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Introduction: In Denmark most IUDs are inserted by general practitioners (GPs). The aim of this study was to throw light on which women choose IUD, the procedure used, and difficulties associated with insertion., Material and Methods: All 232 GPs in Frederiksborg County were invited to participate and 88 agreed. The GP filled in a questionnaire concerning the type of IUD, the age, parity, etc, of the woman and information about the insertion., Results: Eighty-eight GPs contributed with 562 IUD insertions. IUD was mostly used by women above 25 years of age and by women who had given birth to a child. There were no differences in the insertion procedures used by the doctors. Fifty-nine per cent of the women were previous IUD users. Of the former users, 37% reported problems with the previous use of the IUD. Twenty-five per cent of the women in this study reported that they had had heavy or long-lasting menstruation before insertion. Fifty-five per cent of the women had a test for chlamydia before insertion. Twenty-three (4.1%) insertions were abandoned. 26 (4.6%) insertions were described as difficult. The highest frequency was in women using gestagen-releasing IUDs., Conclusion: IUD was mainly used by women, who had given birth to a child. The gestagen releasing IUD was mostly used by the elder group and by women with heavy bleedings before insertion. The procedure was very identical and the number of abandoned and difficult insertions were low and only related to the type of IUD. More female than male doctors participated. Doctors working in partnerships participated more frequently than doctors working alone.

Background: To describe the prevalence of women using systemic hormone replacement therapy in various age groups. To identify their reasons for choosing or not choosing the therapy, reasons for discontinuing the treatment, the prevalence of side effects among current users, and to estimate the duration of treatment., Methods: The study is based on postal questionnaires sent to 23,000 female Danish nurses above the age of 44 years. Out of these 19,953 (86%) responded. The questionnaire gave information on age, use of hormone replacement therapy, use of oral contraceptives, family predisposition and diseases. Duration of hormone replacement therapy was calculated by Cox regression analysis. Chi square tests were used to evaluate differences and 5% was used as the level of significance., Results: Overall, 6673 (33%) had ever used hormone replacement therapy. The prevalence was highest in the age group 55-59, where 29.3% were currently using hormones. The most cited reasons for choosing hormone replacement therapy were vasomotor symptoms (62%) and prevention of osteoporosis (44%). Among never users 43% had not experienced climacteric symptoms, 24% found the therapy unnatural, and 22% were afraid of side effects. It was estimated that 70% still were using hormones five years after the start of therapy, 57% after ten years, and 48% after fifteen years. Women with a family history of osteoporosis used hormones longer than women without this predisposition., Conclusions: One third of all the women had ever used hormone replacement therapy and more than half of ever users used the therapy for more than ten years.

Objective: Our purpose was to examine the effects of postmenopausal estrogen therapy supplemented with progestogen on plasma lipoprotein levels., Study Design: One hundred thirteen women were randomized to receive either placebo or a combination of 17 beta-estradiol and norethindrone acetate administered continuously (Kliogest) or sequentially (Trisequens). Plasma lipoprotein levels were measured at baseline and after 2 years of treatment and compared by analysis of variance., Results: Hormone therapy lowered plasma cholesterol levels (p < 0.001) and low-density lipoprotein cholesterol (Kiogest, p < 0.001; Trisequens, p < 0.01), whereas high-density lipoprotein cholesterol levels were unchanged (Trisequens) or reduced (Kliogest, p < 0.01), primarily because of a decrease in the high-density lipoprotein-2 subfraction (p < 0.05). Low-density lipoprotein/high-density lipoprotein cholesterol ratios remained unchanged., Conclusions: Although hormonal replacement therapy with estradiol combined with norethindrone acetate eliminated the increase in high-density lipoprotein cholesterol levels observed with estrogen monotherapy, the reductions in low-density lipoprotein cholesterol concentrations still suggest reduced cardiovascular risk, according to the National Cholesterol Education Program and to recent observations indicating that risk is not necessarily inversely proportional to high-density lipoprotein cholesterol levels.

The complications of pregnancy and delivery in a material consisting of 841 women without obstetric risk factors were investigated. The deliveries were planned to take place in a department of general surgery with a specialist obstetrician. Seventy-five women (8.9%) were transferred to a specialized obstetric department before delivery, 14 women (1.7%) because of imminent premature delivery. In addition, 69 women were transferred because of removal or their own wish for transfer. A total of 631 patients (90.5%) were delivered vaginally and 66 (9.5%) were delivered abdominally. In thirty-five of these, caesarean sections were performed during the course of delivery. In 34 deliveries (5.1%) vacuo extraction was used. Among 181 women (27.1%), unexpected complications occurred, 80 of these women (12.0%) requiring emergency treatment. A total of 697 infants were delivered. One infant died before delivery because of placental separation. Twenty-two infants (3.2%) were transferred to a paediatric department during the neonatal period, three because of asphyxia. Three of the liveborn infants (0.4%) had Apgar scores at 1 minute between 0 and 3, 40 infants (5.7%) had scores between 4 and 6. After 5 minutes, no infants had Apgar scores between 0 and 3, but three infants had scores between 4 and 6. It is concluded, that the low perinatal mortality and morbidity might indicate, that deliveries in a department of general surgery are safe, provided a specialist obstetrician is available and the rules of referral strictly observed.

