Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002453 (amenorrhea)
 6,245 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ultrasound is the imaging method of choice for evaluating the pregnant abdomen. It appears to be free of any deleterious biologic effects. The fetus and other structures within the uterus can be imaged in great detail, and abnormalities in growth and development of these structures can be demonstrated. Ultrasound has a far less specific role in the evaluation of gynecologic abnormalities. The normal uterus and, less frequently, the normal ovaries can be imaged. Masses arising in these strucutres can often be conclusively demonstrated by ultrasound when physical examination is inconclusive. The ultrasonic texture of these masses, whether they be solid, cystic or complex, can be determined accurately. However, the determination of whether these masses are benign or malignant cannot be made by ultrasound criteria. Ultrasound has also proven useful in evaluating patients with ambiguous genitalia, amenorrhea and suspected PID and also is an effective means of localizing intrauterine contraceptive devices.
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PMID:Ultrasound in obstetrics and gynecology. 62 5

This literature review compares the merits and disadvantages of the levonorgestrel-releasing IUD made by Leiras Pharmaceuticals, Turkey, Finland (LNG-IUD-20), with the Nova-T, Copper-T (TCu) and 220C, and Copper-T-38-Ag (TCu-380Ag). This IUD releases 20 mcg levonorgestrel daily from a Silastic sleeve on the vertical shaft containing 52 mg. The plasma level stabilized after a month at about 0.2 ng/ml, about half as high as that seen with Norplant implants. It is identical in size to the Nova-T. The Cu-T IUDs differ with respect to copper wire or sleeves, or silver-cored wire. The chief studies reviewed here were 2 multi-center trails primarily in European countries, and a 2 large multi-center trials in India. Cumulative pregnancy rates were 0.0 to 0.6 per 100 users for the LNG IUD, compared to slightly higher failures for inert or copper IUDs. While removal rates for bleeding, pain and pelvic inflammatory disease were lower for the LNG-IUD-20, removals for oligomenorrhea, amenorrhea and hormonal side effects were higher than for the other IUDS. In the Indian trials, removals for amenorrhea and irregular bleeding were much higher than rates reported in the European studies, resulting in significantly lower continuation rates overall. The results pointed to district benefits for the LNG-IUD-20, such as lower blood loss and anemia, relief of dysmenorrhea and menorrhagia, as well as possible lower risks of ectopic pregnancy in case of failure, less PID (pelvic inflammatory disease), and the claim by the maker that strictly correct placement is not necessary. Disadvantages of the LNG-IUD-20 are more difficult insertion due to the wider diameter; oligomenorrhea, amenorrhea and irregular bleeding; hormonal side effects such as acne, weight gain, nausea, headache and breast tension; and potential risk of functional ovarian cysts. The LNG-IUD-20 is considered comparable to copper IUDs in effectiveness, safety, longevity, and return to fertility after removal. Users should be counseled that the oligomenorrhea or amenorrhea is neither a medical problem or indicative of infertility, is common for the 1st 2 months, is reversible on removal, may signal an improved hemoglobin profile, relief of dysmenorrhea, and may be preferred to heavy bleeding from other IUDS. The program implications of this IUD are potential lower incidence of ectopic pregnancy and PID. The effect of its use on breast feeding, cost-effectiveness compared to Norplant, in-country manufacture, and cultural acceptance need to be determined in specific locales.
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PMID:An evaluation of the levonorgestrel-releasing IUD: its advantages and disadvantages when compared to the copper-releasing IUDs. 177 15

A levonorgestrel-releasing IUD and the Copper T 380Ag IUD were in randomized comparison for seven years in five clinics. In two other clinics the randomized study was truncated at five years, but use of the Copper T continued. No pregnancies occurred to users of either device in years 6 and 7. Cumulative pregnancy rates were 1.1 per 100 at seven years for the steroid-releasing and 1.4 per 100 for the copper-releasing IUDs. Cumulative rates of PID did not differ between devices. Infection rates appeared to be lowest during the sixth and seventh years of the study. Termination attributable to amenorrhea was the principal contributor to differences in cumulative continuation rates between devices. At the five clinics that carried the comparative study to seven years, cumulative continuation rates were 24.9 per 100 for LNg20 IUD users and 29.4 per 100 for TCu 380Ag users. Women who used either method for periods of five to seven years experienced, on average, marked to mild increases in hemoglobin as compared with levels at admission. The Copper T380 family and the LNg20 IUDs represent the most effective reversible contraceptive methods yet studied in long-term randomized trials.
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PMID:Prolonged intrauterine contraception: a seven-year randomized study of the levonorgestrel 20 mcg/day (LNg 20) and the Copper T380 Ag IUDS. 179 62

