| 1. |
- Marsal, Karel, et al.
(författare)
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Ultraljudsdiagnostik
- 2008
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Ingår i: Obstetrik. - 9789144007311 ; , s. 201-230
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 2. |
- Fritz, Tomas, et al.
(författare)
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Outcome of extremely preterm infants after iatrogenic or spontaneous birth
- 2018
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 97:11, s. 1388-1395
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The risks of preterm birth are known. We investigated the perinatal and infant mortality and morbidity after iatrogenic or spontaneous onset of extremely preterm birth. Material and methods: The present study used data from the population-based EXPRESS study comprising all infants delivered before 27+0 gestational weeks in Sweden between 2004 and 2007. All fetuses alive at admission and with known mode of onset of delivery were included (682 live-born infants; 65 intrapartum deaths). Four multivariate regression models were applied with adjustments for gestational age, fetal gender, multiple pregnancy, and birthweight. Results: After adjustment for gestational age, no significant differences were found between iatrogenic and spontaneous onsets of birth regarding intrapartum death, early neonatal death (0-6 d), or death within 364 days. In the group with iatrogenic onset of delivery, there was an increased risk for severe morbidity (odds ratio [OR] 1.86, 95% confidence interval [95% CI] 1.15-3.02), severe bronchopulmonary dysplasia (OR 1.90, 95% CI 1.10-3.26), and retinopathy of prematurity (OR 1.99, 95% CI 1.21-3.27) after adjustment for gestational age, fetal gender, and multiple pregnancy. After additional adjustment for weight z-scores at 36 gestational weeks, the associations were not significant. Within the group with spontaneous onset of delivery, fetuses with preterm prelabor rupture of membranes had increased mortality risk. Conclusion: No evidence was found for mode of onset of delivery (iatrogenic vs spontaneous) having an impact on neonatal or infant mortality or morbidity in extremely preterm infants. Instead, gestational age and growth deviation at birth seem to be associated with the outcome.
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| 3. |
- Martin, Lene, et al.
(författare)
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Visual function in young adults following intrauterine growth retardation
- 2004
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Ingår i: J Pediatr Ophthalmol Strabismus. - : SLACK, Inc.. ; 41:4, s. 212-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Intrauterine growth retardation (IUGR) resulting in infants born small for gestational age is a known risk factor for neurologic deficits and may predispose to poor cognitive development later in life. We recently found an association between IUGR and a reduced neuroretinal rim area at 18 years of age. We evaluated the possible association between IUGR and visual function. SUBJECTS AND METHODS: We studied 26 subjects who had been born small for gestational age and 20 subjects whose birth weights were appropriate for gestational age (controls) using letter acuity thresholds, color vision testing, full-threshold frequency doubling technology perimetry, and rarebit perimetry at 18 years of age. gestational age had a rarebit hit rate below the normal range as compared with none of the controls (P = .006). These 8 subjects had a significantly smaller rim-disc ratio compared with the subjects who were small for gestational age who had a normal rarebit hit rate (P = .047). The frequency doubling technology indices did not differ significantly between the control group and the group that was small for gestational age, nor did the visual acuity, refraction, and color vision test results. CONCLUSION: These data indicate that IUGR is associated with an increased rate of impaired visual function, which can be detected by using rarebit perimetry but not frequency doubling technology perimetry, visual acuity, or color vision tests.
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| 6. |
- Brodszki, Jana, et al.
