| 1. |
- Danielsson, C., et al.
(författare)
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Management and outcomes of preterm premature rupture of the membranes
- 2018
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Ingår i: CLINICAL AND EXPERIMENTAL OBSTETRICS & GYNECOLOGY. - : I R O G CANADA, INC. - 0390-6663. ; 45:3, s. 419-424
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Tidskriftsartikel (refereegranskat)abstract
- Purpose of investigation: To compare the maternal and neonatal outcomes of preterm premature rupture of the membranes (PPROM) between two management strategies. Materials and Methods: This retrospective cohort study involved 153 pregnant women who presented with PPROM at a gestational age of 28+0 to 36+6 weeks to evaluate the effects of expectant management (EM; labor > 36 hours) and active management (AM; labor < 36 hours) on maternal and neonatal outcomes. The EM and AM groups were also compared independently of gestational age and after being divided into two subgroups: early PPROM (gestational age 28+0 to 33+6 weeks) and late PPROM (34+0 to 36+6 weeks). Results: There were no differences between the AM and EM groups in the rates of maternal infection or placental abruption, or in neonatal outcomes, including low Apgar scores, respiratory distress syndrome, or the need for continuous positive airway pressure (CPAP). In the early PPROM subgroup, arterial umbilical blood base excess levels were more negative in the AM group (p = 0.007). In the late PPROM subgroup, the change in systolic blood pressure between admission to the maternity care center and membrane rupture was greater in the AM group (p = 0.049). Conclusions: There were no clinically significant differences in the maternal and neonatal outcomes of PPROM between AM and EM.
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| 2. |
- Forslund, Maria, 1978, et al.
(författare)
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Health-Related Quality of Life in perimenopausal women with PCOS
- 2022
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Ingår i: Clinical and Experimental Obstetrics and Gynecology. - : IMR Press. - 0390-6663. ; 49:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several studies have shown that younger women with polycystic ovary syndrome (PCOS) have decreased Health-Related Quality of Life (HRQoL) compared with women in general. Method: In this study peri- and postmenopausal women previously diagnosed with PCOS (n = 27) were compared with randomly selected, age-matched controls (n = 94). Mean age of the study participants was 52 years. Structured interviews and Short Form (SF)-36 questionnaires were used. Results: No differences in SF-36 scores were found, median for the physical summary score was 54 vs. 57, for women with PCOS and controls, respectively; and 53 vs. 53 for the mental summary score, with no differences in any of the eight dimensions of HRQoL. There were no significant difference in prevalence of depression and/or anxiety. The use of drugs for mood disorders was 22% in both groups. Conclusion: PCOS women of peri- and postmenopausal ages had similar HRQoL compared with age-matched controls.
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| 3. |
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| 4. |
- Hussein, G., et al.
(författare)
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Assisted Reproduction and Live Births in Uterus Transplantation-The Swedish View
- 2022
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Ingår i: Clinical and Experimental Obstetrics & Gynecology. - : IMR Press. - 0390-6663. ; 49:5
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Uterus transplantation (UTx) has evolved as the first true infertility treatment for absolute uterine factor infertility (AUFI), caused by a lack (congenital or surgical) of the uterus or presence of a non-functional uterus. Ever since the proof-of-concept of UTx as an infertility treatment, by the first live birth in 2014, the field has evolved with a number of ongoing clinical trials in several countries. Results are now gradually building up to estimate the efficacy of the procedure in terms of outcome of assisted reproduction, including live births. An update of these results will be presented along with our own experience. Mechanism: PubMed search for research articles with human UTx procedures. Findings in Brief: We could identify 62 UTx cases with data from research articles in peer-reviewed journals. Out of these, 51 were live donor procedures and 11 were deceased donor UTx. Surgical success was 78% in live donor UTx and 64% in deceased donor UTx. Limited data indicate a pregnancy and live birth rate per embryo transfer (ET), somewhat lower that in the general IVF population. The 24 published live births were premature (<37 gestational weeks) in 83%, with a high frequency (37%) of respiratory distress syndrome. Gestational hypertension/preeclampsia was seen in 17% and gestational diabetes in 12% of pregnancies. Post-natal health of children was fine. Conclusions: Uterus transplantation has entered the scene as the first available treatment for women with absolute uterine factor infertility. The procedure is still in an experimental phase and through ongoing clinical trials, with modifications of procedures, this type of combined infertility treatment and major transplantation surgery will improve regarding outcomes, such as surgical success, rate of pregnancy/live birth per ET, rate of term pregnancy, and rate of live births with only a minor rate of neonatal and postnatal complications.
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| 5. |
- Jordal, Malin, 1973-, et al.
