Sven Skouby - Academia.edu (original) (raw)
Papers by Sven Skouby
Journal of Thrombosis and Haemostasis, 2006
ABSTRACT The use of oral contraceptives (OC) is known to influence a variety of biochemical compo... more ABSTRACT The use of oral contraceptives (OC) is known to influence a variety of biochemical components in human blood. Epidemiological studies have demonstrated that OC increase risk of thrombotic diseases. The risk of venous thrombosis is higher for OC preparations containing desogestrel or gestodene (third-generation progestogens) than for those containing levonorgestrel (second-generation progestogen).Studies of the effect of OC have shown that the concentration of pro-coagulatory and pro-fibrinolytic variables such as prothrombin and plasminogen is increased while the concentration of anticoagulatory and antifibrinolytic variables such as antithrombin and plasminogen activator inhibitor-1 is reduced by treatment with OC.We have used proteomics approach based on high-resolution 2-dimensional gel electrophoresis (2DGE) and mass spectrometry (MS) to study the influence of second and third-generation OC on plasma protein levels and modifications. Plasma samples from two groups of women (13 individuals in each group), one treated with second-generation OC and the other with third-generation OC were studied before initiation of the treatment and after 12 months use of OC.We have created a reference 2DGE proteome map of Sypro Ruby stained plasma proteins based on 6 IPG gel gradients (4.0-5.0, 4.5-5.5, 5.0-6.0, 5.5-6.7, 4.0-7.0 and 6.0-9.0). The gel images from the two patient groups have been analysed by ProteoMiner image analysis software. Protein markers were selected for MS analysis and have been cut out from non fixed wet preparative gels. The results show a number of individual differences between patients, but also clear differences that can be linked to the use of OCs.
Obstetrics and Gynecology
The carbohydrate metabolic status in 10 women with previous non-insulin-dependent diabetes in pre... more The carbohydrate metabolic status in 10 women with previous non-insulin-dependent diabetes in pregnancy and in 8 control subjects was evaluated prospectively during a 6-month treatment period with an oral contraceptive containing 30 micrograms ethinyl estradiol and 150 micrograms levonorgestrel. An oral glucose tolerance test was performed before treatment and after tablet intake for 2 and 6 months. At each test, plasma values of glucose, insulin, and glucagon were measured. Before treatment the non-insulin-dependent diabetic patients demonstrated significantly increased glucose values and decreased insulin values as compared with the values of the control subjects. During treatment they displayed a small but significant rise in plasma insulin values. The glucose tolerance, however, remained unaffected in both groups during the study period. No change in body weight or blood pressure was observed. The results indicate that hormonal contraception of the low dosage type may be administered to women with previously impaired glucose tolerance in pregnancy without any deterioration of the glucose metabolism post partum.
The Lancet
Had we considered the patients with increasingly severe migraine on the pill as a single group th... more Had we considered the patients with increasingly severe migraine on the pill as a single group the significant changes in platelet behaviour would have been overlooked. Our findings indicate that the pill can produce changes in platelet behaviour which are found in non-pill-taking migraine patients.
Journal of Thrombosis and Haemostasis, 2008
Fertility and Sterility
The metabolic effects of four oral contraceptives with different estrogen/progestogen profiles (m... more The metabolic effects of four oral contraceptives with different estrogen/progestogen profiles (monophasic nonalkylated estrogen/norethindrone, low-dose monophasic ethinyl estradiol (EE2)/norethindrone, progestogen only treatment with norethindrone, and triphasic EE2/levonorgestrel) were examined in insulin-dependent diabetic women. During the 6-month study period, no differences were found in fasting plasma glucose, 24-hour insulin requirements, glycated hemoglobin, free fatty acids, low-density lipoprotein cholesterol concentrations, or high-density lipoprotein cholesterol/total cholesterol ratio between the patients in each treatment group. Compared with the nonalkylated estrogen/norethindrone and the triphasic EE2/levonorgestrel formulations, the low-dose EE2/norethindrone combination resulted in small but significant increases in plasma triglyceride and very low-density lipoprotein cholesterol levels (P less than 0.01), which seemed unfavorable from a clinical point of view. Norethindrone-only treatment appeared to be an appropriate alternative to both the nonalkylated estrogen/norethindrone combination and the triphasic EE2/levonorgestrel formulations.
