BJOG : an international journal of obstetrics and gynaecology
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Multicenter Study Clinical Trial
The endometrial response to sequential and continuous combined oestrogen-progestogen replacement therapy.
1. To determine the prevalence of endometrial hyperplasia in postmenopausal women taking standard proprietary regimens of sequential oestrogen/progestogen; 2. to determine the effects of nine months treatment with an oral continuous combined regimen of 2 mg 17beta-oestradiol and 1 mg norethisterone acetate (Kliofem [Kliogest outside the UK]; Novo Nordisk, Denmark) on endometrial histology in postmenopausal women. ⋯ Despite taking standard regimens of sequential HRT containing at least 10 days of progestogen, there was a 5.3% prevalence of complex endometrial hyperplasia, and a 0.7% prevalence of atypical hyperplasia. However, continuous combined HRT (Kliofem) containing daily progestogen is not associated with an increased risk of hyperplasia and will convert the endometrium to normal in those with complex hyperplasia arising during previous sequential HRT.
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Randomized Controlled Trial Comparative Study Clinical Trial
Three methods for hysterectomy: a randomised, prospective study of short term outcome.
To detect differences in clinical short term outcome between total abdominal hysterectomy, vaginal hysterectomy and laparoscopic assisted vaginal hysterectomy. ⋯ Traditional vaginal hysterectomy proved to be feasible and the faster operative technique compared with vaginal hysterectomy with laparoscopic assistance. The abdominal technique was somewhat faster, but time spent in theatre was not significantly shorter. Abdominal hysterectomy required on average a longer hospital stay of one day and one additional week of convalescence compared with traditional vaginal hysterectomy. Vaginal hysterectomy should be a primary method for uterine removal.
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Randomized Controlled Trial Comparative Study Clinical Trial
Subcutaneous versus intracutaneous injections of sterile water for labour analgesia: a comparison of perceived pain during administration.
To investigate whether, during injections of sterile water, there is any difference in perceived pain between intracutaneous and subcutaneous injections. ⋯ The findings suggest that the less painful subcutaneous injection technique should be used.
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To identify and test the predictive power of demographic, obstetric, and psychosocial risk factors of postpartum depression. ⋯ Antenatal focus on psychosocial wellbeing may help to identify women at risk of postpartum depression.
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To assess whether there is a decrease in endometrial thickness following discontinuation of tamoxifen treatment as measured by ultrasound. ⋯ Median thickness of endometrial thickness significantly reduced within six months following tamoxifen discontinuation, and remained constantly low thereafter. This finding may support use of ultrasonographic imaging for the measurement of tamoxifen's effect on the endometrium of postmenopausal breast cancer patients.