Pregnancy despite continued elevation of prolactin levels while on bromergocryptine

A case of long standing secondary amenorrhea with hyperprolactinemia and pregnancy success despite inability to normalize prolactin levels with high doses of bromergocryptine is presented.     

控制性卵巢刺激治疗中血清催乳素水平的变化特点

目的 探讨控制性卵巢刺激(COS)治疗中血清催乳素水平的变化特点.方法 收集接收体外受精-胚胎移植的患者72例,共115个周期,采用促性腺激素释放激素激动剂结合促性腺激素(Gn)长、短方案促排卵治疗,定时经阴道B超监测卵泡发育情况及子宫内膜厚度,并采用酶联免疫发光法检测不同时间点血清雌二醇、黄体生成素(LH)、孕酮和催乳素的水平,分析患者雌二醇、LH、孕酮水平与催乳素水平之间的相关性.结果 对催乳素与雌二醇水平进行相关和回归分析发现,随着雌二醇水平的上升,催乳素水平有显著上升的趋势,两者呈显著正相关关系(r=0.5897,P＜0.01).对催乳素与孕酮水平进行相关和回归分析发现,孕酮水平随催乳素水平的升高而升高,两者呈显著正相关关系(r=0.1412,P＜0.01).但是LH水平与催乳素水平之间未见明显关联.结论 在控制性卵巢刺激治疗中,催乳素的分泌不受Gn的影响,而雌二醇水平的升高可能刺激催乳素的分泌,且催乳素与孕酮水平呈正相关关系.     

Maternal and fetal prolactin in pregnancy-induced hypertension

Summary In plasma from 35 women with pregnancy-induced hypertension (PIH) and 35 normal pregnant women both at 39 weeks of gestation, plasma prolactin levels were measured at 8.30 a.m. (PRL1) and 9.30 a.m. (PRL2) under basal conditions. At delivery umbilical cord blood samples were taken for measurement of fetal prolactin (PRLF). PRL1 and PRL2 were higher in women with PIH, but no significant relations were found betwen PRL1/PRL2 and blood pressure. PRLF did not differ when infants of mothers with PIH and infants of normal pregnant women were compared, but PRLF had a significant direct independent relation with PRL2. The latter relation may be due to the increase in placental oestrogens during pregnancy, which stimulate both the maternal and fetal hypophyses and their prolactin secretion. PRLF did not show any relation with neonatal morbidity, but PRL1 showed a significant direct relation with the Apgar score at 5 min.     

Influences of maternal smoking and fetal sex on maternal serum oestriol,prolactin, hCG,and hPl levels

Summary A total of 222 pregnant women had repeated hormone assays between 20 weeks and delivery; 86 of the women were smokers. The maternal hormone balance appeared to be affected by smoking. Smoking affected maternal serum levels of hPL and hCG in pregnancies with a female fetus whereas maternal serum concentrations of oestriol and prolactin were affected in pregnancies with a male fetus. Significantly higher hCG levels were found in mothers who smoked and had a girl than in those who smoked and had a boy. On the basis of our results we feel that smoking mainly affects the placenta.     

Amniotic fluid prolactin levels in Rhesus isoimmunized patients

The concentration of prolactin in the amniotic fluid (AFPRL) was measured in 75 samples obtained in the third trimester of 14 isoimmunized women. There was a uniform decline in prolactin levels with advancing gestation in each pregnancy (r = −0.89 to −0.99). The decline in AFPRL was similar in uncomplicated pregnancies. AFPRL levels were not predictive of umbilical cord hemoglobin or bilirubin levels and amniotic fluid lecithin/sphingomyelin ratio.     

Plasma prolactin concentrations and copulatory behavior after salsolinol injection in male rats

Purpose

The dopamine-derived endogenous compound, R-salsolinol (SAL), was recently identified as a putative endogenous prolactin (PRL)-releasing factor. However, how SAL influences copulatory behavior is unknown. In this study, we examined the relationship between SAL and copulatory behavior in male rats.

Methods

Male Sprague-Dawley rats administered SAL were exposed to female rats in estrus, the plasma PRL concentration was measured, and the behavioral frequency and time during copulatory behavior were noted.

