| 1. |
- Austveg, B, et al.
(author)
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New global efforts for safer motherhood
- 2004
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 111:5, s. 397-398
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Journal article (other academic/artistic)
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| 2. |
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| 3. |
- Brodszki, Jana, et al.
(author)
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Altered vascular function in healthy normotensive pregnant women with bilateral uterine artery notches.
- 2002
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 109:5, s. 546-552
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To assess endothelial function and vascular mechanical properties in normotensive pregnant women with high resistance in the uteroplacental circulation. DESIGN: Cross-sectional prospective study. SETTING: Doppler ultrasound laboratory at university department of obstetrics and gynaecology referral centre for high risk pregnancies. PARTICIPANTS: Forty-two caucasian normotensive pregnant women: 23 with uncomplicated pregnancies and 19 with bilateral uterine artery notches. METHODS: Flow-mediated dilatation of the brachial artery was measured by ultrasonography at 25 gestational weeks. Concentrations of nitrite and nitrate in the plasma were established at 25 and 32 gestational weeks. The elastic properties of the common carotid artery, abdominal aorta and popliteal artery were measured with an ultrasonic echo-tracking system. RESULTS: Flow-mediated dilatation at two minutes after cuff deflation was significantly lower in the bilateral notch group compared with the control group, 8.3% and 13.7%, respectively (P = 0.0007). The ability to sustain vasodilatation was reduced in the bilateral notch group (P = 0.02). Lower values of nitrite and nitrate in the plasma were found at 32 gestational weeks in the bilateral notch group than in the control group (mean 24.76 microM/L (SD 5.6) and 30.93 microM/L (8.2), respectively; P = 0.008). Nitrite and nitrate levels tended to be lower in the bilateral notch group even at 25 gestational weeks (29.45 microM/L (8.3) and 35.73 microM/L (11.0) in the bilateral notch and control group, respectively; P = 0.09). There was no difference in aortic, carotid or popliteal elasticity between the two groups. CONCLUSIONS: Healthy normotensive pregnant women with bilateral uterine artery notches show impaired endothelial function, but no differences in vascular mechanical properties.
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| 4. |
- Essén, Birgitta, et al.
(author)
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Are some perinatal deaths in immigrant groups linked to sub-optimal perinatal care services? Perinatal audit of infants to women from Africa’s Horn delivered in Sweden 1990-96
- 2002
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 109:6, s. 677-682
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Journal article (peer-reviewed)abstract
- Objective: To test the hypothesis that sub-optimal factors in perinatal care services resulting in perinatal deaths were more common among immigrant mothers from the Horn of Africa, as compared to Swedish mothers. Design: A perinatal audit, comparing cases of perinatal deaths among children of African immigrants residing in Sweden, with a stratified sample of cases among native Swedish women. Setting: Sixty-three cases of perinatal deaths among immigrant east African women delivered in Swedish hospitals in 1990–1996, and 126 cases of perinatal deaths among native Swedish women. Time of death and type of hospital were stratified. Main outcome measures: Sub-optimal factors in perinatal care services, categorised as maternal, medical care, and communication. Results: The rate of sub-optimal factors likely to result in potentially avoidable perinatal death was significantly higher among African immigrants. In the group of antenatal deaths, the OR was 6.2 (CI 1.9-20); the OR for intrapartal deaths was 13 (CI 1.1-166); and the OR for neonatal deaths was 18 (CI 3.3-100), when compared with Swedish mothers. The most common factors were delay in seeking health care, mothers refusing caesarean sections, insufficient surveillance of IUGR (intrauterine growth restriction), inadequate medication, misinterpretation of CTG (cardiotocography), and interpersonal miscommunication. Conclusions: Sub-optimal factors in perinatal care likely to result in perinatal death were significantly more common among east African than native Swedish mothers, affording insight into socio-cultural differences in pregnancy strategies, but also the sub-optimal performance of certain health-care routines in the Swedish perinatal care system.
