| 4771. |
- Nyberg, Sigrid
(author)
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How to determine symptom severity in premenstrual syndrome : a combination of daily symptom ratings and interviews.
- 2011
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In: Sexual and reproductive healthcare. - : Elsevier. - 1877-5764 .- 1877-5756. ; 2:4, s. 161-168
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate how premenstrual symptoms are experienced and affect daily life, and to see if there is an agreement in reported symptom severity based on interviews compared to ratings on a symptom rating scale. STUDY DESIGN: Twenty-two women with different degree of premenstrual symptoms were interviewed about their symptoms. Based on the luteal-phase interviews, they were categorized in four different severity groups: severe (n=5), moderate (n=3), mild (n=8), and no symptoms/cyclicity (n=6). The interviews were then compared with rated symptom scores, number of expressed symptoms per day, number of days with symptoms, and daily life impairment. MAIN OUTCOME MEASURES: Agreement between rated symptom scores and reported symptoms in the interviews. RESULTS: Comparing seven days in luteal phase scorings with interview data the group with no symptoms/cyclicity showed high agreement between severities reported in the interviews and daily rated scores. Among women who reported severe symptoms, an agreement was seen in three out of five. In the mild/moderate group, the agreement was less conclusive. The day of interview there was a high agreement between data from the reported symptom ratings and symptoms reported in the interview. CONCLUSION: Rated symptom scores the day of interview reflects well symptoms reported in the interviews. Mean symptom scores for seven luteal phase days showed an agreement between symptom ratings and symptoms expressed in interviews among women with severe symptoms and no symptoms/cyclicity. In the group with mild/moderate symptoms, data was less conclusive.
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| 4772. |
- Nyberg, Sigrid
(author)
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Mood and physical symptoms improve in women with severe cyclical changes by taking an oral contraceptive containing 250-mcg norgestimate and 35-mcg ethinyl estradiol
- 2013
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In: Contraception. - : Elsevier. - 0010-7824 .- 1879-0518. ; 87:6, s. 773-781
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Journal article (peer-reviewed)abstract
- Background: The purpose of this study was to investigate how women without and with different severity of premenstrual symptoms react to treatment with a combined oral contraceptive containing 250-mcg norgestimate/35-mcg ethinyl estradiol (EE). Focus was placed on mood and physical symptoms. Study Design: This open, prospective study evaluated 24 women using norgestimate/EE for three cycles in a 21/7 regimen. Symptoms and bleeding pattern were captured by daily ratings on the Cyclicity Diagnoser scale. Results: Women with severe premenstrual mood symptoms improved in summarized negative mood (p<.001) and summarized positive mood (p<.05), as well as in swelling (p<.05) and effect on daily life (p<.05). Women with no or mild or moderate symptoms did not show any significant improvement or deterioration in any symptom after 3 months of treatment. Conclusions: Norgestimate 250 mcg/EE 35 mcg significantly improved premenstrual summarized negative mood symptoms during 3 treatment months compared to pretreatment in women with severe premenstrual symptoms, together with improvement in positive symptoms, swelling and effect on daily life. (C) 2013 Elsevier Inc. All rights reserved.
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| 4773. |
- Nyflot, Lill T., et al.
(author)
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The impact of cardiovascular diseases on maternal deaths in the Nordic countries
- 2021
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In: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 100:7, s. 1273-1279
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Journal article (peer-reviewed)abstract
- Introduction Cardiovascular diseases have become increasingly important as a cause of maternal death in the Nordic countries. This is likely to be associated with a rising incidence of pregnant women with congenital and acquired cardiac diseases. Through audits, we aim to prevent future maternal deaths by identifying causes of death and suboptimal factors in the clinical management. Material and methods Maternal deaths in the Nordic countries from 2005 to 2017 were identified through linked registers. The national audit groups performed case assessments based on hospital records, classified the cause of death, and evaluated the standards of clinical care provided. Key messages were prepared to improve treatment. Results We identified 227 maternal deaths, giving a maternal mortality rate of 5.98 deaths per 100 000 live births. The most common cause of death was cardiovascular disease (n = 36 deaths). Aortic dissection/rupture, myocardial disease, and ischemic heart disease were the most common diagnoses. In nearly 60% of the cases, the disease was not recognized before death. In more than half of the deaths, substandard care was identified (59%). In 11 deaths (31%), improvements to care that may have made a difference to the outcome were identified. Conclusions Between 2005 and 2017, cardiovascular diseases were the most common causes of maternal deaths in the Nordic countries. There appears to be a clear potential for a further reduction in these maternal deaths. Increased awareness of cardiac symptoms in pregnant women seems warranted.
