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| 2. |
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| 3. |
- Eneroth-Grimfors, E, et al.
(författare)
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Autonomic cardiovascular control in normal and pre-eclamptic pregnancy.
- 1994
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 73:9, s. 680-4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Pre-eclampsia is regarded as a primary placental disorder, in which defect placentation causes endothelial and cardiovascular disturbances. Evidence of disturbed neural cardiovascular control in this condition has been suggested, as well as in other hypertensive diseases. The purpose of the present study was to non-invasively evaluate the sympathovagal balance during normal and pre-eclamptic pregnancy. METHODS: In twelve healthy pregnant women, thirteen pre-eclamptic women and ten nonpregnant controls, heart rate, blood pressure and breathing movements were registered and recorded on a tape recorder for off-line analysis. Variability in heart rate, blood pressure and breathing movements were computed by an autoregressive spectral analysis algorithm. Heart rate variability was quantitated as the area under the spectral curve, and Student's t-test was performed on logarithmic values. RESULTS: Heart rate variability contained two major components in power, a low frequency peak predominantly attributed to sympathetic tone, and a high frequency peak reflecting vagal tone. Women with pre-eclampsia were characterized by a significantly reduced high frequency peak compared to healthy pregnant (p = 0.03) and non-pregnant (p = 0.02) women. In the low frequency band there were no significant differences in power between the groups. Blood pressure variability did not differ between the groups. CONCLUSIONS: The present results indicate that pre-eclampsia is associated with decreased vagal control of the heart. Furthermore, the results indicate that pregnancy per se does not change sympatho-vagal balance.
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| 4. |
- Lindgren, Richard, et al.
(författare)
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Hormonal replacement therapy and sexuality in a population of Swedish postmenopausal women
- 1993
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 72:4, s. 292-297
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Tidskriftsartikel (refereegranskat)abstract
- All women (n = 2465) living in the community of Linköping, Sweden, aged 55, 57, 59 and 65 years were studied in a cross-sectional trial concerning the prevalence of vasomotor symptoms, hormonal replacement therapy (HRT) and sexual activities. After one reminder, answers were received from 1867 (76%) women. In all, 51% of the women reported vasomotor symptoms. Ten percent of the women used HRT at the time of the survey. Another 10% of the women had previously used oral HRT but had abandoned treatment. One third of these women reported no vasomotor symptoms when they abandoned treatment. One fifth ceased treatment after recommendation from their physician and another fifth because of ‘fear’ of hormonal treatment.Sixty-two percent of the women reported sexual activity. The most common reasons for not having a regular sex-life were lack of partner or lack of desire.
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| 5. |
- Löfgren, Mats, et al.
(författare)
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Effects in vitro of progesterone and two 5 alpha-reduced progestins, 5 alpha-pregnane-3,20-dione and 5 alpha-pregnane-3 alpha-ol-20-one, on contracting human myometrium at term
- 1992
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 0001-6349 .- 1600-0412. ; 71:1, s. 28-33
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Tidskriftsartikel (refereegranskat)abstract
- Progesterone is known to prevent labour at term in domestic animals, but its effect in primates is uncertain. 5 alpha-reduced progesterone metabolites are more potent central nervous system depressants than progesterone is itself. Progesterone and its 5 alpha-reduced metabolites also relax pregnant rat myometrium in vitro. The serum concentration of the initial 5 alpha-reduced metabolite, 5 alpha-pregnane-3,20-dione, is high during pregnancy, but decreases significantly prior to parturition. The next metabolite, 5 alpha-pregnane-3 alpha-ol-20-one, has anaesthetic properties in human beings. The purpose of this study was to ascertain whether these progesterone metabolites also suppress contracting human uterine muscle at term. An in vitro model was devised. Strips of human myometrial muscle were mounted in organ chambers and after regular contractions had become established, the strips were superfused with progestin solutions. The progestins were dissolved in the buffer using an ultrasound bath. Progesterone, used as reference substance, slightly reduced the measured amount of muscular work performed per contraction, recordable after 18 min of exposure (p less than 0.05). Similar results have been reported previously in the literature; 5 alpha-pregnane-3 alpha-ol-20-one showed the same tendency though not significant at the 5% level. 5 alpha-pregnane-3,20-dione evidently reduced the contraction frequency after 10 min of exposure (p less than 0.05). None of the substances affected the duration of the contraction. These 5 alpha-reduced progesterone metabolites are thus not potent inhibitors of contracting human term myometrium in vitro.
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| 6. |
- Löfgren, Mats, et al.