Progestagen-releasing IUDs were developed to diminish the problems of bleeding and pain with inert and copper-containing IUDs. The intrauterine release of the progestagen causes endometrial atrophy, resulting in impairment of nidation, and interferes with transport of the ovum and the spermatozoa. 2 available types, Progestasert, Biograviplan (Alza Corporation, California; Grunenthal) and Levonorgestrel Nova-T (Leiras Pharmaceuticals, Finland), have been sufficiently tested in multinational trials. Compared with Progestasert, LNG Nova-T showed lower pregnancy rates (Pearl Index 0.30), less risk for ectopic pregnancy, and a longer effective lifetime (7 years). With both IUDs, the amount and duration of menstrual blood loss is decreased. Amenorrhea is a frequently occurring side effect of LNG Nova-T, caused by endometrial atrophy. Intermenstrual blood loss and spotting incidences are not uniformly reduced and are still a frequent reason for removal. Preinsertion counseling may improve the acceptance of these nonhealth threatening side effects. With both IUDs, a decrease in menstrual cramps during periods is perceived and a low incidence of PID is found. Basically, the progestagen-releasing IUD can be recommended to all women who wish an IUD for contraception and to women with contraindications for OCs, especially to those with menorrhagia, anemia, or risk for anemia. (author's)
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PMID:Intrauterine steroid contraceptives. 313 66

Description of a clinical case. In the last decade we have witnessed an increase in both ectopic and twin pregnancies. These events have various causes, such as PID, tubal plastic surgery, the use of agents for the induction of ovulation and many others. The number of intra- and extra-associated pregnancies (phenomenon that was considered quite rare in the past) has also been increasing. A medical case that has come under our observation is being discussed. A woman patient arrived in our ward with typical symptomatology of threatened abortion at the 8th week of amenorrhea. The echographic test showed an intra-uterine pregnancy in regular progress associated with right latero uterine tumefaction. The Douglas cavum was full of liquid of probable hematic nature. The promptly performed laparoscopy confirmed the suspicion of intra and extra uterine associated pregnancy. The consequent right adnexectomy through laparotomy led to the solution of the case.
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PMID:[Diagnosis and treatment of intrauterine pregnancy associated with tubal pregnancy. Description of a clinical case]. 798 34

The most common site of localisation of an ectopic pregnancy is the fallopian tube. Rarely an ectopic pregnancy can be found in the ovary, a caesarean section scar, the abdomen or the cervix. Risk factors are previous ectopic pregnancy, PID, endometriosis, previous pelvic surgery, the presence of a coil and infertility. However, a third of women with an ectopic pregnancy have no known risk factors. NICE recommends a low threshold for offering a pregnancy test to women of childbearing age when they attend the surgery. Symptoms and signs appear when the tube starts to tear. When the tube ruptures, the woman will quickly become unwell and haemodynamically unstable because of rapid intra-abdominal blood loss. The most common symptoms of ectopic pregnancy are pelvic or abdominal pain, amenorrhoea, missed period or abnormal period and vaginal bleeding. A positive diagnosis of a urinary tract infection or gastroenteritis does not exclude an ectopic pregnancy. Signs of suspected ectopic pregnancy include pelvic, abdominal, adnexal or cervical motion tenderness, rebound tenderness and abdominal distension. Women who are haemodynamically unstable, or in whom there is significant concern about the degree of pain or bleeding, should be referred directly to A&E, irrespective of the result of the pregnancy test. Stable patients with bleeding who have pain or a pregnancy of six weeks gestation or more or a pregnancy of uncertain gestation should be referred immediately to an early pregnancy assessment (EPA) service, or out-of-hours gynaecology service if the EPA service is not available. Diagnosis is confirmed by transvaginal ultrasound scan to identify the location of the pregnancy.
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PMID:Diagnosis and treatment of ectopic pregnancy. 2363 34