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| 5. |
- Hildingsson, Ingegerd, et al.
(author)
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Few women wish to be delivered by caesarean section
- 2002
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In: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 109:6, s. 618-623
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate how many women wish to have a caesarean section when asked in early pregnancy, and to identify background variables associated with such a wish. DESIGN: National survey. SETTING: Swedish antenatal clinics. POPULATION: 3,283 Swedish-speaking women booked for antenatal care, at approximately 600 Swedish antenatal clinics, during three weeks spread over one year (1999-2000). METHODS: A questionnaire was mailed shortly after the first antenatal visit. MAIN OUTCOME MEASURES: Women's preferences for mode of delivery. RESULTS: 3,061 women completed the first questionnaire, corresponding to 94% of those who consented to participate after exclusion of reported miscarriages. The background characteristics of the study sample were very similar to a one-year cohort of women giving birth in Sweden during 1999. The result showed that 8.2% of the women would prefer to have a caesarean section. A wish for caesarean section was associated with parity, age, civil status, residential area and obstetric history. Women preferring caesarean section were more depressed and worried, not only about giving birth, but also about other things in life. A multivariate logistic regression model showed three factors being statistically associated with a wish for caesarean section: a previous caesarean section, fear of giving birth and a previous negative birth experience. CONCLUSIONS: Relatively few women wish to have a caesarean section when asked in early pregnancy, and these women seem to be a vulnerable group.
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| 6. |
- Moutquin, J.M., et al.
(author)
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Effectiveness and safety of the oxytocin antagonist atosiban versus beta-adrenergic agonists in the treatment of preterm labour
- 2001
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In: British Journal of Obstetrics and Gynaecology. - : Wiley. - 1365-215X .- 1470-0328 .- 1471-0528. ; 108:2, s. 133-142
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Journal article (peer-reviewed)abstract
- Objective To compare the effectiveness and safety of the oxytocin antagonist atosiban with conventional beta-adrenergic agonist (beta-agonist) therapy in the treatment of preterm labour. Design Three multinational, multicentre, double-blind, randomised, controlled trials. Setting Hospitals in Australia, Canada, Czech Republic, Denmark, France, Israel, Sweden, and the UK. Population Women diagnosed with preterm labour at 23-33 completed weeks of gestation. Methods Seven hundred and forty-two women were randomised; 733 received atosiban (n = 363; intravenous (iv) bolus dose of 6.75 mg, then 300 mug/minute iv. for 3h and 100 mug/min iv thereafter) or beta-agonist (n 379; ritodrine, salbutamol or terbutaline iv; dose titrated) for at least 18h and rip to 48 hours. Uterine contraction rate, cervical dilatation and effacement were used to assess progression of labour. An all patients treated analysis, using the Cochran-Mantel-Haenszel test, was performed. Main outcome measures Tocolytic effectiveness was assessed in terms of the number of women undelivered after 48 hours and seven days. Safety was assessed in terms of maternal side effects and neonatal morbidity. Results There were no significant differences between atosiban and beta -agonists in delaying delivery for 48h (88.1% vs 88.9%; P = 0.99) or seven days (79.7% versus 77.6%; P = 0.28). Tocolytic effectiveness was also similar in terms of mean [SD] gestational age at delivery (35.8 [3.9] weeks vs 35.5 [4.1] weeks) and mean [SD] birthweight (2491 [813] g versus 2461 [831] g). Maternal side effects, particularly cardiovascular adverse events (8.3% vs 81.2%, P < 0.001) were reported more frequently in women given beta -agonists, resulting in more treatment discontinuations due to side effects (1.1% vs 15.4%, P = 0.0001). No statistical differences in neonatal/infant outcomes were observed with either study medication. Conclusions In the largest study of tocolytic therapy to date, atosiban was comparable in clinical effectiveness to conventional beta-agonist therapy, but was associated with fewer maternal cardiovascular side effects. We conclude that atosiban has clinical advantages over current tocolytic therapy.
