Showing papers in "Acta Obstetricia et Gynecologica Scandinavica in 1982"

Reproductive performance of women with uterine anomalies. An evaluation of 182 cases.

Abstract: A total of 182 women with uterine anomalies were observed over a period of 18 years. In all, 126 women had 265 pregnancies, fetal survival rate was 66%, perinatal mortality 8% and premature labors occurred in 23%. When the uterine anomalies were grouped according to degree of failure of normal uterine development, the complete septate uteri had the best fetal survival rate (86%), complete bicornuate uteri (50%) and unicornuate (40%) poorest. Cervical cerclage was applied most in the partial bicornuate uteri (17%), where fetal survival in operated cases was: before operation, 53% and after, 100%. The frequency of breech presentation was 40–50% in all groups except complete septate uteri (25%) and complete bicornuate (0%). The highest cesarean section rate (82%) was in deliveries of patients with uterus didelphys. The frequency of cesarean section among total deliveries was 53%. Metroplasty was carried out on 19 patients. The obstetric outcome improved from 10% successful pregnancies before surgery to 88% p...

Detrusor instability score in the evaluation of stress urinary incontinence.

Abstract: The major cause of failure in the surgical treatment of stress urinary incontinence (SUI) in women is an occult detrusor instability. In order to detect detrusor instability and its degree, urological histories were standardized by scoring the replies to ten specific questions with O (indicative of SUI), 1 or 2 (slightly and markedly indicative of detrusor instability, respectively). The sum of the scores was termed the "detrusor instability score" (DIS). The DIS was calculated for 134 patients both preoperatively and 2 years after operation, and 112 of these women were also evaluated by bead-chain urethrocystography (UCG) before operation. The 10% failure rate among the 72 patients with a DIS of 0-7 (exclusive or nearly exclusive detrusor instability) was significantly less than the 32% rate in the 62 women with a DIS of 8-16 (SUI complicated by marked detrusor instability). The 38% failure rate in 47 women of peri- or post-menopausal age and having a DIS of 8-16 was higher than the 10% in the other 87 women. An increased risk of failure was also found in patients who had a DIS of 8-16 together with either a urethral inclination angle of 80 degrees or less (46% failure rate in 28 women) or a posterior urethrovesical angle of 160 degree or less (43% failure rate in 30 women) in lateral bead-chain UCG during straining. The mean DIS decreased after successful surgery, but remained constant in cases of failure. The scored urological data facilitate the detection of patients with detrusor instability. This is potentiated by those lateral bead-chain UCG findings which indicate a low motility of the proximal urethra or bladder neck.

Conservative Treatment of Uterine Arteriovenous Fistula

Abstract: A case of a uterine arteriovenous aneurysm in a 20-year-old woman is described. The patients's main symptom was copious uterine bleeding. The diagnostic difficulties are described and the importance of arteriography is emphasized. The aneurysm was occluded at laparotomy by introducing gel-foam into the uterine artery. The patient subsequently became pregnant and after an uneventful pregnancy was delivered of a healthy child. Thus, this type of conservative treatment seems to offer a possible means of avoiding hysterectomy in young patients with this rare condition who wish to retain their fertility.

Prediction of fetal growth deviation by ultrasonic biometry: I. Methodology

Abstract: Early information of impaired or accelerated fetal growth is of importance for antenatal care. The present study has produced a mathematical formula which in the 33rd week of pregnancy permits prediction of fetal weight deviation at birth. The prediction was based on two ultrasonic examinations: in the 17th week of pregnancy the biparietal diameter (BPD) was measured to assess the fetal gestational age; in the 33rd week of pregnancy, BPD and the abdominal diameter (AD) of the fetus were measured. Fetal growth deviation was then described by comparing the assessed BPD and AD with the expected mean values for the gestational age on the day of this measurement. For 872 fetuses the growth deviation found in the 33rd week was related to the fetal weight deviation at birth; multiple regression analyses were performed and a mathematical formula developed. For practical purposes this formula is expressed in a nomogram.

Massive hyperstimulation and borderline carcinoma of the ovary. A possible association.

Abstract: A patient with persistent ovarian cysts subsequent to clomiphene-induced severe hyperstimulation was found to have borderline ovarian carcinoma. Since several endocrine and epidemiological studies implicate hormonal factors in the genesis of ovarian tumors, a possible association between ovarian hyperstimulation and neoplasia is suggested.

