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- Bergman, B, et al.
(författare)
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Transfer of terbutaline across the human placenta in late pregnancy.
- 1984
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Ingår i: European journal of respiratory diseases. Supplement. - 0106-4347. ; 134, s. 81-6
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Tidskriftsartikel (refereegranskat)abstract
- Placental transfer of terbutaline was studied in 22 women in late pregnancy who were delivered by elective Caesarian section. A single i.v. dose of terbutaline (0.25 or 0.5 mg) was given at various times (13-295 min) before delivery. Immediately after delivery, one blood sample was drawn from the placental side of the umbilical vein and one from the mother's antecubital vein. By use of gas chromatography plus mass spectrometry terbutaline was assayed in maternal plasma and in plasma and whole blood from the umbilical vein. Plasma concentrations in the mothers (Cmv) were initially 7 micrograms/L, while the highest umbilical venous level ( Cuv ) recorded was 3.5 micrograms/L. The ratio Cuv /Cmv increased continuously during the time interval studied and approached unity after 2-3 h. The blood:plasma concentration ratio in venous umbilical blood was initially low. It reached unity after about 60 min, but increased steadily to about 1.5 during the time of study. Thus there was a continuous uptake of terbutaline from plasma into the erythrocytes. The slow in vivo equilibration of terbutaline between plasma and erythrocytes is probably due to the low lipophilicity of the drug. However, the latter characteristic did not seem to impede its diffusion across the placenta to any great degree.
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| 3. |
- Jacobsson, Bo, 1960, et al.
(författare)
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Microbial invasion and cytokine response in amniotic fluid in a Swedish population of women with preterm prelabor rupture of membranes.
- 2003
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Ingår i: Acta obstetricia et gynecologica Scandinavica. - 0001-6349. ; 82:5, s. 423-31
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous studies have shown an association between intra-amniotic microbial invasion and/or inflammation and spontaneous preterm birth. The aim of this study was to investigate the occurrence of intra-amniotic microorganisms and cytokines [interleukin (IL)-6 and IL-8] in a Swedish population, with low incidence of preterm birth, of women with preterm prelabor rupture of membranes and their correlation to preterm birth. METHODS: Amniotic fluid was retrieved transabdominally from 58 patients with preterm prelabor rupture of membranes before 34 weeks of gestation. Polymerase chain reaction (PCR) analyses for Ureaplasma urealyticum and Mycoplasma hominis and culture for aerobic and anaerobic bacteria were performed. IL-6 and IL-8 were analyzed with enzyme-linked immunosorbent assay (ELISA). RESULTS: Microorganisms in amniotic fluid were detected in 13 patients (25%). Patients with bacteria detected in the amniotic fluid had significantly higher levels of IL-6 and IL-8. An amniotic fluid concentration of IL-6 >/= 0.80 ng/ml [relative risk 1.93, 95% confidence interval (CI) 1.13-3.29, sensitivity 63%, specificity 75%] was associated with an increased risk of delivery within 7 days. There was also an association between IL-8 and preterm birth (< 34 weeks). CONCLUSIONS: Intra-amniotic microbial invasion and inflammation in this population of Swedish women with preterm prelabor rupture of membranes were similar to data reported from populations with a higher incidence of preterm delivery. Amniotic IL-6 correlated to the presence of microorganisms and delivery within 7 days and IL-8 to delivery before 34 weeks.
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| 6. |
- Bokström, Hans, 1949, et al.
(författare)
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Obstetrical and pediatric follow-up after uterus transplantation
- 2020
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Ingår i: Uterus Transplantation. Brännström M. (red.). - Cham : Springer. - 9783319941622 ; , s. 183-188
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- The ultimate goal of uterus transplantation is a successful pregnancy, with birth of a healthy baby. This has been accomplished repeatedly after live donor uterus transplantation and up until mid-2019, two times after deceased donor uterus transplantation. Pregnancy is established by embryo transfer in either natural cycle or hormone replacement cycle. After confirmation of viable pregnancy, by transvaginal ultrasound at around gestational week 7, the obstetrician/feto-maternal specialist takes over the responsibility of the medical controls of pregnancy. In the Swedish program, the pregnant woman, with a uterine allograft, is typically seen every second week from gestational week 8 until week 34. Starting from gestational week 35, these visits are weekly until delivery. The patient is seen for laboratory tests, by a midwife for routine controls and by an obstetrician for more specialized investigations including ultrasound. We recommend elective delivery from gestational week 37, although we are aware that deliveries were planned from week 35 regarding the first deliveries of the original Swedish study. Cesarean section is the preferred mode of delivery and so far there are no reports of any spontaneous vaginal deliveries. The four live births after uterus transplantation, that so far have been published, are reviewed in detail in the article. Children born after uterus transplantation should be followed up for many years concerning developmental parameters. Tests that are used in the Swedish studies are outlined in the chapter. © Springer Nature Switzerland AG 2020.