(författare)
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Surgical Healthcare Interventions after Female Genital Mutilation/Cutting : A Review of the Evidence
- 2022
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Ingår i: CLINICAL AND EXPERIMENTAL OBSTETRICS & GYNECOLOGY. - : IMR Press. - 0390-6663 .- 2709-0094. ; 49:6
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Forskningsöversikt (refereegranskat)abstract
- Background: Female genital mutilation/cutting (FGM/C) is a global public health problem associated with an increased risk of physical, sexual, and mental health consequences. Surgical healthcare intervention may alleviate negative health consequences related to FGM/C. In this review, we aim to offer an overview of documented effects of surgical healthcare interventions after FGM/C, from the perspectives of both healthcare providers (HCPs) performing such interventions and the women receiving them.Methods: We searched four databases (PUBMED/MEDLINE, CINAHL, PsychInfo, Cochrane Library) for peer-reviewed articles published between 2000 and 2021, and retrieved a total of 1978 citations (1203 + 775). After scrutinizing the citations with the inclusion criteria (1) observable outcomes of surgical healthcare interventions after FGM/C, (2) HCPs' perceptions of FGM/C-related surgical healthcare and experiences of providing surgical care for FGM/C-affected women, and (3) FGM/C-affected women's perceptions and experiences of the effects of FGM/C-related surgical healthcare, we selected 38 articles to include in this review.Results: HCPs and FGM/C-affected women differed in their views on surgical interventions. While providers seemed to suggest premarital defibulation regardless of a woman's age and marital status, affected women voiced social and marital concerns related to defibulation, which sometimes overrode the physical consequences. On the other hand, some providers were reluctant to perform intrapartum defibulation due to uncertainty or misinformation about infibulated women's wishes, while women often expected and desired defibulation prenatally. And while gynecologists demonstrated skepticism towards clitoral reconstruction, most women who had undergone the procedure were satisfied, particularly regarding the psychosocial and sexual aspects.Conclusions: Providers and recipients of surgical interventions after FGM/C seem to display contrasting views on surgical intervention after FGM/C, which may have implications for healthcare recommendations as well as satisfaction. This apparent ambiguity between providers' and recipients' perceptions of surgical interventions needs further investigation.
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| 6. |
- Lindström, B. E., et al.
(författare)
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Urethral instillations of clobetasol propionate and lidocaine : a promising treatment of urethral pain syndrome
- 2016
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Ingår i: Clinical and Experimental Obstetrics & Gynecology. - : I. R. O. G. Canada, Inc.. - 0390-6663. ; 43:6, s. 803-807
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate topical treatment with clobetasol propionate and lidocaine in women with urethral pain syndrome (UPS) in a retrospective pilot study.Materials and Methods: Urethral instillations of two ml clobetasol propionate cream and two ml lidocaine gel in 30 Caucasian women age 15-74 years with UPS between 1999 and 2006 were evaluated retrospectively. Instillations were given approximately once a week until the patient improved. Between one and 15 (median three) instillations were given. In substudy I a review was undertaken of the medical records to register the treatment effect at the end of the treatment (the last instillation) and any relapses six months thereafter. Substudy II was a follow-up at least five years after last instillation based on medical records and a written questionnaire.Results: Substudy I (n=30): By the end of the treatment 18 women had no symptoms and 12 were improved. Five patients had relapsed within six months. Substudy II (n=28): Twenty-eight women responded to the questionnaire. Four women remained with no symptoms, 18 remained improved, and six had the same symptoms as before treatment. Twenty women thought the treatment was very effective, five rather effective, and three women reported poor effect. Twenty-six women would ask for retreatment if a relapse occurred, two patients would not. No side effects, except transient pain, were reported.Conclusions: This retrospective study and long-term follow-up suggests that urethral instillation of clobetasol propionate and lidocaine is effective in treating women with UPS. Randomized control studies are warranted.
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| 7. |
- Montejo, R., et al.
(författare)
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Doula support in office hysteroscopy: results from a pilot study
- 2021
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Ingår i: Clinical and Experimental Obstetrics & Gynecology. - : IMR Press. - 0390-6663. ; 48:4, s. 955-961
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Tidskriftsartikel (refereegranskat)abstract
- Background: This pilot study aimed to evaluate the feasibility of doula support in office hysteroscopy and the potential effectiveness of doula support during office hysteroscopy to reduce anxiety and pain. Methods: Twenty-eight women, median age 43.5 (range 21-73), with indications for office hysteroscopy received doula support (intervention) or routine care (control group) during the procedure. Feasibility was measured in terms of successful office hysteroscopies, duration, and adverse events. Outcome measures were Spielberg State-Trait Anxiety Inventory-S (STAI-S), and the Numeric Rate Scale (NRS) for pain intensity. Results: The results showed similar success rates, duration, and adverse events between the groups, with no differences in reported pain intensity. Both groups had high, comparable levels of anxiety before the procedure (Doula group mean STAI-S score = 45.4, control group = 45.8). After the procedure, the doula group showed slightly increased anxiety while the control group showed slightly decreased anxiety. There was a significant difference between groups favoring the control group when comparing STAI-S mean score post-procedure (48.6 in the Doula group versus 44.1 in the control group p = 0.033). However, when analyzing the mean change across groups (p = 0.205) that difference was not significant. Discussion: To conclude, this pilot study suggests that Doula support may be feasible but not superior to routine care support in office hysteroscopy. High anxiety levels may be more relevant than pain during the procedure. Further investigation of the state and trait anxiety in office hysteroscopy populations in different health care contexts is recommended.