Results

In the control and SAL groups, plasma PRL concentrations at 15 min before exposure to the female were 7.3 ± 2.0 and 8.0 ± 1.5 ng/ml, respectively. Moreover, plasma PRL concentrations in males immediately after exposure to the female were 7.4 ± 1.2 and 68.0 ± 5.9 ng/ml, respectively (P < 0.05). All (8/8) of the control animals ejaculated in the presence of the female, whereas only 33% (2/6) of the SAL group ejaculated. An increasing tendency for mount latency and intromission latency and a decreasing tendency for intromission frequency were observed in the SAL group.

Conclusions

Copulatory behavior was inhibited in male rats after SAL injection, suggesting that SAL is a copulatory behavior inhibiting factor.     

Circulating blood levels of gonadotropins and prolactin in the normal menstrual cycle

Circulating blood levels of luteinizing hormone, follicle-stimulating hormone and prolactin are reported in 17 normally menstruating Nigerian women. The profiles of the secretion of these pituitary hormones are similar to those reported in other ethnic groups. A significant midcycle peak of prolactin, coinciding with the peaks of luteinizing hormone and follicle stimulating hormone was also observed.     

Laboratory and clinical significance of macroprolactinemia in women with hyperprolactinemia

The role of macroprolactinemia in women with hyperprolactinemia is currently controversial and can lead to clinical dilemmas, depending upon the origin of macroprolactin, the presence of hyperprolactinemic symptoms and monomeric prolactin (PRL) levels. Macroprolactinemia is mostly considered an extrapituitary phenomenon of mild and asymptomatic hyperprolactinemia associated with normal concentrations of monomeric PRL and a predominance of macroprolactin confined to the vascular system, which is biologically inactive. Patients can therefore be reassured that macroprolactinemia should be considered a benign clinical condition, resistant to antiprolactinemic drugs, and that no diagnostic investigations or prolonged follow-up should be necessary. However, a significant proportion of macroprolactinemic patients appears to suffer from hyperprolactinemia-related symptoms and radiological pituitary findings commonly associated with true hyperprolactinemia. The symptoms of hyperprolactinemia are correlated to the levels of monomeric PRL excess, which may be explained as coincidental, by dissociation of macroprolactin, or by physiological, pharmacological and pathological causes. The excess of monomeric PRL levels in such cases is of primarily importance and the diagnosis of macroprolactinemia is misleading or inadequate. However, macroprolactinemia of pituitary origin associated with radiological findings of pituitary adenomas may rarely occur with similar hyperprolactinemic manifestations, exclusively due to bioactivity of macroprolactin. Therefore, in such cases with hyperprolactinemic signs and pituitary findings, macroprolactinemia should be considered a pathological biochemical condition of hyperprolactinemia. Accordingly, individualized diagnostic investigations with the introduction of dopamine agonists, or other treatment with prolonged follow-up, should be mandatory. The review analyses the laboratory and clinical significance of macroprolactinemia in hyperprolactinemic women suggesting clinically useful diagnostic and treatment strategies.     

Effectiveness of art-based distraction on reducing pediatric patients' pain and anxiety during venipuncture: A randomized controlled trial

BackgroundVenipuncture is a common procedure resulting in intense discomfort, anxiety, and pain in children. In this regard, we examined the effectiveness of a simple and practical art-based intervention on pain and anxiety in children who underwent venipuncture procedures.MethodIn this parallel randomized control trial, children aged 6–12 years were randomly allocated to either an intervention or a control group. The intervention group (n = 73) received an art-based intervention called Trace Image and Coloring for Kids-Book (TICK-B) during the venipuncture procedure compared to no intervention in the control group (n = 71). The children, their parents, and an observer nurse rated the outcomes 1–2 min after the venipuncture procedure was finished.FindingsThe patients in the intervention group had a substantially lower mean value of pain and anxiety—as rated by children, their parents, and an observer nurse—compared to the control patients. The average values of pain reported by the children, parents, and observer nurse were 3.50, 3.52, and 3.49 in the intervention group in contrast to 6.53, 6.59, and 6.45 in the control group (a large effect). Similarly, the patients in the intervention group had significantly lower mean values of anxiety compared to the control group: 0.88, 1.43, and 1.42 vs. 3.09, 2.52, and 2.52, respectively.ConclusionsThis study showed that TICK-B is an effective technique to reduce the levels of pain and anxiety in children undergoing venipuncture procedures.Practice implicationsThe TICK-B can be used easily by nurses to relieve the pain of children during venipuncture procedures.Trial registrationClinical Trial Registry, NCT04690257. Registered on December 30, 2020.     