Over a 2-month period a register was kept of all dilatation and curettage procedures performed in Frederiksborg County, Denmark, involving women aged 40-59 years. The total recorded was 284. In the same period, questionnaires were sent out to 1200 women in the county who fell within the same, randomly selected age group, to establish the number of women treated with sequential oestrogen/progestogen and those who had been hysterectomized. Based on the results and the total female population in the county, it was calculated that the frequency of the procedure in sequentially-treated women as compared with untreated women was 3.1 times higher in the 55-59 age group. In the 40-54 age group no difference in the incidence of curettage in the sequentially-treated women could be demonstrated.

Fifty-five women aged 21-51 years were treated in 1977 and 1978 with cryocoagulation (single-freezing technique) for cervical intraepithelial neoplasia (CIN I-III). 92% of these patients were followed up 7-8 years after this treatment. The primary success rate i.e. the proportion between the number of women in whom dysplastic changes were not re-encountered within the first 15 months after treatment and the total number of women treated was 94.5%. After the period of observation of 7-8 years, the success rate was 100% for CIN I + II and 79.5% for CIN III.

Feto-placental function was assessed by 24-hour excretion of estrogen in urine and by the concentration of human Placental Lactogen (hPL) in serum in pregnant women whose previous pregnancy was terminated by legally induced abortion. The mean 24-hour excretion of estrogens in urine and the mean concentration of hPL in serum were no lower in this group than in women without previous induced abortion. Neither was the frequency of a low 24-hour excretion of estrogens in urine or low concentration of hPL in serum (values less than mean - 1.96 s) found to be increased. This study could not demonstrate an increased frequency of dysfunction of the feto-placental unit during the last part of pregnancy in women with previous legally induced abortion. These findings indicate that legal abortion does not seem to increase the frequency of retarded intrauterine growth in a subsequent pregnancy.

Using the registration of all pregnant women living within a particular geographical district of Copenhagen the risk of spontaneous abortion has been calculated by means of a decremental method. A total of 3,042 pregnancies were registered and the total risk of spontaneous abortion was calculated at 10 per cent. In 431 women the previous pregnancy had been terminated by a legally induced abortion. Increased risk of spontaneous abortion could not be demonstrated in this group, where the cumulative risk of spontaneous abortion was 12 per cent. In particular, the risk of late abortion was not seen to increase.

With the purpose of elucidating the characteristics in patients with cancer of the ovary who have survived 10 years compared with patients who have not survived 10 years, 161 patients with epithelial cancer and 15 patients with granulosa cell tumor who have survived 10 years, group A, have been compared with 157 patients with epithelial cancer and 14 patients with granulosa cell tumor, who have not survived 10 years, group B. The study showed that among epithelial tumors the stage of tumor and the histological picture in the form of "low potential malignance" or adenocarcinoma was of decisive importance for 10 years survival. No correlation between information such as age, marital status, profession, duration of symptoms, and the nature of symptoms and 10 years survival could be found in patients with tumor in stages I and II. Neither could the gynaecological examination, the nature of the surgical treatment nor radiation therapy be correlated with 10 years survival in stages I and II. 32 of the 152 patients with epithelial cancer in stages I and II, who have survived 10 years, have either died from their ovarian disease or have later on developed cancer localized to cervix ro corpus uteri. The author points out the risk of not removing both ovaries as well as the uterus and recommends that such patients are followed for many years after the treatment. In 29 patients with granulosa cell tumor neither the medical history, the stage of the tumor nor the treatment could be correlated with 10 years survival.

The purpose of this study was to demonstrate if decreased fertility could be shown in women whose previous pregnancy had been terminated by a legally induced abortion. In 7 270 pregnant women fertility was measured as the time elapsed from the couple started sexual intercourse without using contraception to the present pregnancy. This interval was called "the latent period" and fertility was defined as reduced if it was longer than one year. In women whose previous pregnancy had been terminated by legally induced abortion subsequent decreased fertility could not be shown when compared with women whose previous pregnancy had ended in a live birth, the frequency of a latent period longer than one year not differing between these groups. When induced abortion had been complicated by pelvic inflammatory disease the frequency of a latent period more than one year was found to be higher than in women without this complication.

Outcome of pregnancy after amniocentesis was studied in a randomised controlled trial of 4606 women, age-range 25-34 years, without known risk of genetic disease. Spontaneous abortion rate was 1.7% in the study group after amniocentesis and 0.7% in the control group after ultrasound (relative risk 2.3). In the study group, increased levels of maternal serum alpha-fetoprotein before amniocentesis, perforation of the placenta during amniocentesis, and withdrawal of discoloured amniotic fluid were associated with an increased risk of spontaneous abortion. In the first six weeks after amniocentesis/ultrasound scan, amniotic fluid leakage occurred more often in the study group but there was no difference in the rate of vaginal bleeding. Frequency of postural malformations in the infants in the two groups was the same. In the study group, respiratory distress syndrome was diagnosed more often (relative risk 2.1) and more babies were treated for pneumonia (relative risk 2.5).