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| 8. |
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| 9. |
- Rööst, Mattias, 1977-, et al.
(author)
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A qualitative study of conceptions and attitudes regarding maternal mortality among traditional birth attendants in rural Guatemala
- 2004
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In: British Journal of Obstetrics and Gynaecology. - : Wiley. - 0306-5456 .- 1365-215X .- 1470-0328 .- 1471-0528. ; 111:12, s. 1372-1377
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To explore conceptions of obstetric emergency care among traditional birth attendants in rural Guatemala, elucidating social and cultural factors. STUDY: design Qualitative in-depth interview study. SETTING: Rural Guatemala. SAMPLE: Thirteen traditional birth attendants from 11 villages around San Miguel Ixtahuacán, Guatemala. METHOD: Interviews with semi-structured, thematic, open-ended questions. Interview topics were: traditional birth attendants' experiences and conceptions as to the causes of complications, attitudes towards hospital care and referral of obstetric complications. MAIN OUTCOME MEASURES: Conceptions of obstetric complications, hospital referrals and maternal mortality among traditional birth attendants. RESULTS: Pregnant women rather than traditional birth attendants appear to make the decision on how to handle a complication, based on moralistically and fatalistically influenced thoughts about the nature of complications, in combination with a fear of caesarean section, maltreatment and discrimination at a hospital level. There is a discrepancy between what traditional birth attendants consider appropriate in cases of complications, and the actions they implement to handle them. CONCLUSION: Parameters in the referral system, such as logistics and socio-economic factors, are sometimes subordinated to cultural values by the target group. To have an impact on maternal mortality, bilateral culture-sensitive education should be included in maternal health programs.
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| 10. |
- Steinwall, Margareta, et al.
(author)
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ONO-8815Ly, an EP2 agonist that markedly inhibits uterine contractions in women.
- 2004
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 111:2, s. 120-124
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Journal article (peer-reviewed)abstract
- Objective To determine the effect of ONO-8815Ly on uterine contractions. Design A randomised, double-blind, placebo-controlled, dose-ascending, cross-over study. Setting Department of Obstetrics and Gynaecology, University Hospital of Lund, Sweden. Population Seventeen, healthy, parous and permanently sterilised women. Methods Intrauterine pressure was recorded on days 1-3 of bleeding of two menstruations. Subjects were intravenously treated with 4 or 8 mug/minute of ONO-8815Ly or placebo for 130 minutes. Intravenous bolus injections of oxytocin, 50 pmol/kg body weight, were given 10 minutes before, during infusion after 60 and 120 minutes and 60 minutes after completion of infusion. The plasma concentrations of ONO-8815Ly were measured in samples obtained immediately before each oxytocin injection. Main outcome measure Area under pressure recording curve (AUC) 10 minutes before and after each oxytocin injection. Results Twelve women, six in each dose group, completed both recordings. Of these, two women of each group were not included in efficacy analysis due to non-responsiveness to oxytocin or missing baseline value. The AUC over 10 minutes before oxytocin injection after 60 minutes of infusion of ONO-8815Ly at 4 and 8 mug/minute was reduced to 21% and 37% of that before infusion, respectively. The AUC after oxytocin at that time amounted to 21% and 19%, respectively, of that before infusion. The activity and responsiveness remained low after 120 minutes but started to return to baseline 60 minutes after stopping infusion. Placebo had no effect. Conclusions ONO-8815Ly is a potent inhibitor of spontaneous uterine contractility in non-pregnant women and it reduces the uterine response to oxytocin injections.
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| 11. |
- Steinwall, Margareta, et al.
(author)
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Oxytocin mRNA content in the endometrium of non-pregnant women.