Obstetrics and Gynecology
The relationship between the deterioration of glucose tolerance and plasma prolactin (PRL) levels... more The relationship between the deterioration of glucose tolerance and plasma prolactin (PRL) levels was investigated in 15 normal pregnant women and in 15 women with gestational diabetes mellitus. Oral glucose tolerance tests were performed in late pregnancy and postpartum, and the insulin, glucagon, and PRL responses were measured. In late pregnancy the gestational diabetics revealed significantly elevated fasting glucose levels compared with the normal pregnant women and after the glucose challenge their insulin responses were significantly diminished and the suppression of glucagon less pronounced. These differences in glucose metabolism were markedly reduced early postpartum. There was no difference in basal PRL concentrations between the two groups neither in pregnancy nor postpartum. The PRL levels were not altered during the oral glucose tolerance tests and no correlation between the deterioration of glucose tolerance and the PRL concentrations could be demonstrated in either group. These results indicate that abnormal PRL levels are not of pathophysiologic importance for the development of gestational diabetes mellitus.
Fertility and Sterility
A study has been performed covering the clinical consequences of copper intrauterine device inser... more A study has been performed covering the clinical consequences of copper intrauterine device insertion in 103 insulin-dependent women and in 119 nondiabetic control subjects. Furthermore, the progress of corrosion has been measured in 15 intrauterine devices removed from diabetic women, and the results were compared with data obtained from nondiabetic women. The clinical data did not reveal any differences in the total continuation rates or in the removal rates because of accidental pregnancy or pelvic inflammation between the diabetic and the nondiabetic women after 3 and 12 months. Also, the maximal depth of corrosion as well as the distribution and the biochemical constitution of the corrosion products deposited on the copper wires were found identical in the two groups studied.
The European Journal of Contraception and Reproductive Health Care
International journal of fertility
The third generation of combination estrogen/progestogen oral contraceptives (OCs) first became a... more The third generation of combination estrogen/progestogen oral contraceptives (OCs) first became available in the early 1980s. The gonanes (e.g., norgestimate, desogestrel, and gestodene) are alternatives to the long-standing progestogens, norethindrone and norgestrel/levonorgestrel. While the newer compounds are related to levonorgestrel, their biochemical structure differs. All, however, are strongly progestogenic with respect to ovulation inhibition and are very selective in their affinity for endometrial progesterone receptors. At present, experience with the third-generation combined OCs is relatively limited, and extensive comparative data have yet to be accrued. Nevertheless, these ultra-low-dose compounds appear to be as efficacious as the traditional OCs, while their cycle control may be slightly superior. In addition, the incidence of minor side effects, such as nausea, weight gain, and mastalgia, compares favorably with that of the earlier OCs. In combination with estrogen, these new progestogens have revealed a neutral or possibly beneficial effect on lipid/lipoprotein metabolism. Thus, the newer progestogens do not appear to have adverse effects on the cardiovascular system and offer a range of noncontraceptive health benefits.
Ugeskrift for laeger
Development in oral contraceptives during the past 20 years has involved continued reduction in t... more Development in oral contraceptives during the past 20 years has involved continued reduction in the total quantity of hormone and alterations in the oestrogen/gestagen ratio and in the steroid structure for the gestagens employed. These changes have been undertaken primarily to counteract metabolic side effects and influence on the haemostatic system. Inhibition of the mechanism of ovulation is, however, also dependent on the steroid dosage and in cases where low-dosage oral contraception is employed, ultrasound investigations have demonstrated a risk of continued ripening of follicles during treatment. Correspondingly, hormone measurements during the pill-free week have demonstrated increase in the follicle-stimulating hormone, luteinizing hormone and the oestrogen concentration. The permissible margin of error in employing oral contraception has therefore diminished and is more dependent on the dosage and potency, particularly of gestagens. As the critical phase for failure of treatment is the first week of intake of oral contraceptives, it is important that treatment is commenced at the correct time not only at the commencement of treatment but also after the pill-free periods. If a pill is forgotten during the preovulatory oestrogen level and two pills are then taken, this may be interpreted by the organism as a positive oestrogen feed-back and, theoretically, this may result in increased gonadotropin production and thus further increase the risk of ovulation. In cases with the risk of malabsorption on account of gastro-intestinal disease and in cases with interaction with other medicaments, employment of alternative forms of contraception is recommended.(ABSTRACT TRUNCATED AT 250 WORDS)
Advances in Contraception
Obstetrics and Gynecology
ABSTRACT
Clinical and experimental obstetrics & gynecology
Fifty women with human papillomavirus (HPV)-induced abnormal cervical smears were randomly alloca... more Fifty women with human papillomavirus (HPV)-induced abnormal cervical smears were randomly allocated to either CO2-laser vaporization or routine control. The success rate at the 6 months check was 100% after laser treatment compared to that of 72% in the control group (p less than 0.05). Although longer follow-up is needed to fully establish the efficacy of the treatment, the method seems appropriate to this large group of women at risk of developing cervical intraepithelial neoplasia.