(författare)
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Reproducibility of ultrasonic fetal volume blood flow measurements
- 1998
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Ingår i: Clinical Physiology. - : Wiley. - 1365-2281 .- 0144-5979. ; 18:5, s. 479-485
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Tidskriftsartikel (refereegranskat)abstract
- The intraobserver reproducibility of ultrasonic volume blood flow measurements in the human fetus was evaluated in this study. A new approach, simultaneous measurement of the vessel diameter and the flow velocity with a pulsed-wave Doppler ultrasound synchronized with a real-time ultrasound phase-locked echo-tracking system, was used to estimate volume blood flow (VBF) in the fetal descending aorta. Measurements were performed in a longitudinal study on 20 normally grown fetuses. Intraobserver reproducibility of repeated estimations of mean blood flow velocities throughout gestation was very good, with high values of intraclass correlation coefficient (IntraCC 0.80-0.91) and low values of coefficient of variation (CV 4-11%). The IntraCC of repeated vessel diameter measurements throughout gestation was low (0.30-0.68), whereas the values of CV were acceptable (< 12%), with the exception of the period between 140 and 167 gestational days (CV > 12%). The lower reproducibility of vessel diameter measurement contributed directly to the relatively low reproducibility of VBF estimations overall (IntraCC 0.25-0.70; CV 17-28%), as these are calculated from a formula using both flow velocity and vessel diameter. Nevertheless, the synchronized approach gives absolute values of vessel diameter, flow velocity and VBF comparable with values reported in the human fetus previously. The new method provides, by taking the vessel wall pulsations into consideration and by measuring diameter and velocity simultaneously, a more complete information on fetal haemodynamics and fetal physiology.
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| 7. |
- Gardiner, Helena, et al.
(författare)
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Ventriculo-vascular interaction in the normal development of the fetal circulation
- 2001
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Ingår i: Early Human Development. - 1872-6232. ; 65:2, s. 97-106
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine cardiovascular physiology in the healthy fetus during normal development. DESIGN: Twenty normal fetuses were studied longitudinally from 20 weeks to term. Serial echocardiography was performed, and arterial and venous diameter pulse wave characteristics and aortic pulse wave propagation velocity (PWV) were examined in the thoracic descending aorta (AoD) and inferior caval vein (IVC) using an ultrasonic phase-locked echo-tracking system. Statistical analyses included ANOVA, paired t-test and logistic regression where appropriate. RESULTS: Aortic PWV, maximum incremental and late decremental velocities increased with gestation while the relative pulse amplitude decreased, reflecting falling distal impedance. There was a linear increase in cardiac preload and relative pulse amplitude in the IVC with gestation that correlated significantly with the presence of end-diastolic flow in the pulmonary artery and improvement in right ventricular diastolic function. CONCLUSIONS: Non-invasive concurrent assessment of preload, ventricular function and impedance are possible in the fetus and may prove useful in the longitudinal study of fetal adaptation to pathophysiological changes.
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| 8. |
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| 9. |
- Pirhonen, JP, et al.
(författare)
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A longitudinat study of maternal oxygen saturation during short-term submaximal exercise
- 2003
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961. ; 23:1, s. 37-41
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Longitudinal prospective study before, during and after normal pregnancy of the effect of short-term submaximal exercise on maternal oxygen saturation. Methods: Fourteen healthy women were recruited to the study before a planned pregnancy, and were followed seven times during the pregnancy and for up to 6 month after delivery. A submaximal bicycle exercise test with a target heart rate of 85% of the predicted age-adjusted maximum was performed. Maternal oxygen saturation was continuously recorded using a pulse oximeter. Results: Maternal oxygen saturation at maximum work-load had increased significantly already at 8 weeks gestation compared with preconception levels, and remained at a significantly higher level until 29 weeks of gestation. Thereafter, the oxygen saturation continued to be higher even at 6 month postpartum. During the exercise test, the lowest saturation was found during the late recovery period, this remained unchanged before, during and after pregnancy. Conclusion: A pregnant woman responds to short-term exercise by increasing the oxygen saturation until 29 weeks. After that, the saturation level decreases but remains at a higher level even 6 month after delivery compared with preconception levels.
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| 10. |
- Austeng, Dordi, et al.
(författare)
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Incidence of and risk factors for neonatal morbidity after active perinatal care : extremely preterm infants study in Sweden (EXPRESS)
- 2010
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:7, s. 978-992
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage >= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.
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