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| 7. |
- Brännström, Mats, 1958, et al.
(författare)
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Live birth after robotic-assisted live donor uterus transplantation.
- 2020
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Ingår i: Acta obstetricia et gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 99:9, s. 1222-1229
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Tidskriftsartikel (refereegranskat)abstract
- The proof-of-concept of uterus transplantation, as a treatment for absolute uterine factor infertility, came with the first live birth after uterus transplantation, which took place in Sweden in 2014. This was after a live donor procedure, with laparotomy in both donor and recipient. In our second, ongoing trial we introduced a robotic-assisted laparoscopic surgery of the donor to develop minimal invasive surgery for this procedure. Here, we report the surgery and pregnancy behind the first live birth from that trial.In the present study, within a prospective observational study, a 62-year-old mother was the uterus donor and her 33-year-old daughter with uterine absence as part of the Mayer-Rokitansky-Küster-Hauser syndrome, was the recipient. Donor surgery was mainly done by robotic-assisted laparoscopy, involving dissections of the utero-vaginal fossa, arteries and ureters. The last part of surgery was by laparotomy. Recipient laparotomy included vascular anastomoses to the external iliac vessels. Data relating to in vitro fertilization, surgery, follow up, obstetrics and postnatal growth are presented.Three in vitro fertilization cycles prior to transplantation gave 12 cryopreserved embryos. The surgical time of the donor in the robot was 360minutes, according to protocol. The durations for robotic surgery for dissections of the utero-vaginal fossa, arteries and ureters were 30, 160 and 84minutes, respectively. The remainder of donor surgery was by laparotomy. Recipient surgery included preparations of the vaginal vault, three end-to-side anastomoses (one arterial, two venous) on each side to the external iliacs and fixation of the uterus. Ten months after transplantation, one blastocyst was transferred and resulted in pregnancy, which proceeded uneventfully until elective cesarean section in week 36+1 . A healthy boy (Apgar 9-10-10) was delivered. Follow up of child has been uneventful for 12months.This is the first report of a live birth after use of robotic-assisted laparoscopy in uterus transplantation and is thereby a proof-of-concept of use of minimal invasive surgery in this new type of transplantation.
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| 8. |
- Brännström, Mats, 1958, et al.
(författare)
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Livebirth after uterus transplantation.
- 2015
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Ingår i: Lancet. - 1474-547X. ; 385:9968, s. 607-616
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Tidskriftsartikel (refereegranskat)abstract
- Uterus transplantation is the first available treatment for absolute uterine infertility, which is caused by absence of the uterus or the presence of a non-functional uterus. Eleven human uterus transplantation attempts have been done worldwide but no livebirth has yet been reported.
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| 9. |
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| 10. |
- Brännström, Mats, 1958, et al.
(författare)
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One uterus bridging three generations: first live birth after mother-to-daughter uterus transplantation
- 2016
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282 .- 1556-5653. ; 106:2, s. 261-266
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine whether a uterus from the mother of a woman with absolute uterine factor infertility can be transplanted to daughter and carry a pregnancy with delivery of a healthy child. Patient(s): Twenty eight-year-old woman with uterine agenesis, her male partner, and her 50-year-old mother. Intervention(s): In vitro fertilization with embryo cryopreservation before live donor uterus transplantation (UTx). Induction immunosuppression. Embryo transfer 12 months after UTx, pregnancy controls, delivery, and hysterectomy. Main Outcome Measure(s): Results of IVF-ET, parameters of pregnancy/birth, and surgical data of transplantation/cesarean section/hysterectomy. Result(s): Two IVF cycles before UTx resulted in 10 cryopreserved embryos. Donor surgery included hysterectomy with vascular pedicles of uterine vessels and proximal vessels up to and including parts of internal iliacs. Recipient surgery was by bilateral vascular connections to external iliacs, vaginal-vaginal anastomosis, and uterine fixation. Pregnancy occurred at the first single ET, and the pregnancy proceeded uneventfully until gestational week 34, when the patient developed cholestasis with intense pruritus. Cesarean section was performed at 34+6, with delivery of a healthy boy (weight 2,335 g). Hysterectomy was performed 3.5 months after delivery. The weight of the healthy child at 12 months was 9.3 kg. Grandmother (uterus donor) and mother are in good health 3 years after UTx. Conclusion(s): This is the first report of a live birth after mother-to-daughter UTx, and it also represents the second birth ever after human UTx. (C) 2016 by American Society for Reproductive Medicine.
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