Peroperative Electrocoagulation of Endocervical Mucosa and Later Carcinoma of the Cervical Stump

Abstract: The incidence of carcinoma of the cervical stump is, according to literature, 0.3—1.9%. During the years 1952–78, 2712 subtotal hysterectomies for benign conditions were performed in the Department of Obstetrics and Gynecology in Turku. During the operation the endocervical mucosa was electrocoagulated before closing the stump. Of these patients, 3 have since developed carcinoma of the cervical stump; thus the incidence in our material is 0.11%. It has been supposed that subtotal hysterectomy might have certain benefits in some cases. If so, and in view of the cancer risk being so low in our material, we feel that subtotal hysterectomy is still an applicable method.

On the use of plasma proteins as indicators of the metabolic effects of combined oral contraceptives.

Abstract: Ethinylestradiol (EE, 17α-ethynyl-1,3,5(10)-es-tratriene-3,17β-diol) 30 μg daily, in combination with 150μg per day of desogestrel (Org 2969,17α-ethynyl-18-methyl-11-methylene-4-estrene-17β-ol) or levonorgestrel (17α-ethynyl-18-methyl-4-estrene-17β-ol-3-one), was administered to two groups of 10 healthy human women who had been without hormonal treatment during 3 months prior to the study. The preparations were given for three 21-day cycles with 7-day intervals. Blood samples were taken before treatment and at the end of the third treatment period. Serum sex-hormone binding globulin (SHBG), ceruloplasmin, ornsomucoid, C1-esterase inhibitor and C4 were analyzed by electroimmunoassay and transcortin was assayed as cortisol-binding capacity. Serum testosterone was assayed by radioimmunoassay of methylenedichloride extracts using an antiserum with about 20% cross-reactivity for dihydrotestosterone (DHT).The increases in serum ceruloplasmin and transcortin concentrations were the same in both groups (about 80%...

Outcome of Pregnancy After Conization

Abstract: The outcome of 635 pregnancies in 197 women before and after conization is reported. After conization a significant increase in premature deliveries occurred in young women (age 21-25), nulliparae representing the highest risk. The rate of premature deliveries in this age group was 4.4% before conization and 30.6% after conization. No such increase could be found in any other age group. Labor was notably short in non-parous women and in parous women it started with rupture of the membranes significantly more often after conization. In addition, a significant increase in the frequency of cervical stenosis was observed, but this was of clinical significance in only one case. Treatment in the form of prophylactic cerclage did not reduce the incidence of either premature delivery or of late spontaneous abortion.

Screening for cancer of the uterine cervix in Iceland 1965--1978.

Abstract: The trends in the mortality and morbidity from cervical cancer in Iceland for the period 1965–1978 are examined in relation to the screening programme that began in 1964. By 1970 over 80% of the female population under the age of 65 had been screened at least once, and by 1977 over 65% of women under the age of 75 had been screened at least twice. Mortality fell by 60% between 1959–1970 and 1975–1978, with a corresponding fall in the incidence of advanced tumors. The mortality rates among the unscreened population are more than ten-fold greater than among the screened. The greater part of the fall in mortality is attributed to the mass screening programme.

Effect of Prostaglandin E2 and F2α on the Systemic and Pulmonary Circulation in Pregnant Anesthetized Women

Abstract: The hemodynamic effect of prostaglandin F2 alpha (PGF2 alpha) and of prostaglandin E2 (PGE2) was studied in 12 healthy volunteers admitted for suction abortion at 10--12 weeks of gestation. They were anesthesized using natrium thiomebumal, pethidine and pancuronium bromide. PGF 2 alpha was given as an intravenous infusion of 100 micrograms/min, the dose being increased by 100 micrograms every 10 min to a maximum of 300 micrograms/min. PGE2 was administered with 5 micrograms/min, the dose being increased by 5 micrograms every 10 min to a maximum of 15 micrograms/min. During infusion of 300 micrograms PGF2 alpha a significant increase iun cardiac output and femoral arterial pressure of 40% and 25% respectively was measured together with an increase in the pulmonary arterial pressure (125%). Pulmonary vascular resistance was doubled, with a concomitant decrease in systemic resistance (11%). These changes were followed by a significant decrease in pH and PaO2, whereas an increase in PaCO2 was found. During infusion of PGE2 a significant, 36% increase in cardiac output was measured during infusion of 15 micrograms/min PGE2, together with a decrease in systemic blood pressure (31%) and resistance (33%). Heart rate rose significantly, while stroke volume showed only a small increase, and pulmonary pressure was unchanged. These changes were followed by an increase in PaO2. PGF2 alpha seems to have a positive inotropic effect on the heart, whereas its response to PGE2 seems to be a result of the peripheral vasodilatation. The slight decrease in systemic blood pressure without change in pulmonary hemodynamics makes PGE2 suitable for induction in patients with cardiopulmonary diseases.

