| 1. |
- Bjälkander, O, et al.
(författare)
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Female genital mutilation in sierra leone: forms, reliability of reported status, and accuracy of related demographic and health survey questions
- 2013
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Ingår i: Obstetrics and gynecology international. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2013, s. 680926-
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Tidskriftsartikel (refereegranskat)abstract
- Objective.To determine forms of female genital mutilation (FGM), assess consistency between self-reported and observed FGM status, and assess the accuracy of Demographic and Health Surveys (DHS) FGM questions in Sierra Leone.Methods.This cross-sectional study, conducted between October 2010 and April 2012, enrolled 558 females aged 12–47 from eleven antenatal clinics in northeast Sierra Leone. Data on demography, FGM status, and self-reported anatomical descriptions were collected. Genital inspection confirmed the occurrence and extent of cutting.Results.All participants reported FGM status; 4 refused genital inspection. Using the WHO classification of FGM, 31.7% had type Ib; 64.1% type IIb; and 4.2% type IIc. There was a high level of agreement between reported and observed FGM prevalence (81.2% and 81.4%, resp.). There was no correlation between DHS FGM responses and anatomic extent of cutting, as 2.7% reported pricking; 87.1% flesh removal; and 1.1% that genitalia was sewn closed.Conclusion.Types I and II are the main forms of FGM, with labia majora alterations in almost 5% of cases. Self-reports on FGM status could serve as a proxy measurement for FGM prevalence but not for FGM type. The DHS FGM questions are inaccurate for determining cutting extent.
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| 2. |
- Bullarbo, Maria, 1958, et al.
(författare)
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Nitroglycerin for management of retained placenta: a multicenter study.
- 2012
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Ingår i: Obstetrics and gynecology international. - : Hindawi Limited. - 1687-9597 .- 1687-9589. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- The primary aim was to determine if sequential administration of oxytocin and nitroglycerin is effective for management of retained placenta when performed by obstetricians with no experience of the method. Secondary aims were to examine possible adverse effects of nitroglycerin. One hundred and five women with retained placenta were randomly selected to receive either 1mg nitroglycerin or placebo tablets sublingually if intravenous oxytocin had failed to expel the placenta. At two of the hospitals some of the midwives were familiar with the use of nitroglycerin. The other midwives and all the participating obstetricians had no clinical experience of the method. In the treatment group, detachment of placenta following nitroglycerin occurred in 37.3% of the women compared to 20.4% in the placebo group (P = 0.056). In the two hospitals with some experience of the method, placenta was removed in 9 of 19 (47.4%) women in the nitroglycerin group compared to 3 of 17 (15.0%) women in the placebo group. No adverse effects of clinical importance were registered. Although the difference between the two groups did not reach statistical significance, the higher success rate in the two hospitals with some experience could indicate that clinical experience is of importance in order to achieve placental detachment.
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| 3. |
- Bungum, Mona
(författare)
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Sperm DNA integrity assessment: a new tool in diagnosis and treatment of fertility.
- 2012
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Ingår i: Obstetrics and Gynecology International. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- Infertility affects 15% of all couples. Although male infertility factors with reduced semen quality are contributing to about half of all involuntary childlessness, the value of standard semen parameters in prediction of fertility in vivo and choice of proper method for assisted reproduction is limited. In the search for better markers of male fertility, during the last 10 years, assessment of sperm DNA integrity has emerged as a strong new biomarker of semen quality that may have the potential to discriminate between infertile and fertile men. Sperm DNA Fragmentation Index (DFI) as assessed by the flow cytometric Sperm Chromatin Structure Assay (SCSA) can be used for evaluation of sperm chromatin integrity. The biological background for abnormal DFI is not completely known, but clinical data show that DFI above 30% is associated with very low chance for achieving pregnancy in natural way or by insemination, but not in vitro. Already when the DFI is above 20%, the chance of natural pregnancy may be reduced, despite other sperm parameters being normal. Thus this method may explain a significant proportion of cases of unexplained infertility and can be beneficial in counselling involuntary childless couples need of in vitro fertilisation.
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| 4. |
- Fried, S, et al.
