American journal of obstetrics and gynecology
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Persistent bleeding is a common reason for the discontinuation of contraception. Standard terminology for describing bleeding patterns by reference period is presented. Observed bleeding patterns with oral contraceptives, depot medroxyprogesterone acetate, the levonorgestrel subdermal implant, and intrauterine devices are described. ⋯ Published studies suggest that oral contraceptives containing new nonandrogenic progestins have bleeding patterns as acceptable as older low estrogen formulations. Approaches to the evaluation and treatment of intermenstrual bleeding with contraceptive methods are reviewed. Patient education on expected bleeding patterns is essential to compliance and continuation.
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Am. J. Obstet. Gynecol. · May 1994
Investigation of the acid-base balance of coelomic and amniotic fluids in early human pregnancy.
The aim of our study was to analyze and compare the acid-base status of coelomic and amniotic fluids in early human pregnancy. ⋯ The coelomic fluid composition was indicative of an anaerobic metabolic acidosis probably related to the accumulation of acid compounds from placental metabolism. During the same period of gestation the composition of the amniotic fluid demonstrated a metabolic alkalosis that probably arises from the accumulation of basic substances through the unkeratinized embryonic skin and from the metabolism of organic anions in the embryonic tissues. The changes in the amniotic composition and acid-base balance at the end of the first trimester may correspond to the switch from the mesonephros to the metanephros and result from the excretion in the amniotic fluid of acid metabolic fetal bioproducts through the maturing kidneys.