- 2004
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 111:3, s. 266-270
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Journal article (peer-reviewed)abstract
- Objective To study oxytocin mRNA in the human endometrium at different phases of the menstrual cycle. Design An exploratory study in non-pregnant women. Setting The Department of Obstetrics and Gynecology, Lund University Hospital, Sweden. Participants Thirty-three women of fertile age undergoing hysterectomy or endometrial curettage on routine benign gynaecologic indications. Methods Endometrial tissue was obtained throughout the menstrual cycle. The presence of oxytocin mRNA was investigated by in situ hybridisation and by real time PCR. Main outcome measures Oxytocin mRNA signalling intensity found by in situ hybridisation of tissue obtained at different times of the menstrual cycle. Relative amounts of oxytocin mRNA measured by real time PCR. Results The signal for oxytocin mRNA obtained by in situ hybridisation was more pronounced in glandular epithelial cells than in stromal cells. Furthermore, it was most marked around mid-cycle. The expression of oxytocin mRNA was confirmed by real time PCR. Conclusions The results indicate that oxytocin may be synthesised in the endometrium of non-pregnant women, particularly in the glandular epithelial cells. Hormone released from these sources may have a paracrine action on the uterus. Oxytocin mRNA expression seems to be ovarian hormone dependent with the highest concentration around mid-cycle.
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| 12. |
- Strevens, Helena, et al.
(author)
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Author's Reply.
- 2004
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 111:2, s. 193-195
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Journal article (peer-reviewed)abstract
- Abstract is not available. Author's Reply to correspondence about article "Glomerular endotheliosis in normal pregnancy and pre-eclampsia"
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| 13. |
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| 14. |
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| 15. |
- Tchoudomirova, Krasimira, et al.
(author)
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Vaginal microbiological flora, and behavioural and clinical findings in women with vulvar pain
- 2001
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 108:5, s. 451-455
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study genital symptoms and signs in women with vulvar pain, and the association with potential risk factors such as microbiological agents, sexual behaviour and genital hygiene. DESIGN: Prospective cohort study of apparently healthy women attending for contraceptive advice. SETTING: Two family planning clinics and one youth clinic in Sweden. POPULATION: Out of 996 women recruited, 79 women (7.9%) had, on request, complaints of current burning and smarting vulvar pain and/or superficial dyspareunia (our definition of vulvar pain) while 917 women without such symptoms served as controls. RESULTS: Complaints of dysmenorrhoea, vaginal discharge, genito-anal pruritus, dysuria, and abdominal pain were more frequent in the study group, than in the control group. In the women with vulvar pain, erythemas, superficial ulcerations, and fissures were found significantly more frequently. Vaginal candidosis was the only current genital infection that occurred more often in the study group, than among the controls. There were no differences in the history of gonorrhoea, genital chlamydial infection, genital herpes, genital warts, and candidosis between the two groups. The sexual debut of the women with vulvar pain occurred later in life, compared with the control group. Control subjects were more likely to use tampons for menstrual sanitation, than the women with vulvar pain. CONCLUSIONS: Neither infectious conditions caused by current known agents, with the exception of candidosis in some cases, nor behavioural factors, such as sexual behaviour and genital hygiene habits could in this study explain vulvar pain.
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| 16. |
- Teleman, Pia, et al.
(author)
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Overactive bladder: prevalence, risk factors and relation to stress incontinence in middle-aged women.