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| 4774. |
- Nygren, Karl-Gosta, et al.
(author)
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Population-based Swedish studies of outcomes after in vitro fertilisation
- 2007
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 86:7, s. 774-782
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Research review (peer-reviewed)abstract
- Background. Various outcomes have been described during pregnancy and among infants born to women after in vitro fertilisation (IVF) treatments. This mini-review summarises recent population-based Swedish studies about the short- and long-term effects of IVF on the infant and child, and also comments on disturbances of pregnancies and deliveries occurring after IVF. Methods. Data on women who had IVF treatments and gave birth in Sweden during the period 1982-2001 were collected from all clinics performing IVF. By linkage with the Swedish Medical Birth Register, the Swedish Register of Congenital Malformations, the Swedish Hospital Discharge Register, the Swedish Cancer Register, and the Swedish Cause of Death Register, data on short- and long-term complications were retrieved. Results. From 1982 to 2001, a total of 13,261 women gave birth to 16,280 infants after IVF treatment. During the final years of the study, nearly half of the pregnancies occurred after intracytoplasmic sperm injection (ICSI). Characteristics of women who delivered after IVF were analysed. Various anomalies in pregnancy and delivery outcome were found, but few long-term effects. Conclusions. Most deviations, except for multiple pregnancies, could be explained by parents characteristics, notably their subfertility status. Little difference was found between pregnancies after standard IVF and pregnancies after ICSI.
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| 4775. |
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| 4776. |
- Nyman, Viola, 1961, et al.
(author)
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Glancing beyond or being confined to routines: Labour ward midwives' responses to change as a result of action research
- 2013
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In: Midwifery. - : Elsevier BV. - 0266-6138. ; 29:6, s. 573-578
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Journal article (peer-reviewed)abstract
- Objective to examine midwives' responses to a changed approach in the initial encounters with women and their partners in the labour ward. Design as part of a local project to improve hospital based childbirth care, Action Research (AR) was undertaken with midwives. To establish their beliefs, practices, and responses to change during the first cycle, 37 out of 57 midwives were interviewed. Data analysis was guided by interpretative description. Setting a labour ward in western Sweden. Findings two themes emerged: ‘Glancing beyond routines’ describes how the changed care approach enabled ‘valuing the idea’ and ‘acquiring extended space to create a lingering presence’. The theme ‘being confined to inherent routines’ expresses ‘resistance to the need for change’ and a ‘feeling of pressure to change’. Key conclusions the AR study design enabled the midwives to reflect on their routines and to transform tacit use-in-action to reflection-in-action. Midwives who persisted in being confined to inherent routines felt pressured by the change process. Others felt that the AR process granted them official licence to create chronological and emotional space in which they could ‘be’ and not just ‘do’. Implications for practice to a greater or lesser extent, midwives in this setting had integrated relatively impersonal system-wide technocratic norms of childbirth into their belief systems and behaviours. The data suggest that a whole-system shift is necessary to enable caring, behaviours based on the formation of positive relationships to become the key driver of the first encounter on the labour ward.
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| 4777. |
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| 4778. |
- Nystedt, Astrid, et al.