Psychological and physiological stress: impact on preterm birth

Stress increases corticotropin-releasing hormone and may ultimately result in increased uterine contractility. Stress also increases cytokine production, which independently may lead to preterm birth or increase susceptibility to infection, thereby increasing the risk of preterm birth. Finally, stress may change health behaviors that lead to preterm birth. Research findings on the relationship between stress and preterm birth have been contradictory. In this article, the authors propose a model of the relationship between stress and preterm birth, evaluate the research on stress and pregnancy outcomes, and discuss the implications for nursing practice and research.     

超促排卵周期血清雌孕激素水平及比值与妊娠的关系

目的 :探讨超促排卵周期中血清雌、孕激素水平的变化及其比值与妊娠的关系。方法 :112例不孕患者经普通IVF -ET(包括ICSI)过程 ,于注射HCG日及移植后 5天 (对照组 15例于排卵前期及黄体中期 )测定血清雌、孕激素水平。结果 :IVF周期排卵前 (注HCG日 )E2 值、黄体期E2 、P值均显著高于自然周期。在IVF周期中 ,当排卵前期与黄体期E2 值之比介于 1～ 2及黄体期P/E2 值介于 10 0～ 40 0之间时 ,其临床妊娠率显著提高。结论 :在IVF周期中 ,黄体期与排卵前期E2 值保持一定比例 ,可能增加子宫内膜的容受性 ;而超促排卵周期适当地补充孕激素以调节P/E2 比值将有利于胚胎着床 ,提高妊娠率     

Suppression of luteal phase, but not midcycle, prolactin levels by chronic follicular phase opiate antagonism

Objective: To investigate whether establishment and maintenance of chronic opioid blockade throughout the follicular phase of the menstrual cycle influences midcycle and luteal phase prolactin levels.Design: Randomized, double-blind, crossover study.Setting: Academic research environment.Patient(s): Volunteers, aged 21–35 years, with regular menstrual cycles.Intervention(s): Naltrexone (50 mg) or placebo were administered on cycle days 2–14. Blood samples were obtained in the early follicular phase and in the periovulatory and midluteal phases of the menstrual cycle.Main Outcome Measure(s): Serum prolactin levels.Result(s): In the early follicular phase, serum prolactin levels were equivalent in naltrexone (12.0 ± 2.7 μg/L; mean ± SE) and placebo (12.1 ± 2.9 ug/L) cycles. A statistically significant increase in serum prolactin was observed on the day of the LH surge (naltrexone: 22.6 ± 3.7 μg/L; placebo: 21.7 ± 2.7 μg/L; P < 0.05 versus early follicular phase), but no difference between treatments was observed. However, midluteal prolactin levels were statistically significantly lower in naltrexone cycles compared with placebo cycles (12.6 ± 3.3 versus 15.4 ± 3.0 )ug/L; P < 0.05).Conclusion(s): Chronic blockade of opioid activities during the follicular phase does not affect midcycle prolactin increments, but withdrawal of opioid blockade may enhance opioid effects on prolactin levels in the luteal phase.     