(författare)
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Outpatients' perspectives on problems and needs related to female genital mutilation/cutting: a qualitative study from somaliland
- 2013
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Ingår i: Obstetrics and gynecology international. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2013, s. 165893-
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore female outpatients’ perspectives on problems related to female genital mutilation/cutting (FGM/C) and their views on information, care, and counseling.Setting. An FGM/C support center at a maternity clinic in Hargeisa, Somaliland.Methods. A qualitative, descriptive study, using content analysis of seven semistructured interviews with female outpatients.Results. All participants had been ignorant of the etiology of their FGM/C-related complications and hesitant to seek care. All had undergone infibulation but did not wish the same for their daughters. In recent years they had learnt through religious leaders and media campaigns that infibulation was unapproved by Islam. A less severe FGM/C type, “Sunna,” was more accepted; however, few could define what “Sunna” meant. Condemning and ridiculing attitudes against uncircumcised women prevailed in their community.Conclusions. New ideas and concepts related to FGM/C enter the common discourse in the Somali society while traditional norms and values still prevail. Religion was shown to have a strong impact on FGM/C practices and beliefs. Interventions aiming to raise awareness of health consequences of all types of FGM/C, as well as where to seek care for complications, are needed in Somaliland. Involvement of religious leaders in anti-FGM/C programs is essential.
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| 5. |
- Gambadauro, Pietro, et al.
(författare)
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Intrauterine Adhesions following Conservative Treatment of Uterine Fibroids
- 2012
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Ingår i: Obstetrics and Gynecology International. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- Uterine fibroids are common in women of reproductive age and various conservative treatments are available. In order to achieve a successful conservative treatment of fibroids, functional integrity of the uterus is as important as tumor removal or symptoms relief. In this context, intrauterine adhesions must be recognized as a possible complication of conservative management of uterine fibroids, but diagnostic pitfalls might justify an underestimation of their incidence. Hysteroscopic myomectomy can cause adhesions as a result of surgical trauma to the endometrium. The average reported incidence is around 10% at second-look hysteroscopy, but it is higher in certain conditions, such as the case of multiple, apposing fibroids. Transmural myomectomies also have the potential for adhesion, especially when combined with uterine ischemia. Uterine arteries embolization also carries a risk of intracavitary adhesions. Prevention strategies including bipolar resection, barrier gel or postoperative estradiol, might be useful, but stronger evidence is needed. In view of current knowledge, we would recommend a prevention strategy based on a combination of surgical trauma minimization and identification of high-risk cases. Early hysteroscopic diagnosis and lysis possibly represents the best means of secondary prevention and treatment of postoperative intrauterine adhesions.
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| 6. |
- Gustavsson, Catharina, et al.
(författare)
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Obstetricians/Gynecologists' Problems in Sickness Certification Consultations : Two Nationwide Surveys.
- 2016
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Ingår i: Obstetrics and Gynecology International. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2016
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Tidskriftsartikel (refereegranskat)abstract
- Although O/Gs perceived sickness certification as problematic, there was less perceived severity of problems in 2012 compared to 2008, possibly because interventions regarding sickness certification have been introduced in Sweden recent years. Still, more organizational support, for example, time and supervision, are needed to enhance O/Gs' sickness certification practices.
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| 7. |
- Isman, E, et al.
(författare)
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Midwives' Experiences in Providing Care and Counselling to Women with Female Genital Mutilation (FGM) Related Problems
- 2013
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Ingår i: Obstetrics and gynecology international. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2013, s. 785148-
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim of this study was to elucidate midwives experiences in providing care and counselling to women with FGM related problems.Setting. The study was conducted at a maternity clinic in Hargeisa, Somaliland.Method. A qualitative, inductive study were performed with eight midwives living in Somaliland. The interviews had semi-structured questions. Content analysis was used for the analysis.Findings. The main findings of the present study were how midwives are challenged by culture and religion when providing FGM counselling. The most prominent challenge is the perception that FGM is an important part of the culture and from this point of view the midwives work is apprehended as interfering and subverting the Somali culture. Having personal experience of FGM emerged as a benefit when counselling women.Conclusion. There is a contradiction between the professional actions of performing FGM despite a personal belief against FGM. Midwives as a professional group could be important agents of change and further research is needed about the midwives role in this process.
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| 8. |
- Källén, Bengt
(författare)
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The problem of confounding in studies of the effect of maternal drug use on pregnancy outcome.
- 2012
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Ingår i: Obstetrics and Gynecology International. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- In most epidemilogical studies, the problem of confounding adds to the uncertainty in conclusions drawn. This is also true for studies on the effect of maternal drug use on birth defect risks. This paper describes various types of such confounders and discusses methods to identify and adjust for them. Such confounders can be found in maternal characteristics like age, parity, smoking, use of alcohol, and body mass index, subfertility, and previous pregnancies including previous birth of a malformed child, socioeconomy, race/ethnicity, or country of birth. Confounding by concomitant maternal drug use may occur. A geographical or seasonal confounding can exist. In rare instances, infant sex and multiple birth can appear as confounders. The most difficult problem to solve is often confounding by indication. The problem of confounding is less important for congenital malformations than for many other pregnancy outcomes.
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| 9. |
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