Diabetes
Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed fo... more Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed for on average 6 yr after the index pregnancy. Thirty percent had diabetes mellitus at the follow-up examination, and preliminary results indicate that at least another third will develop diabetes during a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels remained unchanged during a 6-mo treatment. However, insulin response to oral glucose increased significantly after hormonal intake for 6 mo. A triphasic preparation resulted in a significantly lower insulin response than a low-dose monophasic preparation. However, the results indicate that low-dose oral-contraceptive compounds appear to be safe for women with previous GDM when administered for limited periods. At the follow-up examination, we found no increased risk of developing diabetes in women with previous GDM who used oral contraception. We consider the intrauterine contraceptives (IUD) a safe and effective alternative for women with previous GDM. Of 154 women with GDM, 33% chose IUD, 22% a combination-type oral contraceptive, and 16% barrier methods as their first choice of contraception 2 mo postpartum. We conclude that family planning and qualified contraceptive advice are important in women with previous GDM.
Diabetes
Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed fo... more Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed for on average 6 yr after the index pregnancy. Thirty percent had diabetes mellitus at the follow-up examination, and preliminary results indicate that at least another third will develop diabetes during a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels remained unchanged during a 6-mo treatment. However, insulin response to oral glucose increased significantly after hormonal intake for 6 mo. A triphasic preparation resulted in a significantly lower insulin response than a low-dose monophasic preparation. However, the results indicate that low-dose oral-contraceptive compounds appear to be safe for women with previous GDM when administered for limited periods. At the follow-up examination, we found no increased risk of developing diabetes in women with previous GDM who used oral contraception. We consider the intrauterine contraceptives (IUD) a safe and effective alternative for women with previous GDM. Of 154 women with GDM, 33% chose IUD, 22% a combination-type oral contraceptive, and 16% barrier methods as their first choice of contraception 2 mo postpartum. We conclude that family planning and qualified contraceptive advice are important in women with previous GDM.
Ugeskrift for laeger
Thirty-four healthy young women were allocated to 12 consecutive cycles of treatment with monopha... more Thirty-four healthy young women were allocated to 12 consecutive cycles of treatment with monophasic combinations of: 20 micrograms ethinyl estradiol and 150 micrograms desogestrel (n = 15) or 30 micrograms ethinyl estradiol and 75 micrograms gestodene (n = 19). In both groups plasma levels of fibrinogen and factor VII increased while the capacity of coagulation inhibition was affected by increased protein C and decreased protein S levels. Increased fibrinolytic capacity was indicated by elevated activity and reduced antigen levels of tissue plasminogen activator and reduced activity and concentration of tissue plasminogen activator inhibitor. The ratio between thrombin-antithrombin-III-complexes and fibrin degradation products were unchanged signifying no effect of hormonal intake on the balance between thrombin formation and fibrin resolution. In conclusion, the dynamic balance between generation and resolution of fibrin was undisturbed during treatment with both hormonal compounds and our findings do not provide evidence for increased risk of thrombosis in normal women.
Ugeskrift for laeger
Thirty-four healthy young women were allocated to 12 consecutive cycles of treatment with monopha... more Thirty-four healthy young women were allocated to 12 consecutive cycles of treatment with monophasic combinations of: 20 micrograms ethinyl estradiol and 150 micrograms desogestrel (n = 15) or 30 micrograms ethinyl estradiol and 75 micrograms gestodene (n = 19). In both groups plasma levels of fibrinogen and factor VII increased while the capacity of coagulation inhibition was affected by increased protein C and decreased protein S levels. Increased fibrinolytic capacity was indicated by elevated activity and reduced antigen levels of tissue plasminogen activator and reduced activity and concentration of tissue plasminogen activator inhibitor. The ratio between thrombin-antithrombin-III-complexes and fibrin degradation products were unchanged signifying no effect of hormonal intake on the balance between thrombin formation and fibrin resolution. In conclusion, the dynamic balance between generation and resolution of fibrin was undisturbed during treatment with both hormonal compounds and our findings do not provide evidence for increased risk of thrombosis in normal women.