- 2004
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 111:6, s. 600-604
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Journal article (peer-reviewed)abstract
- Objective To investigate the prevalence of and factors associated with overactive bladder in middle-aged women. Design Cross sectional population-based study. Setting Southern Sweden and the Women's Health in the Lund Area study (WHILA 1995-2000) where 6917 (64% of the invited) women, 50-59 years old in 1995, participated. Population From the WHILA study, 1500 women reporting troublesome urinary incontinence (INCONT-1) and 1500 without incontinence (CONT-1) were selected by computerised randomisation and received the Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaire in January 2001. Methods Overactive bladder was defined in two versions using the ICS definition of 2002 as either urgency alone (OAB-1) or urgency combined with frequency more than eight times per day and/or nocturia twice or more per night (OAB-2). Risk factors were analysed by multiple logistic regression analyses. Main outcome measures Prevalence figures and odds ratios with corresponding 95% confidence intervals. Results The prevalence of OAB-1 was 46.9% in the INCONT-1 and 16.7% in the CONT-1 group, and that of OAB-2 was 21.6% and 8.1%, respectively. Most urgency occurred in combination with stress incontinence (i.e. as mixed incontinence). The overlap between stress and urge symptoms increased with the frequency of stress incontinence episodes (P< 0.001). Metabolic risk factors were body mass index (BMI) >= 30 for OAB-1, OAB-2 and stress incontinence, positive metabolic screening for OAB-1, family history of diabetes for OAB-2 and elevation of BMI >= 25% since the age of 25 for stress incontinence. Stress incontinence was associated with the current use of hormonal replacement therapy. Conclusions Overactive bladder and stress incontinence are intimately associated with each other. Both OAB and stress incontinence are associated with abnormal metabolic factors, mainly increased BMI.
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| 17. |
- Aneblom, Gunilla, et al.
(author)
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Knowledge, use and attitueds towards emergency contraceptive pills among Swedish women presenting for induced abortion
- 2002
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In: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 109:2, s. 155-160
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate the knowledge, experiences and attitudes towards emergency contraceptive pills (ECP) among women presenting for induced abortion. DESIGN: Survey by self-administered waiting room questionnaires. SETTING: Three large hospitals in the cities of Uppsala, Västerås and Orebro in Sweden. POPULATION: 591 Swedish-speaking women consecutively attending the clinics for an induced abortion during a four-month period in 2000. RESULTS: The response rate was 88% (n = 518). As many as 43% had a history of one or more previous abortions and 43% were daily smokers. Four out of five women, 83%, were aware of ECP, but only 15 women used it to prevent this pregnancy. Fewer, 38%, knew the recommended timeframes for use and 54% had knowledge of the mode of action. The two most common sources of information about ECP were media and friends. One out of five, 22%, had previously used the method, and at the time of conception, 55% would have taken ECP if it had been available at home, and 52% were positive to having ECP available over the counter. CONCLUSIONS: Emergency contraception is well known but is still underused. Lack of awareness of pregnancy risk may be one limiting factor for its use. Making ECP available over the counter may be an important measure towards better availability. Information strategies to the public are needed before ECP will be a widely used back-up method.
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| 18. |
- Ankardal, Maud, 1957, et al.
(author)
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A randomised trial comparing open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence
- 2004
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In: Bjog. - : Wiley. - 1470-0328. ; 111:9, s. 974-81
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To compare open Burch colposuspension using sutures with laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence. DESIGN: Multicentre, prospective randomised trial. SETTING: Departments of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Goteborg, Boras County Hospital and Orebro University Hospital, Sweden. POPULATION: Women with genuine stress urinary incontinence or mixed incontinence with a predominantly stress component were included, and were randomised to either open colposuspension (n= 120) or laparoscopic colposuspension (n= 120). METHODS: Women were randomised to open colposuspension with sutures or laparoscopic colposuspension with polypropylene mesh and staples. Anaesthesia/operation time, blood loss, complications and other related surgical parameters were compared. MAIN OUTCOME MEASURES: Objective and subjective cure rates from 48-hour frequency-volume chart, a 48-hour pad test and a subjective assessment of the woman's incontinence and quality of life performed one year after surgery. RESULTS: Objective and subjective cure rates were higher after open compared with laparoscopic colposuspension (P < 0.001). Quality of life was improved following surgery in both groups (P < 0.0001) and the improvement was significantly greater in the open colposuspension group (P < 0.05) with regard to physical activity. Performing an open colposuspension was less time consuming (P < 0.0001), resulted in more blood loss (P < 0.0001), longer catheterisation time (P < 0.01), greater risk of urinary retention (P < 0.01) and a longer hospital stay (P < 0.0001) compared with performing a laparoscopic colposuspension. The rate of serious complications was low in both groups. CONCLUSION: Open colposuspension had a higher objective and subjective cure rate one year after surgery but with a greater blood loss, greater risk of urinary retention and a longer hospital stay than laparoscopic colposuspension.
