysterectomy--an audit in Slovakia in 2007]. / Peripartálne hysterektómie--audit na Slovensku v roku 2007.

OBJECTIVE: An audit was performed to assess the number, indications and complications of peripartum hysterectomy at the departments of obstetrics/gynecology in Slovakia in 2007. DESIGN: Observational descriptive study. SETTING: Department of Obstetrics and Gynecology, Faculty Hospital Nitra and Constantine the Philosopher University Nitra. METHOD: An official questionnaire of Slovak Society of Obstetrics and Gynecology was sent to all 63 departments of obstetrics/gynecology to find the number of peripartum hysterectomy performed in the year 2007. Differences between intrapartum and postpartum cases were compared. RESULTS: 44 from 63 institutions responded to the survey (response rate 69.8%). There were 38,485 deliveries and 24 cases of peripartum hysterectomies. The incidence of peripartum hysterectomy was 0.62/1000 deliveries, 1 case occurred in 1604 deliveries. 16 (66.7%) patients had a total abdominal hysterectomy with the remaining 8 (33.3%) having a sub-total hysterectomy. All operations were emergent. 18 procedures were performed during delivery and 6 in the postpartum period. Hypogastric artery ligation before hysterectomy were performed on 2 patients in the postpartum group. 20 of 24 (83.3%) patients delivered by cesarean section, three (12.5%) by spontaneous vaginal delivery and one (4.2%) with vaccumextraction. The indications for emergency peripartum hysterectomy were: placenta praevia 6 cases (25%), placental abruption with disseminated intravascular coagulation 6 (25%), placenta accreta 3 (12.5%), uterine atony 3 (12.5%), uterine rupture 3 (12.5%) and retroperitoneal haematoma 3 (12.5%). The youngest patient was 15 year-old, the oldest one was 39. After hysterectomy 10 (41.7%) women were admitted to the intensive care unit. There was no maternal mortality, but five newborns died due to perinatal asphyxia. There were more blood transfusions in the group of postpartum hysterectomies in comparison with intrapartum cases (4.0 +/- 1.3 transfusion units vs 9.1 +/- 3.5, p < 0.05), as well as the longer hospital stay (10.3 +/- s4.2 days vs. 19.1 +/- 5.3, p < 0.05). CONCLUSIONS: Peripartal hysterectomy is a dramatic but a life saving procedure. It is usually associated with significant maternal and fetal morbidity and mortality. Every obstetric service should have access to a surgical team capable of performing emergency peripartal hysterectomy.