Journal of Thrombosis and Haemostasis, 2006
ABSTRACT The use of oral contraceptives (OC) is known to influence a variety of biochemical compo... more ABSTRACT The use of oral contraceptives (OC) is known to influence a variety of biochemical components in human blood. Epidemiological studies have demonstrated that OC increase risk of thrombotic diseases. The risk of venous thrombosis is higher for OC preparations containing desogestrel or gestodene (third-generation progestogens) than for those containing levonorgestrel (second-generation progestogen).Studies of the effect of OC have shown that the concentration of pro-coagulatory and pro-fibrinolytic variables such as prothrombin and plasminogen is increased while the concentration of anticoagulatory and antifibrinolytic variables such as antithrombin and plasminogen activator inhibitor-1 is reduced by treatment with OC.We have used proteomics approach based on high-resolution 2-dimensional gel electrophoresis (2DGE) and mass spectrometry (MS) to study the influence of second and third-generation OC on plasma protein levels and modifications. Plasma samples from two groups of women (13 individuals in each group), one treated with second-generation OC and the other with third-generation OC were studied before initiation of the treatment and after 12 months use of OC.We have created a reference 2DGE proteome map of Sypro Ruby stained plasma proteins based on 6 IPG gel gradients (4.0-5.0, 4.5-5.5, 5.0-6.0, 5.5-6.7, 4.0-7.0 and 6.0-9.0). The gel images from the two patient groups have been analysed by ProteoMiner image analysis software. Protein markers were selected for MS analysis and have been cut out from non fixed wet preparative gels. The results show a number of individual differences between patients, but also clear differences that can be linked to the use of OCs.
Obstetrics and Gynecology
The carbohydrate metabolic status in 10 women with previous non-insulin-dependent diabetes in pre... more The carbohydrate metabolic status in 10 women with previous non-insulin-dependent diabetes in pregnancy and in 8 control subjects was evaluated prospectively during a 6-month treatment period with an oral contraceptive containing 30 micrograms ethinyl estradiol and 150 micrograms levonorgestrel. An oral glucose tolerance test was performed before treatment and after tablet intake for 2 and 6 months. At each test, plasma values of glucose, insulin, and glucagon were measured. Before treatment the non-insulin-dependent diabetic patients demonstrated significantly increased glucose values and decreased insulin values as compared with the values of the control subjects. During treatment they displayed a small but significant rise in plasma insulin values. The glucose tolerance, however, remained unaffected in both groups during the study period. No change in body weight or blood pressure was observed. The results indicate that hormonal contraception of the low dosage type may be administered to women with previously impaired glucose tolerance in pregnancy without any deterioration of the glucose metabolism post partum.
The Lancet
Had we considered the patients with increasingly severe migraine on the pill as a single group th... more Had we considered the patients with increasingly severe migraine on the pill as a single group the significant changes in platelet behaviour would have been overlooked. Our findings indicate that the pill can produce changes in platelet behaviour which are found in non-pill-taking migraine patients.
Journal of Thrombosis and Haemostasis, 2008
Fertility and Sterility
The metabolic effects of four oral contraceptives with different estrogen/progestogen profiles (m... more The metabolic effects of four oral contraceptives with different estrogen/progestogen profiles (monophasic nonalkylated estrogen/norethindrone, low-dose monophasic ethinyl estradiol (EE2)/norethindrone, progestogen only treatment with norethindrone, and triphasic EE2/levonorgestrel) were examined in insulin-dependent diabetic women. During the 6-month study period, no differences were found in fasting plasma glucose, 24-hour insulin requirements, glycated hemoglobin, free fatty acids, low-density lipoprotein cholesterol concentrations, or high-density lipoprotein cholesterol/total cholesterol ratio between the patients in each treatment group. Compared with the nonalkylated estrogen/norethindrone and the triphasic EE2/levonorgestrel formulations, the low-dose EE2/norethindrone combination resulted in small but significant increases in plasma triglyceride and very low-density lipoprotein cholesterol levels (P less than 0.01), which seemed unfavorable from a clinical point of view. Norethindrone-only treatment appeared to be an appropriate alternative to both the nonalkylated estrogen/norethindrone combination and the triphasic EE2/levonorgestrel formulations.