Does cervix conization increase the risk of complications in subsequent pregnancies

Abstract: In a series of 414 patients who underwent cervix conization because of cancer in situ, the risk of complications in subsequent pregnancies was analyzed by studying the outcome of their 923 pregnancies before and after cone biopsy. After conization the incidence of late spontaneous abortion was seven times higher than before. Moreover, 20.5% of pregnancies following cone biopsy required cervix cerclage because of suspected cervical insufficiency, or cesarean section because of a scarred cervix stenosis.

Comparison between tamoxifen and clomiphene for induction of ovulation.

Abstract: The effectiveness of tamoxifen and clomiphene in inducing ovulation was compared in 46 women with anovulatory infertility. All the women were given both the drugs in an alternate way. If one cycle was treated by tamoxifen the next was treated by clomiphene and vice versa. Forty-one out of the 46 women (89.1%) ovulated at least once during the study. Similar ovulation rates were achieved by tamoxifen (56.2%) and clomiphene (62.9%). The lengths of the ovulatory cycles and their luteal phases and the mid-luteal phase serum progesterone levels did not differ significantly between the two compounds. Nor did the occurrence of luteal phase defects during the tamoxifen and clomiphene treatment cycles differ. Thirty-seven of the 46 women (80.4%) responded similarly to both drugs. Thus, tamoxifen is just as effective as clomiphene in inducing ovulation in women with anovulation.

Oxytocin, Prostaglandins, and Contractility of the Human Uterus at Term Pregnancy

Abstract: The contractile properties of myometrial "mini-strips" from the upper and lower uterine segments were studied by a superfusion technique. These samples of myometrium were taken from women delivered by elective cesarean section in the 39th week of pregnancy. The frequency of spontaneous contractions was significantly higher in isthmic myometrial specimens than in corpus specimens, whereas amplitude and duration of contractions did not differ. Both isthmic and corpus myometrium were stimulated by prostaglandin E2 at low concentrations and inhibited at high concentrations. PGF2 alpha induced an excitory response in the isthmic strips but surprisingly not in preparations from the corpus. However, PGF2 alpha restored normal spontaneous activity following inhibition of the contractility with indomethacin. Oxytocin caused an excitory response over a wide concentration range in both types of specimen and this response was not reduced by pretreatment with indomethacin. These findings suggest that endogenous prostaglandin synthesis is a necessary prerequisite for spontaneous myometrial activity at term pregnancy and that prostaglandins are not essential for the excitatory effect of oxytocin.

Pain Relief in Labor by Transcutaneous Electrical Nerve Stimulation: Testing of a modified stimulation technique and evaluation of the neurological and biochemical condition of the newborn infant

Abstract: In this prospective randomized study of pain relief in labor, the effect of transcutaneous electrical nerve stimulation (TNS) performed over both the low-back and suprapubic region was evaluated and compared with a control group not receiving TNS. Both high frequency and pulse train TNS were used. The study included 24 induced labors. In the TNS group, conventional methods were added when needed, while in the control group only conventional methods were used. Assessment of low-back and suprapubic pain was performed by the parturient each hour during the first stage. In the TNS group most of the parturients reported minimal or moderate low-back pain throughout labor, while parturients in the control group reported an increased intensity of low-back pain as labor progressed. The effect of suprapubic pain was insignificant in both groups. Neither TNS nor nitrous oxide-oxygen mixture and pethidine could reduce this pain component. Course of labor, uterine activity and fetal heart patterns were similar in the two groups. The neonates were evaluated with Apgar score, assays of blood samples from the umbilical vein including blood lactate, plasma hypoxanthine and blood gas, and neurobehavioral assessment on two occasions. All newborn infants were in good condition and no significant differences between the two groups could be demonstrated.

Estimation of fetal weight by ultrasound measurement. II. Clinical application of a new formula.