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| 19. |
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| 20. |
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| 21. |
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| 22. |
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| 25. |
- Hilden, Malene, et al.
(author)
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A history of sexual abuse and health : A Nordic multicentre study
- 2004
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In: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 111:10, s. 1121-1127
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Journal article (peer-reviewed)abstract
- Objectives: To determine if a history of sexual abuse is associated with objective and subjective indicators of health and if certain abusive incidents had a stronger impact on health than others. Design: A cross-sectional, multicentre study. Setting: Five gynaecological departments in the five Nordic countries. Sample: Three thousand five hundred and thirty-nine gynaecology patients. Methods: The NorVold Abuse Questionnaire (NorAQ) on abuse history and current health was mailed to all patients who consented to participate. Main outcome measures: Reason for index visit at the gynaecologic clinic as well as several questions on health were recorded. General health status was measured as self-estimated health, psychosomatic symptoms (headache, abdominal pain, muscle weakness, dizziness), number of health care visits and number of periods on sick leave. Result: A history of sexual abuse was reported by 20.7% of respondents. A history of sexual abuse was significantly associated with chronic pelvic pain as reason for index visit (P < 0.01), laparoscopic surgery (P < 0.01), psychosomatic symptoms (P < 0.01), self-estimated poor health (P < 0.01), many health care visits (P < 0.01) and high incidence of sick leave (P < 0.01). Several subgroups within the group of sexually abused women were more likely to report poor health: women abused as both children and adults, women who experienced additional emotional and/or physical abuse and women abused by a person they knew. Conclusion: Sexual abuse has a profound impact on women's health. Taking a history of sexual abuse seems particularly warranted when the patient presents with chronic pelvic pain or symptoms of a vague and diffuse nature.
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| 26. |
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| 27. |
- Larsson, Margareta, et al.
(author)
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Emergency Contraceptive Pills in Sweden : Evaluation of an information campaign
- 2004
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In: BJOG : an international journal of obstetrics and gynaecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 111:8, s. 820-827
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate a community-based intervention regarding emergency contraceptive pills, including a mass media campaign and information to women visiting family planning clinics.DESIGN: Quasi-experimental.SETTING: Two counties in Sweden.POPULATION: Eight hundred randomly selected women aged 16-30 years, 400 women in the intervention group and 400 in a comparison group.METHODS: Postal questionnaires before (2002) and after (2003) the intervention.MAIN OUTCOME MEASURES: Exposure to the intervention, knowledge, attitudes, practices and intention to use emergency contraceptive pills.RESULTS: Before the intervention, the response rate was 71% (n= 564); after the intervention, the corresponding figure was 83% (n= 467); overall response rate 58%. Two-thirds (64%) of the targeted women had noticed the information campaign. One out of six who had visited a family planning clinic during the intervention year recalled being given information about emergency contraceptive pills. Specific knowledge and attitudes improved over time in both groups, but there was no difference in change between the groups. The proportion of women who had used emergency contraceptive pills increased from 27% to 31% over time. Intention to use emergency contraceptive pills in case of need was reported by 74% of the women and remained stable over time, but logistic regression showed that information during the previous year contributed to willingness to use the method in the intervention group.CONCLUSIONS: Knowledge, attitudes and practices about emergency contraceptive pills increased in both groups. Emergency contraceptive pills is gradually becoming a more widely known, accepted and used contraceptive method in Sweden, a trend that may have limited the impact of the intervention.
