Pentti A. Järvinen

Liver-function tests during intake of contraceptive tablets in pre-menopausal women.

In a previous study in postmenopausal women elevated serum levels of glutamic oxaloacetic transaminase and glutamic pyruvic transaminase were found in every case whereas other workers found no evidence of abnormal liver function in premenopausal women. A study is reported which was undertaken to explain this apparent discrepancy. The incidence of abnormal liver-function tests was studied in 109 premenopausal women (mean age 29.4) taking contraceptive tablets. Volidan was given to 45 women and Lyndiol to 39 women aged 17-41 for contraception; Orgametril was administered therapeutically to 25 women aged 23-52. Standard liver-function tests were performed at regular intervals in every case. The same low incidence of abnormal results was found in the Volidan and Orgametril groups; serum-transaminase levels were raised in 4% of women and the bromsulphthalein (BSP) retention was increased in 19%. In the Lyndiol group however the incidence was much higher with raised serum-transaminase levels in 18% of cases and increased BSP retention in 48%. In all cases the liver-function tests returned to normal within 4 weeks of withdrawal of the drug.

Importance of the type of the Progestogen in oral Contraceptives

It has been shown before that treatment with an oral contraceptive drug results in elevation of the serum transaminase levels and affects the excretion of broms~phthalein in postmenopausal women (Eisalo et al. 1964). However, it was not possible to obtain conclusive evidence as to whether the oestrogen component (mestranol) of the drug alone or the synergistic action of oestrogen and progestogen was responsible for the abnormal results observed in the liver function tests. Further, there was a higher incidence of abnormal results in the liver function tests in the pre-menopausal women when a preparation (Lyndiol) was given in which the oestrogen was methylated and the progestogen component was a nor-testosterone derivative than when a preparation containing a non-methylated oestrogen (Volidan), with a pregnane derivative, progestogen, was used (Eisalo et al. 1965). Therefore it was deemednecessary to investigate the importance of the oestrogen and especially the methylation of the phenolic hydroxyl, using the same progestogen component from the pregnane series.

CLASSIFICATION OF THE TOXAEMIAS OF PREGNANCY

THE American Committee on Maternal Welfare interval, has an adequate urinary volume. suggested the following classification of the (There is almost no maternal mortality.) toxaemias of pregnancy, which has been adopted (2) Severe-occurrence of one or more of the by many obstetric clinics: following signs or symptoms: A . Pre-eclampsia . (a) Coma of 6 or more hours duration. (b) Temperature of 39” C. or more. (1) Mild-if one or more of the following (c) Pulse rate over 120 per minute. signs are present: (d) Respiratory rate over 40 per minute. (a) 0edema-a weight gain of 600 €5 Or more (e) More than 10 convulsions. per week. ( f ) Cardiovascular impairment. (b) Blood pressure-from normal to 159/100. (c) Proteinuria-from 0.1 to 1.99 g. per 24 hours. (d) Symptoms-mild if present. The above classification was slightly amended by Werko, and in this changed form it has been applied at Helsinki University Women’s Clinic also. His classification was : (2) Severe A. Mild eclampsism or pre-eclampsia: proteinuria, blood pressure ranging from 140/90 present : to 160/110, slight oedema. (I) Oedema-a gain of 1 to 3 kilograms per B. Severe eclampsism: proteinuria, blood pressure over 160/110, oedema, subjective (2) Bloodpressure-constantly over 160/100. symptoms. (3) Proteinuria-constant excretion of 3 g. C. Eclampsia : proteinuria, hypertension, con-

EFFECT OF DIFFERENT ANESTHESIA METHODS ON EOSINOPENIC RESPONSE TO SURGICAL STRESS

Using the reaction of circulating eosinophils as an indicator, the authors studied the influence of three different anesthesia meshods (closed system, open ether and spinal anesthesia) on the surgical stress as a function of the duration of operation. The material studied consisted of 435 gynecological cases.