Abstract: A formula for the estimation of fetal weight combining real-time ultrasonic measurements of the fetal biparietal diameter (BPD) and the abdominal transverse diameter (ATD) was applied to 264 unselected pregnancies. The measurements were performed within 4 days of delivery. The weight range of the fetal birth weights was 850-5100 g. The fetuses were divided into five weight groups according to their birth weight and the prediction errors (estimated weight minus birth weight) analyzed. For the whole group the SD of prediction errors was 258 g. SD of prediction errors increased with the increase in fetal weight. The formula did not significantly over- or underestimate fetal weight in any of the weight groups. The results obtained for the growth-retarded fetuses and the fetuses in breech position did not differ from the results overall. There was no significant difference between mean prediction errors or variances for the measurements performed by four different observers. It is concluded that the formula can be readily applied in daily clinical practice. It provides adequate information on fetal weight in the weight range 900-5000 g. For practical application a nomogram has been developed.

Estrogen replacement therapy after the menopause. Estrogenicity and metabolic effects.

Abstract: Certain metabolic effects were investigated in post-menopausal women undergoing oral estrogen replacement therapy for 6 months using various substances. The increases in serum concentration of the estrogen-sensitive proteins, pregnancy zone protein (PZP), and sex hormone binding globulin (SHBG) had very similar and dose-dependent patterns. Ethinyl-estradiol was found to be much more potent than the "natural" estrogens. Estriol in various doses did not increase the protein level. Gonadotropin inhibition occurred in a dose-dependent manner. In terms of FSH suppression ethinyl-estradiol was approximately 120 times as potent as the "natural" estrogens. There was a striking resemblance between the "estrogenicity" of four different estrogens when expressed both in inhibition of gonadotropins and in induction of the two serum proteins SHBG and ceruloplasmin. Estriol caused a significant depression of FSH when given orally in a dose of 2 mg three times daily. Prolactin was found to decrease during treatment with low doses of estrogens. Estrogen therapy was found to have only moderate effects on adrenal androgens. Tamoxifen, and anti-estrogen, was found to exert distinctly estrogenic effects during treatment of post-menopausal women. In post-menopausal women with low amounts of circulating estrogens the tamoxifen-receptor complex itself may produce a net estrogenic response. Serum samples from post-menopausal women treated with ethinyl estradiol 0.05 mg and estrone sulphate 2.5 mg daily were found to reduce the lymphocyte reactivity in mixed lymphocyte cultures.

Transfer of propranolol and sotalol across the human placenta. Their effect on maternal and fetal plasma renin activity.

Abstract: Eighty milligrams of propranolol or sotalol was administered orally to two groups of 8 parturients who were to undergo elective cesarean section. This was performed 3 hours after drug administration. The transplacental passage of both drugs was registered in each patient. The maternal concentration of propranolol was approximately four times that in the umbilical circulation, while the sotalol level in maternal circulation was twice that in the umbilical circulation. The administration of beta-adrenoceptor antagonists caused a significant decrease in maternal plasma renin activity. After these doses of beta blockers, no difference in the plasma renin activity was found in the umbilical circulation, when compared with the previous normal values at cesarean section.

Is the Relaxing Effect of β-Adrenergic Agonists on the Human Myometrium only Transitory?

Abstract: The β-adrenergic receptor function in myometrial strips taken from pregnant women at cesarean section was studied. The material consisted of myometrial strips from 10 patients treated with terbutaline for threatening premature parturition and an untreated control group of 10 patients. The basal cAMP levels were lower and the cAMP production after receptor stimulation in vitro was less in myometrial strips taken from terbutaline-treated women than in the untreated control group. The phosphodiesterase activity was greater in myometrial strips taken from terbutaline-treated women, indicating a faster rate of degradation of cAMP in these women. Studies on the β-adrenergic receptor function in leukocytes from venous blood Samples during treatment with terbutaline for preterm labor demonstrated a gradual decline in receptor function, as shown by a successive reduction in cAMP production after stimulation with a β-adrenergic agonist in vitro. The results presented may explain the merely temporary inhibitory effe...

A Study of Parental Attitudes after Donor Insemination (AID)

Abstract: Artificial donor insemination (AID) is important in the treatment of infertility when the couples' wish for a family is denied because of male sterility. However, very little is known regarding the continued development of AID families and their attitudes to insemination after the child is born. This study is based on a questionnaire anonymously completed by 92 couples returning to obtain a second child by insemination. None of the parents regretted his or her decision regarding insemination and the majority were prepared to recommend the method to other couples in the same situation. Apart from one couple the parents intended to withhold the truth from the child regarding its origin. The majority of parents chose not to inform anyone else regarding the child's conception. The parents were therefore anxious that case notes and details concerning insemination were treated with the utmost discretion and confidentiality. The parents in this study clearly indicated they preferred insemination to adoption. A l...