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| 28. |
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| 29. |
- Mårtensson, Lena, et al.
(author)
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Subcutaneous versus intracutaneous injections of sterile water for labour analgesia : a comparison of perceived pain during administration
- 2000
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In: British Journal of Obstetrics and Gynecology. - : Wiley-Blackwell. - 1470-0328 .- 1471-0528. ; 107:10, s. 1248-1251
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Journal article (peer-reviewed)abstract
- Objective To investigate whether, during injections of sterile water, there is any difference in perceived pain between intracutaneous and subcutaneous injections.Design Blind controlled trial with cross-over design.Setting Göteborg and Skövde, Sweden.Participants One hundred healthy female volunteers.Methods The women were randomised into two groups and subjected to two trials, within one week of each other. During the first trial one group ( n= 50 ) received the intracutaneous injection first, followed by the subcutaneous injection. The second group ( n= 50 ) was given the subcutaneous injection first, followed by intracutaneous injection. In both groups all the injections were given in reverse order during the second trial.Main outcome measures Experienced pain during the administration of sterile water injections, measured by visual analogue scale.Results The analysis showed intracutaneous injections to be significantly more painful than subcutaneous injections, even after adjusting for injection day and for left/right site of injection (mean 60.8 vs 41.3, P < 0.001 ).Conclusions The findings suggest that the less painful subcutaneous injection technique should be used.
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| 30. |
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| 31. |
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| 32. |
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| 33. |
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| 34. |
- Olausson, PO, et al.
(author)
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Premature death among teenage mothers
- 2004
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In: BJOG : an international journal of obstetrics and gynaecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 111:8, s. 793-799
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Journal article (peer-reviewed)
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| 35. |
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| 36. |
- Swahnberg, Katarina, et al.
(author)
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Women's perceived experiences of abuse in the health care system : their relationship to childhood abuse
- 2004
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In: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 111:12, s. 1429-1436
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Journal article (peer-reviewed)abstract
- Objectives The aim of this study was to determine whether there was an association between any lifetime experiences of emotional, physical and/or sexual abuse and perceived abuse in the health care system. Furthermore, we wanted to ascertain if adult victims of perceived abuse in the health care system reported exposure to childhood emotional, physical and/or sexual abuse more often than non-victims did.Design A cross sectional questionnaire study. The first hypothesis was tested in the total sample, and the second hypothesis in a case–control analysis. The cases were those women who reported perceived experiences of abuse in the health care system as adults. Exposure was defined as experience of emotional, physical and/or sexual abuse in childhood.Settings Three Swedish gynaecological clinics.Sample A total of 2439 gynaecology patients (response rate 81%).Methods Postal questionnaire.Main outcome measure Associations between experiences of emotional, physical and/or sexual abuse, and perceived abuse in the health care system; all operationalised in The NorVold Abuse Questionnaire (NorAQ).Results A general association was found between lifetime experiences of emotional, physical and/or sexual abuse and perceived abuse in the health care system. Adult victims of abuse in the health care system reported experiences of emotional, physical and/or sexual abuse in childhood more often than non-victims did. These findings also held after adjustment for age and educational level.Conclusions We found associations between experiences of any lifetime abuse and perceived abuse in the health care system. Adult victimisation in the health care system was associated with childhood exposure to emotional, physical and/or sexual abuse. These associations call for attention and need to be further investigated.
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| 37. |
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| 38. |
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| 39. |
- Ingemarsson, Ingemar
(author)
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Gender aspects of preterm birth.
- 2003
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - 1471-0528. ; 110, s. 34-38
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Journal article (peer-reviewed)
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| 40. |
- Lindqvist, Pelle, et al.