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| 8. |
- Nunes, I, et al.
(författare)
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Prolonged saltatory fetal heart rate pattern leading to newborn metabolic acidosis
- 2014
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Ingår i: Clinical and Experimental Obstetrics and Gynecology. - : I R O G Canada, Inc.. - 0390-6663. ; 41:5, s. 507-11
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The saltatory pattern, characterized by wide and rapid oscillations of the fetal heart rate (FHR), remains a controversial entity. The authors sought to evaluate whether it could be associated with an adverse fetal outcome. Material and Methods: The authors report a case series of four saltatory patterns occurring in the last 30 minutes before birth in association with cord artery metabolic acidosis, obtained from three large databases of internally acquired FHR tracings. The distinctive characteristics of this pattern were evaluated with the aid of a computer system. Results: All cases were recorded in uneventful pregnancies, with normal birth weight singletons, born vaginally at term. The saltatory pattern lasted between 23 and 44 minutes, exhibited a mean oscillatory amplitude of 45.9 to 80.0 beats per minute (bpm) and a frequency between four and eight cycles per minute. Conclusions: A saltatory pattern exceeding 20 minutes can be associated with the occurrence of fetal metabolic acidosis.
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| 9. |
- Padma, Arvind M., et al.
(författare)
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Uterus bioengineering as a future alternative to uterus transplantation
- 2022
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Ingår i: Clinical and Experimental Obstetrics & Gynecology. - : IMR Press. - 0390-6663. ; 49:3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To review the current knowledge on uterus bioengineering and discuss potential future directives. Uterus bioengineering may solve two major hurdles in organ transplantation of a uterus, organ shortage and control of rejection by immunosuppression. Mechanism: Literature search using PubMed. Findings in brief: Sixty-seven references were summarized that describe the scientific progress made on uterus bioengineering, including other studies related to the topic. Most articles describe work on rat models, including proof of-concept that uterus bioengineering can be used to restore fertility after a partial uterine injury. These promising results are currently being translated to larger and more clinically relevant animal models. In particular, uterus-specific scaffolds produced by a process called "decellularization" that were developed for the mouse, rat, rabbit, pig, goat, and sheep. These scaffolds stimulated angiogenesis and regeneration in vitro and in vivo, and successfully harbored various types of cells for an extended time in vitro. Additionally, applications for endometrial extracellular matrix-specific hydrogels derived from decellularized uterus tissue is discussed. Current challenges for uterus bioengineering are also addressed, e.g., the cellular reconstruction phase, and how they might be improved. Conclusions: Significant progress was made during the last decade with convincing evidence from multiple independent groups in experiments with small animal models. Initial steps towards large animal uterus bioengineering were made. The future continuation of such studies will provide important data required to translate these ideas to an experimental phase in the human. Partial uterus reconstruction through a bioengineered tissue transplantation is closer to a clinical reality compared to whole uterus bioengineering principles aimed to replace a donor in a UTx setting.
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| 10. |
- Stenfelt, C., et al.
(författare)
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Effects of the colour and design of a new pelvic examination chair on comfort during gynaecological examination
- 2020
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Ingår i: CLINICAL AND EXPERIMENTAL OBSTETRICS & GYNECOLOGY. - : IMR PRESS. - 0390-6663. ; 47:4, s. 556-559
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The main question was whether the colour of a new design of pelvic examination chair could affect how the examination procedure was perceived. A prototype was constructed without vertical leg support and with built-in heating in the upholstery. To improve integrity, the perineum was exposed only during the examination. Main Outcome Measures: The patients were invited to evaluate the two different chair colours used, light blue and off-white, respectively. After vaginal ultrasound, the patients answered an anonymous questionnaire about their experience of the examination and how they perceived the comfort, warmth, integrity and colour of the chair. There were also questions regarding the absence of vertical leg support. Results: The questionnaire evaluation demonstrated the importance of colour since integrity was rated significantly higher in the light-blue chair than in the off-white. Similarly, the blue chair was experienced as significantly more comfortable than the white. Conclusions: The effect of colour was investigated in a new pelvic examination chair without vertical leg support, developed to suit men, women and also non-binary and transgender persons. It was also designed for increased comfort and integrity. The experience of colour had a significant positive (p < 0.001) effect on how the comfort, integrity and the absence of vertical leg support were perceived.
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