The Influence of Gestational Age on the Ability of the Fetus to Pass Meconium in Utero: Clinical implications

Abstract: (1982) The Influence of Gestational Age on the Ability of the Fetus to Pass Meconium in Utero: Clinical implications Acta Obstetricia et Gynecologica Scandinavica: Vol 61, No 3, pp 275-277

Effects of Estrogen Deficiency in Women Castrated When Young

Abstract: In earlier studies on the effects of castration, most of the women had been operated on late in the reproductive period of life. In the present material all the 142 women had been oophorectomized between the ages of 15 and 30 years because of advanced salpingitis. Not only the tubes but also the ovaries had been radically removed. The series was analyzed in respect of causes of death, survival, morbidity, osteoporosis and hormonal state. Complete oophorectomy was found to be followed by (i) a significant increase in the frequency of coronary heart diseases; (ii) an increase in serum cholesterol and triglyceride levels, most significantly in those aged below 60–65 years; (iii) an increased incidence of fractures; (iv) an increased frequency of nervous disorders of psychological rather than endocrinological origin.

Influence of the Menopause on Ischaemic Heart Disease and its Risk Factors and on Bone Mineral Content

Abstract: A comprehensive population study of women in Gothenburg, Sweden, was carried out in 1968-69. Altogether 1462 women participated (participation rate 90.1%). Five age strata were studied, i.e. women born in 1930, 1922, 1918, 1914 and 1908. The same women were restudied in 1974-1975 (participation rate 80.3% of the initial sample and 89.1% of those participating in 1968-69). In addition, a study of bone density, using photon absorptiometry, was carried out in a systematic subsample in 1976. The median age at natural menopause in the population sample was found to be 50 years and 3 months. About 5% of women aged 44 or more had stopped menstruating after hysterectomy and a similar proportion were postmenopausal as a consequence of bilateral oophorectomy. Information is also given about the percentages of the women receiving oestrogens either as substitution therapy or as oral contraceptives. Different factors influencing the age at menopause are discussed. Smoking was found to be one of the most important of these. The influence of the menopause on ischaemic heart disease and its risk factors has been studied both cross-sectionally and longitudinally. The most striking differences were found for serum cholesterol and serum triglycerides, with higher values in postmenopausal women than in premenopausal of the same ages. For bone mineral content, higher values were observed in premenopausal or recently postmenopausal women than in women of the same ages who had been postmenopausal for a long time. The observed differences in bone mineral content could not be explained by other factors studied.

Malignant cervical teratoma of the fetus

Abstract: Cervical teratomas have been defined and one new case is now added to the 116 cases previously reported. We have been able to find only six reports of malignant teratoma in the literature so far. The problem of diagnosis and obstetric management are discussed briefly. The incidence of appearance of the tumor is described and the likelihood of hydramnios or of acute obstructive symptoms of the trachea and esophagus at birth are discussed. The differential diagnosis includes cystic hygroma, congenital goitre, bronchial cyst, lymphangioma, neuroblastoma, parotid tumor and carcinoma of the thyroid. The object of this review is to present a synoptic description of these tumors, their clinical manifestations, management, treatment and prognosis, so that it may afford the attending obstetrician a guideline in understanding this rare entity.

Role of Hormones in the Etiology and Prevention of Endometrial and Breast Cancer

Abstract: Although there is a slightly increased risk of endometrial cancer from estrogen therapy for menopausal women, progestogens given along with the estrogen significantly decrease the incidence of this malignancy to a rate lower than that of untreated women. Postmenopausal women predisposed to adenocarcinoma of the endometrium because of increased endogenous estrogens can be identified with the progestogen challenge test and treated with cyclic progestogens for 10 days each month to prevent endometrial cancer. Oral contraceptives containing both estrogens and progestogens in each tablet are protective against developing adenocarcinoma of the endometrium, whereas the sequential birth control pills provided less protection. The incidence of breast cancer is significantly lower in both estrogen and estrogen-progestogen users than in postmenopausal women never using these hormones. In those women found to have breast cancer while using these hormones, the prognosis is better than that found in women never exposed...