(author)
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Maternal carriership of factor V Leiden associated with pathological uterine artery doppler measurements during pregnancy
- 2001
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - 1471-0528. ; 108:10, s. 5-1103
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Journal article (peer-reviewed)abstract
- Abstract To determine whether increased vascular resistance in the uterine artery is associated with carriership of factor V Leiden, a retrospective study was undertaken of 231 pregnant women who were monitored with Doppler velocimetry of the uterine arteries. These women had been part of a prospective study of 2,480 pregnant women in whom factor V Leiden had been analysed. When compared with non-carriers of factor V Leiden, carriers had a tendency towards an increased proportion of pathological Doppler measurements, including a significant increase in bilateral uterine artery notches (7/33 vs 16/198, relative risk 3.1; 95% CI 1.2-8.1). This suggests an increased vascular resistance in the uteroplacental circulation among carriers of factor V Leiden.
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| 41. |
- Petridou, E, et al.
(author)
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Are there common triggers of preterm deliveries?
- 2001
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In: British Journal of Obstetrics and Gynecology. - 1470-0328 .- 1471-0528. ; 108:6, s. 598-604
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To assess the effect(s) of transient events which are perceived as stressful on the inseption of preterm delivery.DESIGN: A case-control study, with immature infants as cases and borderline term babies as controls.SETTING: A teaching maternity hospital in Athens.POPULATION: All infants born at less than 37 weeks of gestation, during a twelve-month period.METHODS: Information was collected about maternal socio-demographic and lifestyle characteristics, clinical variables and stressful events occurring within two weeks prior to delivery.MAIN OUTCOME MEASURES: Factors affecting the risk of preterm delivery.RESULTS: Extreme prematurity (<33 weeks) is more common among younger (<25 years of age) and older (>29 years of age) women and is positively associated with parity, body mass index and smoking, whereas it is inversely associated with educational level, regular physical exercise and serious nausea/vomiting. After controlling for these factors, however, only coitus during the last weeks of pregnancy had a significant triggering effect on prematurity (P = 0.004, odds ratio 3.21, 95% CI 1.45 to 7.09 for very immature babies, and P = 0.04, OR = 2.20, 95% CI 1.03 to 4.70 for immature babies). On the contrary, several events perceived as stressful, such as illness of relatives or friends, husband's departure, loss of employment, were unrelated to the onset of premature labour.CONCLUSIONS: Coitus during the last few weeks of pregnancy appears to increase the risk of preterm delivery, while a possible detrimental effect of physical exertion seems more limited. Stressful events should not receive undue attention as possible causes of preterm delivery.
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- Prochazka, M, et al.
(author)
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Factor V Leiden in pregnancies complicated by placental abruption
- 2003
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In: BJOG: An International Journal of Obstetrics & Gynaecology. - 1471-0528. ; 110:5, s. 462-466
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Journal article (peer-reviewed)abstract
- Objective Recent studies suggest an increased prevalence of obstetric complications in female carriers of hereditary or acquired thrombophilias. The aim of the study was to determine if carriership of the factor V (FV) Leiden mutation (activated protein C [APC] resistance) is higher in women who have had of placental abruption during pregnancy. Design A retrospective case-control study. Setting University Hospital MAS, Malmo, Sweden. Methods A comparison of 102 women with placental abruption with 2371 prospectively collected controls. Carriership of FV Leiden was determined and the women were interviewed. Main outcome measures Proportion of FV Leiden carriership, first degree heritage of thrombosis and previous placental abruption in cases and controls. Results Carriage of FV Leiden was found in 15.7% of women who have had placental abruption as compared with 10.8% of controls (P = 0.12, odds ratio [OR] = 1.5, 95% confidence interval [CI] = 0.9-2.7). Around 20% of women with placental abruption reported first degree heritage for venous thrombosis, as compared with 6.7% of controls (P less than or equal to 0.001). Conclusions FV Leiden carriership was not significantly different in women with placental abruption. However, there was an increased prevalence of first degree heritage for venous thrombosis in women with placental abruption, indicating a higher prevalence of thrombophilia among women with placental abruption.
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