Obstetrics and Gynecology
The relationship between the deterioration of glucose tolerance and plasma prolactin (PRL) levels... more The relationship between the deterioration of glucose tolerance and plasma prolactin (PRL) levels was investigated in 15 normal pregnant women and in 15 women with gestational diabetes mellitus. Oral glucose tolerance tests were performed in late pregnancy and postpartum, and the insulin, glucagon, and PRL responses were measured. In late pregnancy the gestational diabetics revealed significantly elevated fasting glucose levels compared with the normal pregnant women and after the glucose challenge their insulin responses were significantly diminished and the suppression of glucagon less pronounced. These differences in glucose metabolism were markedly reduced early postpartum. There was no difference in basal PRL concentrations between the two groups neither in pregnancy nor postpartum. The PRL levels were not altered during the oral glucose tolerance tests and no correlation between the deterioration of glucose tolerance and the PRL concentrations could be demonstrated in either group. These results indicate that abnormal PRL levels are not of pathophysiologic importance for the development of gestational diabetes mellitus.
Fertility and Sterility
A study has been performed covering the clinical consequences of copper intrauterine device inser... more A study has been performed covering the clinical consequences of copper intrauterine device insertion in 103 insulin-dependent women and in 119 nondiabetic control subjects. Furthermore, the progress of corrosion has been measured in 15 intrauterine devices removed from diabetic women, and the results were compared with data obtained from nondiabetic women. The clinical data did not reveal any differences in the total continuation rates or in the removal rates because of accidental pregnancy or pelvic inflammation between the diabetic and the nondiabetic women after 3 and 12 months. Also, the maximal depth of corrosion as well as the distribution and the biochemical constitution of the corrosion products deposited on the copper wires were found identical in the two groups studied.
The European Journal of Contraception and Reproductive Health Care
International journal of fertility
The third generation of combination estrogen/progestogen oral contraceptives (OCs) first became a... more The third generation of combination estrogen/progestogen oral contraceptives (OCs) first became available in the early 1980s. The gonanes (e.g., norgestimate, desogestrel, and gestodene) are alternatives to the long-standing progestogens, norethindrone and norgestrel/levonorgestrel. While the newer compounds are related to levonorgestrel, their biochemical structure differs. All, however, are strongly progestogenic with respect to ovulation inhibition and are very selective in their affinity for endometrial progesterone receptors. At present, experience with the third-generation combined OCs is relatively limited, and extensive comparative data have yet to be accrued. Nevertheless, these ultra-low-dose compounds appear to be as efficacious as the traditional OCs, while their cycle control may be slightly superior. In addition, the incidence of minor side effects, such as nausea, weight gain, and mastalgia, compares favorably with that of the earlier OCs. In combination with estrogen, these new progestogens have revealed a neutral or possibly beneficial effect on lipid/lipoprotein metabolism. Thus, the newer progestogens do not appear to have adverse effects on the cardiovascular system and offer a range of noncontraceptive health benefits.
Ugeskrift for laeger
Development in oral contraceptives during the past 20 years has involved continued reduction in t... more Development in oral contraceptives during the past 20 years has involved continued reduction in the total quantity of hormone and alterations in the oestrogen/gestagen ratio and in the steroid structure for the gestagens employed. These changes have been undertaken primarily to counteract metabolic side effects and influence on the haemostatic system. Inhibition of the mechanism of ovulation is, however, also dependent on the steroid dosage and in cases where low-dosage oral contraception is employed, ultrasound investigations have demonstrated a risk of continued ripening of follicles during treatment. Correspondingly, hormone measurements during the pill-free week have demonstrated increase in the follicle-stimulating hormone, luteinizing hormone and the oestrogen concentration. The permissible margin of error in employing oral contraception has therefore diminished and is more dependent on the dosage and potency, particularly of gestagens. As the critical phase for failure of treatment is the first week of intake of oral contraceptives, it is important that treatment is commenced at the correct time not only at the commencement of treatment but also after the pill-free periods. If a pill is forgotten during the preovulatory oestrogen level and two pills are then taken, this may be interpreted by the organism as a positive oestrogen feed-back and, theoretically, this may result in increased gonadotropin production and thus further increase the risk of ovulation. In cases with the risk of malabsorption on account of gastro-intestinal disease and in cases with interaction with other medicaments, employment of alternative forms of contraception is recommended.(ABSTRACT TRUNCATED AT 250 WORDS)
Advances in Contraception
Obstetrics and Gynecology
ABSTRACT
Clinical and experimental obstetrics & gynecology
Fifty women with human papillomavirus (HPV)-induced abnormal cervical smears were randomly alloca... more Fifty women with human papillomavirus (HPV)-induced abnormal cervical smears were randomly allocated to either CO2-laser vaporization or routine control. The success rate at the 6 months check was 100% after laser treatment compared to that of 72% in the control group (p less than 0.05). Although longer follow-up is needed to fully establish the efficacy of the treatment, the method seems appropriate to this large group of women at risk of developing cervical intraepithelial neoplasia.
