Morishita H, Higuchi K, Nakago K, Hashimoto T, Mitani H, Mori T, Oshima I
Nihon Sanka Fujinka Gakkai Zasshi. 1983 Jul;35(7):939-46.
Hypothalamic-pituitary-ovarian function in women during the first month postpartum has been studied. The plasma LH-RH level in puerperal women was very low on days 5 and 10 postpartum and thereafter increased, but was still significantly lower on day 30 postpartum than that in eumenorrheic women on day 8 or 9 of the normal cycle. Serum FSH reached a very low level on days 5 and 11 postpartum, then gradually increased to a slightly higher level on day 30 postpartum than that in eumenorrheic women. The serum estradiol level fell immediately after delivery and remained low until day 30 postpartum. No response of serum FSH or LH to LH-RH was found on day 11 postpartum. However, daily injections of LH-RH from days 5 through 10 postpartum caused an increased secretion in FSH on day 11 postpartum, both basally and in response to LH-RH. On day 20 postpartum, serum FSH responded excessively to LH-RH in all women, but the response in serum LH was restored in a half of them. The mean basal level of serum FSH was significantly higher in cases demonstrating the response in serum FSH and LH than that in cases demonstrating the response in only serum FSH. Serum FSH and LH showed excess and normal responses respectively to LH-RH on day 30 postpartum. It is concluded that hypothalamic secretion of LH-RH decreases during the first month postpartum, especially for the first 10 days, and the low basal level of serum FSH and unresponsiveness of the pituitary to LH-RH observed in the early puerperium may result from hypothalamic hypofunction.
对产后第一个月女性的下丘脑 - 垂体 - 卵巢功能进行了研究。产后第5天和第10天,产后女性的血浆促黄体生成素释放激素(LH - RH)水平非常低,此后升高,但产后第30天仍显著低于正常周期第8天或第9天的月经正常女性。血清促卵泡生成素(FSH)在产后第5天和第11天降至非常低的水平,然后逐渐升高,产后第30天略高于月经正常女性。血清雌二醇水平在分娩后立即下降,并一直保持低水平直至产后第30天。产后第11天未发现血清FSH或LH对LH - RH有反应。然而,产后第5天至第10天每天注射LH - RH可使产后第11天的FSH基础分泌及对LH - RH的反应性增加。产后第20天,所有女性的血清FSH对LH - RH反应过度,但其中一半女性的血清LH反应恢复正常。血清FSH和LH均有反应的病例中,血清FSH的平均基础水平显著高于仅血清FSH有反应的病例。产后第30天,血清FSH和LH分别对LH - RH表现为过度反应和正常反应。结论是,产后第一个月,尤其是前10天,下丘脑促黄体生成素释放激素(LH - RH)分泌减少,产褥早期观察到的血清FSH基础水平低及垂体对LH - RH无反应可能是下丘脑功能减退所致。