(author)
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Diverse definitions of prolonged labour and its consequences with sometimes subsequent inappropriate treatment
- 2014
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In: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 14, s. 233-
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Journal article (peer-reviewed)abstract
- Background: Prolonged labour very often causes suffering from difficulties that may have lifelong implications. This study aimed to explore the prevalence and treatment of prolonged labour and to compare birth outcome and women's experiences of prolonged and normal labour. Method: Women with spontaneous onset of labour, living in a Swedish county, were recruited two months after birth, to a cross-sectional study. Women (n = 829) completed a questionnaire that investigated socio-demographic and obstetric background, birth outcome and women's feelings and experiences of birth. The prevalence of prolonged labour, as defined by a documented ICD-code and inspection of partogram was calculated. Four groups were identified; women with prolonged labour as identified by documented ICD-codes or by partogram inspection but no ICD-code; women with normal labour augmented with oxytocin or not. Results: Every fifth woman experienced a prolonged labour. The prevalence with the documented ICD-code was (13%) and without ICD-code but positive partogram was (8%). Seven percent of women with prolonged labour were not treated with oxytocin. Approximately one in three women (28%) received oxytocin augmentation despite having no evidence of prolonged labour. The length of labour differed between the four groups of women, from 7 to 23 hours. Women with a prolonged labour had a negative birth experience more often (13%) than did women who had a normal labour (3%) (P < 0.00). The factors that contributed most strongly to a negative birth experience in women with prolonged labour were emergency Caesarean section (OR 9.0, 95% CI 1.2-3.0) and to strongly agree with the following statement 'My birth experience made me decide not to have any more children' (OR 41.3, 95% CI 4.9-349.6). The factors that contributed most strongly to a negative birth experience in women with normal labour were less agreement with the statement 'It was exiting to give birth' (OR 0.13, 95% CI 0.34-0.5). Conclusions: There is need for increased clinical skill in identification and classification of prolonged labour, in order to improve care for all women and their experiences of birthing processes regardless whether they experience a prolonged labour or not.
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| 4779. |
- Nystedt, Astrid, et al.
(author)
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Low psychosocial resources during early pregnancy are not associated with prolonged labour.
- 2006
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 125:1, s. 29-33
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To examine if a low level of psychosocial resources in early pregnancy is associated with the occurrence of prolonged labour. STUDY DESIGN: A cross sectional study of 644 women expecting their first child. Participants were asked to complete a questionnaire at their first antenatal visit, measuring psychosocial resources defined as social network and support, work-related psychosocial factors, control of daily life and health characteristics. Outcome was prolonged labour at the end of the pregnancy. RESULTS: A low level of psychosocial resources was not associated with prolonged labour. The majority of women reported that the degree of support was high in early pregnancy. CONCLUSIONS: A perceived low level of psychosocial resources in early pregnancy did not increase the risk of prolonged labour at the subsequent delivery.
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| 4780. |
- Nystedt, Astrid, et al.
(author)
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Women's and men's negative experience of child birth-A cross-sectional survey
- 2018
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In: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 31:2, s. 103-109
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Journal article (peer-reviewed)abstract
- Background: A negative birth experience may influence both women and men and can limit their process of becoming a parent. Aims: This study aimed to analyze and describe women's and men's perceptions and experiences of childbirth. Design: A cross-sectional study of women and their partners living in one Swedish county were recruited in mid pregnancy and followed up two months after birth. Women (n = 928) and men (n = 818) completed the same questionnaire that investigated new parents' birth experiences in relation to socio-demographic background and birth related variables. Results: Women (6%) and men (3%) with a negative birth experiences, experienced longer labours and more often emergency caesarean section compared to women (94%) and men (97%) with a positive birth experience. The obstetric factors that contributed most strongly to a negative birth experience were emergency caesarean and was found in women (OR 4.7, 95% CI 2.0-10.8) and men (OR 4.5, Cl 95% 1.4-17.3). In addition, pain intensity and elective caesarean section were also associated with a negative birth experiences in women. Feelings during birth such as agreeing with the statement; 'It was a pain to give birth' were a strong contributing factor for both women and men. Conclusions: A negative birth experience is associated with obstetric factors such as emergency caesarean section and negative feelings. The content of negative feelings differed between women and men. It is important to take into account that their feelings differ in order to facilitate the processing of the negative birth experience for both partners.
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