Irradiation and Bleomycin in the Treatment of Inoperable Vulval Carcinoma

Abstract: Fifteen patients with inoperable squamous cell carcinoma of the vulva were treated with Bleomycin and irradiation. Only 2 patients were also treated with vulvectomy and bilateral lymphadenectomy 2 weeks later. One patient survived more than 4 years without signs of recurrence, another survived 2½ years and 2 more 18 and 12 months respectively. The rest died less than 6 months after the treatment. Three patients developed signs of lung fibrosis. Bleomycin and irradiation may render a tumor operable, but in most cases this regime merely aims at palliation.

Ultrasonic Growth Pattern of Fetuses with Chromosomal Abberations

Abstract: A retrospective analysis of the ultrasonic growth patterns of two 13-15 trisomies, two 18-trisomies and eight 21-trisomies is presented. The patterns were examined by serial cephalometry, abdominometry and head-to-abdomen circumference measurements. Early and symmetric growth retardation was revealed by ultrasonography and later confirmed by postnatal pediatric examinations in the 13-15 trisomies and 18-trisomies. In the 21-trisomies, fetal growth was normal.

Progestogen effects and their relationship to lipoprotein changes. A report from the Oral Contraception Study of the Royal College of General Practitioners.

Abstract: The Oral Contraception Study of the Royal College of General Practitioners is a long-term, controlled, prospective survey which is not in its 14th year. The substantial data accumulated permits assessment of the effects of particular brands upon morbidity. We have shown that the progestogen content of the Pill is associated with the incidence of hypertension, benign breast disease and, more important, of total arterial disease. The data support the findings of other investigators who have shown that progestogens lower HDL-cholesterol levels and that low HDL-cholesterol increases the risk of arterial disease. The implications are that the progestogen content of an oral contraceptive and the relative potency of estrogen and progestogen it contains must be considered carefully not only in terms of present clinical practice, but also in terms of the direction of new Pill formulation development.

Treatment of vaginal candidosis with natamycin and effect of treating the partner at the same time

Abstract: Thirty-three patients with vaginal candidosis were treated with natamycin vaginal tablets for 10 days and their partners were treated double-blind with natamycin cream/placebo cream. Follow-up examinations were carried out one week after the treatment was discontinued and again about one month later. The cure rate in patients having actively treated partners was 94%, not differing significantly from the cure rate of 88% in patients whose partners had been treated with placebo. One month after the treatment there was a high recurrence/re-infection rate, about 30% in both groups. Thus, treating the partners of patients with vaginal candidosis has no influence upon the therapeutic outcome or recurrence rate. The recurrence is presumably due to re-infection from the patient herself.

Randomized Prospective Studies on Metabolic Effects of Oral Contraceptives

Abstract: The results of two randomized prospective studies on metabolic changes induced in groups of healthy Young women by commercial oral contraceptives (OC) are described. In the first study, four low-estrogen (30 μg or 35 μg ethinylestradiol) combined products were compared, while in the second, effects of four different formulations, each containing levonorgestrel plus ethinylestradiol, were determined. Results are presented for oral glucose tolerance and plasma insulin responses, serum total cholesterol, HDL-cholesterol, triglycerides, coagulation factors I, VII, VIII, and X, plasminogen, anti-thrombin III, and (for study no. two only) renin activity, substrate, and concentration. In the first study, products containing norethisterone or ethynodiol diacetate were associated with significant increases in serum triglycerides and total cholesterol, though HDL cholesterol fell. Coagulation and fibrinolytic factors showed similar changes. The product containing levonorgestrel showed the smallest alteration in all...

Hilus cells from human postmenopausal ovaries: Gonadotrophin sensitivity, steroid and cyclic amp production

Abstract: Strips of ovarian hilar tissue taken from 11 post-menopausal women were examined histologically and found to contain clusters of hilus cells in contiguity with non-myelinated nerve fibers. No other steroidogenically active structures were found. Specimens from these strips were incubated for 30 and 240 minutes in Krebs bicarbonate buffer containing 5.5 mM glucose and 1% bovine serum albumin. The specimens produced measureable amounts of androstenedione, estradiol-17 beta and progesterone in vitro. The major steroid formed was androstenedione, and this pattern of steroidogenesis appeared similar to that of postmenopausal ovarian stroma. However, the amounts of steroids formed were considerably higher than in stromal tissue. This implies that the hilus cells possibly may be of greater importance, qualitatively, than the stroma cells for steroidogenesis in the postmenopausal ovary. Addition of hCG to the incubated specimens elicited increase in both cyclic AMP formation and steroid synthesis, especially of estradiol-17 beta, indicating a preserved responsiveness to gonadotrophin in hilus cells from postmenopasual ovaries.