Diabetes
Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed fo... more Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed for on average 6 yr after the index pregnancy. Thirty percent had diabetes mellitus at the follow-up examination, and preliminary results indicate that at least another third will develop diabetes during a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels remained unchanged during a 6-mo treatment. However, insulin response to oral glucose increased significantly after hormonal intake for 6 mo. A triphasic preparation resulted in a significantly lower insulin response than a low-dose monophasic preparation. However, the results indicate that low-dose oral-contraceptive compounds appear to be safe for women with previous GDM when administered for limited periods. At the follow-up examination, we found no increased risk of developing diabetes in women with previous GDM who used oral contraception. We consider the intrauterine contraceptives (IUD) a safe and effective alternative for women with previous GDM. Of 154 women with GDM, 33% chose IUD, 22% a combination-type oral contraceptive, and 16% barrier methods as their first choice of contraception 2 mo postpartum. We conclude that family planning and qualified contraceptive advice are important in women with previous GDM.
Diabetes
Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed fo... more Women with gestational diabetes mellitus (GDM) diagnosed in the period 1978-1984 were followed for on average 6 yr after the index pregnancy. Thirty percent had diabetes mellitus at the follow-up examination, and preliminary results indicate that at least another third will develop diabetes during a subsequent pregnancy. Therefore, family planning and contraceptive guidance should follow the lines for women with pregestational diabetes. When low-dose hormonal contraceptives containing ethinyl estradiol and levonorgestrel were given to women with previous GDM, glucose tolerance and lipoprotein levels remained unchanged during a 6-mo treatment. However, insulin response to oral glucose increased significantly after hormonal intake for 6 mo. A triphasic preparation resulted in a significantly lower insulin response than a low-dose monophasic preparation. However, the results indicate that low-dose oral-contraceptive compounds appear to be safe for women with previous GDM when administered for limited periods. At the follow-up examination, we found no increased risk of developing diabetes in women with previous GDM who used oral contraception. We consider the intrauterine contraceptives (IUD) a safe and effective alternative for women with previous GDM. Of 154 women with GDM, 33% chose IUD, 22% a combination-type oral contraceptive, and 16% barrier methods as their first choice of contraception 2 mo postpartum. We conclude that family planning and qualified contraceptive advice are important in women with previous GDM.
Ugeskrift for laeger
Thirty-four healthy young women were allocated to 12 consecutive cycles of treatment with monopha... more Thirty-four healthy young women were allocated to 12 consecutive cycles of treatment with monophasic combinations of: 20 micrograms ethinyl estradiol and 150 micrograms desogestrel (n = 15) or 30 micrograms ethinyl estradiol and 75 micrograms gestodene (n = 19). In both groups plasma levels of fibrinogen and factor VII increased while the capacity of coagulation inhibition was affected by increased protein C and decreased protein S levels. Increased fibrinolytic capacity was indicated by elevated activity and reduced antigen levels of tissue plasminogen activator and reduced activity and concentration of tissue plasminogen activator inhibitor. The ratio between thrombin-antithrombin-III-complexes and fibrin degradation products were unchanged signifying no effect of hormonal intake on the balance between thrombin formation and fibrin resolution. In conclusion, the dynamic balance between generation and resolution of fibrin was undisturbed during treatment with both hormonal compounds and our findings do not provide evidence for increased risk of thrombosis in normal women.
Ugeskrift for laeger
Thirty-four healthy young women were allocated to 12 consecutive cycles of treatment with monopha... more Thirty-four healthy young women were allocated to 12 consecutive cycles of treatment with monophasic combinations of: 20 micrograms ethinyl estradiol and 150 micrograms desogestrel (n = 15) or 30 micrograms ethinyl estradiol and 75 micrograms gestodene (n = 19). In both groups plasma levels of fibrinogen and factor VII increased while the capacity of coagulation inhibition was affected by increased protein C and decreased protein S levels. Increased fibrinolytic capacity was indicated by elevated activity and reduced antigen levels of tissue plasminogen activator and reduced activity and concentration of tissue plasminogen activator inhibitor. The ratio between thrombin-antithrombin-III-complexes and fibrin degradation products were unchanged signifying no effect of hormonal intake on the balance between thrombin formation and fibrin resolution. In conclusion, the dynamic balance between generation and resolution of fibrin was undisturbed during treatment with both hormonal compounds and our findings do not provide evidence for increased risk of thrombosis in normal women.