[Cryptorchism. Treatment with human chorionic gonadotropin or gonadotropin-releasing hormone?]. / Kryptorkisme. Behandling med human chorion gonadotropin eller gonadotropinfrigørende hormon?

In a modified double-blind study on the effect of human chorionic gonadotrophin (hCG), gonadotrophin releasing hormone (GnRH) and placebo, 163 prepubertal boys (aged 1.8-13.0) with bilateral and 94 (aged 1.5-13.1 years) with unilateral cryptorchidism fulfilled the inclusion criteria and completed the treatment protocol. hCG was administered as intramuscular injections twice weekly for three weeks. GnRH and placebo were given intranasally. hCG was superior to GnRH and placebo in the treatment of both bilateral (p < 0.0016) and unilateral (p < 0.013) cryptorchidism with success rates of respectively 23% and 19%. Linear and logistic regression analysis on the results obtained by treatment of bilateral disease showed that all treatments were more successful the younger the age of the boys. The data indicated that bilateral and unilateral cryptorchidism respond differently to hormonal treatment. We conclude that the success rates obtained in this study justify the use of hCG in prepubertal boys with cryptorchidism.

Lecithin-spingomyelin ratio in amniotic fluid for determination of the optimal time of termination of pregnancy.

PIP: Lecithin/sphingomyelin ratio (L/S), as a tool for determining optimal labor induction and elective ceasarean section time, assesses the pulmonary maturity of the fetus to avoid newborn idiopathic respiratory disease syndrome (IRDS). To decide time of pregnancy termination, amniocentesis was performed and L/S assayed. If L/S was 2.1 induction or surgery was begun, assuming fetal pulmonary maturity; if 2.1 procedures were postponed. In 17/76 cases, the initial L/S was 2.1; in 8 of these cases L/S 2.1 was demonstrated 18-36 days after amniocentesis, and only 1 child developed IRDS. In 5 cases termination was delayed 5 or 6 days, and none of these children developed IRDS. In only 3 cases with primary low L/S values and no chance to delay delivery more than a few days were L/S values below 2 at birth. All 3 children developed IRDS. 2 cases with borderline L/S did not develop IRDS. In 56 cases L/S was higher than 2.1 and pregnancy was terminated; 3 of these infants developed IRDS, but these cases could not have been avoided by using the L/S method. A total of 7 children developed the syndrome (9.1%), 6 moderately and 1 severely. In cases where pregnancy termination could not be postponed, methylprednisolone was injected in uteri to accelerate fetal pulmonary maturity.^ieng

Alpha-fetoprotein concentration in amniotic fluid during the last trimester in normal pregnancies and in pregnancies with severe fetal abnormalities.

The concentration of alpha-fetoprotein (AFP) in the amniotic fluid was studied during the last trimester of pregnancy. 129 samples of amniotic fluid were collected by transabdominal amniocentesis in 94 pregnant women. Only women with uncomplicated pregnancies giving birth to normal infants at term were included. The 90% reference interval was calculated and a distinct decrease in the amniotic fluid AFP concentration was found during the last trimester. An AFP concentration above the 90% reference interval was found in 8 out of 10 cases of anencephaly. Normal AFP concentration was found in a case of congenital heart disease with severe oedema, and a low concentration was found in a case of Down's syndrome (Trisomy 21).