Objective: To investigate the expression of the P450c17 gene in postmenopausal human ovaries compared with normal cycling ovaries.Design: Prospective nonrandomized clinical research study.Setting: Servei de Medicina Reproductiva and Centre d'Investigacions en Bioquimica i Biologia Molecular, Hospitals Vall d'Hebron, Barcelona, Spain.Patient(s): Six premenopausal women and four postmenopausal women undergoing bilateral oophorectomy for nonovarian gynecologic disease.Intervention(s): Extraction of 10 mL of peripheral venous blood for hormone measurements. Extraction of RNA from surgically removed ovaries for Northern blot, ribonuclease protection, and reverse transcriptase polymerase chain reaction Southern blot assays.Main Outcome Measure(s): Definition of the reproductive cycle state of each patient and determination of the level of P450c17 gene expression in all samples with the use of the semiquantitative reverse transcriptase polymerase chain reaction Southern blot assay.Result(s): P450c17 messenger RNA levels in postmenopausal ovaries varied considerably between samples. Although the levels were similar to those detected in the early follicular phase. one of the samples had levels as high as those observed in the late follicular phase.Conclusion(s): Although the degree Varied from one sample to another, all the postmenopausal ovaries studied expressed the P450c17 gene at the messenger RNA level. In a sample from a patient with endometrial adenocarcinoma. the level was as high as the levels observed in che lute follicular phase. (Fertil Steril(R) 1999; 71:528-35. (C) 1999 by American Society Reproductive Medicine.)

This paper presents the results of a review of seven ovarian pregnancies occurring during an 11 year period (1976-1986). The prevalence of the disease is higher than that expected either for the number of deliveries or for all ectopic pregnancies. The presence of etiological factors such as pelvic inflammatory disease, previous abdominal surgery, endometriosis or use of IUD, is considered. Four of these cases presented in actual users of IUD and one in an infertile woman previously diagnosed of endometriosis. The clinical pattern was similar to that recorded for tubal ectopic pregnancies. The role of IUDs and other risk factors in the apparent increase in the number of ectopic pregnancies detected is discussed. Measures to increase accuracy in the detection of early ovarian pregnancies are proposed.

Ever today diabetes and pregnancy constitute a high risk situation of the mother as well for the fetus, since still high maternal-fetal mortality rates are observed. A series of 134 diabetic women (99 type A, 15 type B, and 20 type C) were evaluated during pregnancy and delivery, and the results obtained during two different periods of time (1972-1975 and 1976-1978) are analyzed. From the results obtained the reduction of the indexes of perinatal mortality (before and after birth) stands out. These facts could probably be related to a change in the protocol applied during the last years and consisting in the administration of a carbohydrate supplement at night in order to avoid nocturnal hypoglycemias, admission of patients after the 32nd-34th week of pregnancy, complete rest in bed, control of the maturity of the fetus, etc. Likewise, there was a lack of significant rise in the presence of macrosomias, premature births, or urinary infection in the mother. As it was to be expected, the incidence of hydramnios as well as toxemia was higher than normal. The evaluation of the newborns through the Apgar score proved that 20 percent of the neonates in the type C diabetes were still partially or seriously depressed after 5 minutes of birth. A protocol of assistance in this special situation affords an evident reduction in perinatal mortality.

In a double-blind and randomized study the administration of a betamimetic drug to the mother from week 33 to 35 produces a significant increase in amniotic fluid palmitic acid levels. We suggest that the administration of a betamimetic drug during pregnancy to the mother can be useful in producing an acceleration of the fetal lung maturation.