雌激素替代疗法对绝经后妇女血浆一氧化氮的影响

目的探讨雌激素替代疗法（ＥＲＴ）对绝经后妇女血浆一氧化氮（ＮＯ）含量的影响。方法测定１７例健康绝经后妇女（健康组）,２１例患高血脂症绝经后妇女（高血脂组）应用ＥＲＴ前及应用ＥＲＴ４周后血浆ＮＯ及血清雌二醇（Ｅ２）含量,并与１０例健康绝经后妇女应用安慰剂（对照组）进行对照。结果对照组应用安慰剂前后,ＮＯ含量无变化;健康组及高血脂组应用ＥＲＴ后,ＮＯ含量明显升高,健康组升高尤其明显;健康组应用ＥＲＴ４周后Ｅ２水平与ＮＯ升高有明显相关性。结论绝经后妇女补充雌激素,可通过升高ＮＯ含量发挥其对心血管的保护作用。     

Serum testosterone, DHEAS, and prolactin levels in patients with a Bartholin’s abscess

This study examines Prolactin and Androgen concentrations in 15 women with a Bartholin's gland abscess and in 15 matched normal controls. The Dehydroepiandrosterone sulfate concentrations were higher in the Bartholin's abscess group as compared to the concentrations in the control group [7.0±3.1 mmol/l versus 4.3±1.3 mmol/l (p<0.05), respectively]. The Prolactin and the Testosterone levels did not differ statistically between the two groups. Received: 28 December 1995 / Accepted: 28 January 1997     

Effect of danazol on serum prolactin and cortisol levels

In order to investigate the effect of Danazol (D) on serum prolactin (PRL) and cortisol levels, D was given orally in a daily dose of 400 mg for 2 weeks to 4 women (400 mg group) and 600 mg to 5 women (600 mg group) at one month and more after menopause and oophorectomy. The blood samples were taken through an indwelling catheter into the cubital vein every 20 minutes for 2 hours before and after the administration of D. Serum hormone levels were determined by each specific RIA. In a comparison in each individual of mean hormone levels of 7 serum samples before and after D, (1) serum PRL levels were significantly lowered in 2 women after D of 400 mg (p less than 0.001) and in one woman after D of 600 mg (p less than 0.001), but increased in one woman after D of 600 mg (p less than 0.001), (2) serum cortisol levels were significantly lowered in one woman after D of 400 mg (p less than 0.01) and in 4 women after D of 600 mg (p less than 0.001). When the mean hormone levels in the 400 and 600 mg group (an average of the mean hormone levels of 7 samples in each group) were compared before and after D, (1) the mean serum PRL levels were not significantly affected by D in either group, (2) the mean serum cortisol levels were significantly lowered by D in the 600 mg group, but not in the 400 mg group. The present study demonstrated that serum PRL levels were not consistently affected by D in the condition without ovarian hormones, and serum cortisol levels were lowered after a relatively larger dose of D.     

Effect of Lisuride on serum prolactin levels during puerperium

A new semisynthetic ergot derivative, Lisuride, has been administered to 40 women who wanted to have lactation inhibited. Purpose of the study was to evaluate the drug's effect on serum PRL levels. Treatment was carried out for 7 days with daily doses of 300 or 600 microgram. Lisuride lowered PRL levels, and the decrease was significantly more marked for the 600 microgram dose.     

Postpartum evaluation of stress urinary incontinence among primiparas

Objective

To assess the prevalence of postpartum stress urinary incontinence (SUI); the relationship between postpartum SUI and mode of delivery; and the association between SUI and other obstetric factors.

Method

In this prospective study, 1000 primiparas with no history of UI were recruited and followed up for 4 months after delivery. The χ² and Fisher's Exact tests were used to calculate the effects of the nominal variables.

Result

The prevalence of postpartum SUI was 14.1%, and the mode of delivery was significantly associated with SUI. The prevalence rates were 15.9% after vaginal delivery, 10.7% after elective cesarean section (CS), and 25% after CS performed for obstructed labor. The prevalence of postpartum SUI was similar following spontaneous vaginal delivery and CS performed for obstructed labor (P = .21). Meanwhile, elective CS with no trial of labor was found to be associated with a significantly lower prevalence of postpartum SUI (P = .01; χ² = 12.42). A maternal body mass index greater than 30 before pregnancy and fetal weight higher than 3000 g appeared to be associated with an increased rate of SUI (P = .001; χ² = 17.6 and P = .000; χ² = 22.5, respectively).

Conclusion

Elective CS significantly reduced the rate of postpartum SUI.