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哺乳期卵巢功能的恢复。

The recovery of ovarian function during breast-feeding.

作者信息

Shaaban M M, Sayed G H, Ghaneimah S A

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt.

出版信息

J Steroid Biochem. 1987;27(4-6):1043-52. doi: 10.1016/0022-4731(87)90188-9.

Abstract

The pattern of breast-feeding was daily recorded and the serum concentrations of prolactin (PRL), FSH, LH, estradiol (E2) and progesterone (prog) were measured at weekly intervals in 26 breast-feeding mothers from the time of delivery and up to the resumption of regular ovulation or to the end of the first postpartum year. Twelve postpartum non-breast-feeding women were similarly studied as controls. An algorithm was used to characterize ovulatory events into three types: the first, with evidence highly suggestive of normal ovulation (EHSO), the second, with evidence of probable ovulation (EPO) and the third with evidence indicating questionable ovulation or deficient corpus luteum function (QO/DCT). Pregnancy preceded the first menstruation in one woman in each of the breast-feeding and control groups. Of the 19 breast-feeding women who started to menstruate during the first postpartum year, five had EHSO, one had EPO, 5 had EQO/DCL and 7 had anovulatory (AO) menstruation. The corresponding figures in the 11 controls were 6, 2, 3 and 0. Pregnancy occurred before a second menstruation in one woman in both the study group and the controls. In 18 breast-feeding women observed, the second menstruation was preceded by EHSO in 7, by EPO in 3, by EQO/DCL in one and AO in 7. In 10 controls the corresponding figures were 7, 3, 0 and 0. Out of a total of 79 menstruations observed during breast-feeding the incidence of AO was 30% and of QO/DCL was 15%. In actively breast-feeding mothers, hyperprolactinemia persisted for more than 1 yr. However, menstruation and ovulation occasionally occurred before the drop of PRL to concentrations seen during the normal menstrual cycle. In the majority of women, low E2 levels were present during lactational amenorrhea, but with occasional spikes in some. A few women maintained somewhat high values of E2 for several weeks before the resumption of menstruation. The implications of these hormonal findings to the attempts to improve on the contraceptive effect of breast-feeding are discussed.

摘要

每天记录母乳喂养模式,并对26名母乳喂养母亲从分娩时起直至恢复正常排卵或产后第一年末,每周测量一次血清催乳素(PRL)、促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)和孕酮(prog)的浓度。12名产后非母乳喂养女性作为对照进行了类似研究。使用一种算法将排卵事件分为三种类型:第一种,有高度提示正常排卵的证据(EHSO);第二种,有可能排卵的证据(EPO);第三种,有表明可疑排卵或黄体功能不足的证据(QO/DCT)。母乳喂养组和对照组各有一名女性在首次月经前怀孕。在产后第一年内开始月经的19名母乳喂养女性中,5名有EHSO,1名有EPO,5名有EQO/DCL,7名有无排卵性(AO)月经。11名对照组中的相应数字分别为6、2、3和0。研究组和对照组各有一名女性在第二次月经前怀孕。在观察的18名母乳喂养女性中,第二次月经前有7名是EHSO,3名是EPO,1名是EQO/DCL,7名是AO。10名对照组中的相应数字分别为7、3、0和0。在母乳喂养期间观察到的总共79次月经中,AO的发生率为30%,QO/DCL的发生率为15%。在积极母乳喂养的母亲中,高催乳素血症持续超过1年。然而,月经和排卵偶尔会在PRL降至正常月经周期水平之前发生。在大多数女性中,哺乳期闭经期间E2水平较低,但有些女性偶尔会出现峰值。少数女性在恢复月经前几周E2值保持在较高水平。讨论了这些激素研究结果对提高母乳喂养避孕效果的尝试的影响。

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