(författare)
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Serum concentrations of progesterone and 5α-pregnane-3,20-dione during labor and early post partum
- 1990
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 0001-6349 .- 1600-0412. ; 69:2, s. 123-126
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Tidskriftsartikel (refereegranskat)abstract
- Serum 5α-pregnane-3,20-dione (5αDHP) and progesterone (P) concentrations were studied in 11 women with uncomplicated pregnancies and deliveries during spontaneous labor and immediately after delivery. Blood samples were drawn 3–6 times during labor, as soon as possible post partum and 1, 3, 6 and 12 h post partum. P and 5αDHP were analysed using RIA methods. There were no significant changes during labor in serum concentration of P and 5αDHP, the values being 366 nmol/l ± 25 SE and 128 nmol/l ±16 SE respectively. Whereas an earlier study has shown a significant decrease in 5αDHP serum concentration between late pregnancy and spontaneous labor, this study showed no decrease during labor, indicating that the decrease occurred before the onset of labor. After parturition, the elimination of P from serum was faster and proportionally greater than for 5αDHR with a half-life of 38 min for P and 58 min for 5αDHP. About 2—3 h post partum the serum concentrations stabilized just above luteal phase values. 12 h post partum, P and 5αDHP were 12% and 23% respectively of pre-partum values. Read More: http://informahealthcare.com/doi/abs/10.3109/00016349009006156
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| 7. |
- Malcus, Peter, et al.
(författare)
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Doppler blood flow changes and placental morphology in pregnancies with third trimester hemorrhage
- 1992
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 71:1, s. 39-45
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Tidskriftsartikel (refereegranskat)abstract
- Combined real-time ultrasound and pulsed Doppler ultrasound examinations were performed in 67 patients with third trimester hemorrhage and other symptoms related to placental abruption, starting from the onset of symptoms to delivery. In 52 of the cases, placental morphology was investigated by light microscopy. Thirteen patients were ultimately given the diagnosis abruptio placentae. None of the morphological placental changes considered had any statistical relationship to placental abruption. Patients with placental centrocotyledon hemorrhages and infarction more often had abnormal umbilical artery flow velocity waveforms at the onset of symptoms, and more frequent abnormal arcuate artery flow velocity waveforms were found among those with placental infarction alone. Abnormal flow velocity waveforms in the umbilical and arcuate arteries were associated with placental abruption, both at the onset of symptoms and at the final examination before delivery. The results indicate an increased risk for placental abruption if the arcuate and/or umbilical artery flow velocity waveforms are abnormal in patients with third trimester hemorrhage.
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| 8. |
- Pasker-de Jong, P. C., et al.
(författare)
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Psychopharmaceuticals and perinatal deaths
- 1992
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 0001-6349 .- 1600-0412. ; 71:6, s. 492-3
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Tidskriftsartikel (refereegranskat)
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| 9. |
- Platz-Christensen, Jens Jörgen, et al.
(författare)
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A longitudinal follow-up of bacterial vaginosis during pregnancy.
- 1993
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Ingår i: Acta obstetricia et gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 72:2, s. 99-102
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Tidskriftsartikel (refereegranskat)abstract
- Bacterial vaginosis (BV) has been considered by many investigators to be a risk factor for preterm labor. We have followed vaginal pH and the persistence of clue cells in Papanicolaou stained smears in 119 pregnant women during the course of pregnancy. Of 19 patients with clue cells in their smears during the first trimester, 11 (58%) still had clue cells at the second visit during the third trimester. Of the 100 patients without clue cells during their first trimester, none exhibited clue cells during the third trimester. If the persistence of clue cells is truly a risk factor for adverse pregnancy outcome, screening in the first trimester would identify a risk group of 15%. This risk group diminishes to 9% at the time of the third trimester. Vaginal pH > 4.5 had a recovery sensitivity of 76% and specificity of 83%. If clue cells can be considered as the identifying standard for bacterial vaginosis, the sensitivity and specificity of pH is 89% and 94%, respectively. The establishment of the diagnosis of BV during pregnancy and, in some cases, the treatment of the condition may be important as routine procedures in the antenatal center.
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| 10. |
- Rydhstrom, Håkan, et al.
(författare)
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No relation between maternal weight gain and stillbirth
- 1994
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 73:10, s. 779-781
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. To evaluate the relationship between stillbirth in singleton pregnancy (> or = 28 weeks gestation) and maternal weight (weight gain) from 24 completed weeks. METHODS. All fetal deaths (n = 210) at five delivery units during seven years in southern Sweden were analysed. To each case a control mother was selected, the only matching criteria being parity and place of delivery. Regression analysis was used for comparison of body weight gain in cases and controls. RESULTS. Mothers experiencing stillbirth had a significantly lower mean body weight at 24 weeks gestation than control mothers (63.5 kg vs 67.3 kg; t = 2.4, p < 0.05). No significant difference between cases and controls was found in mean weight gain during pregnancy from 24 completed gestational weeks to delivery, even when the last three measurements before delivery for cases and controls were compared separately. CONCLUSION. There is no difference in body weight gain between mothers with stillbirth and mothers giving birth to a live infant.
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| 11. |
- Tydén, Tanja, 1949-, et al.
(författare)
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Sexual behavior and sexually transmitted diseases among Swedish university students.
- 1991
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 0001-6349 .- 1600-0412. ; 70:3, s. 219-24
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Tidskriftsartikel (refereegranskat)abstract
- Students at Uppsala University, Sweden, were interviewed about their sexual behavior, their knowledge of and attitudes to sexually transmitted diseases (STDs) and related issues. The purpose of the study was to ascertain trends in behavior and attitudes as an indication of the likely risk of the spread of STDs, in particular AIDS, among students. Results revealed that change of partner was commonplace. A significant number of students had suffered from an STD. Students' claims that their own sexual practices, and those of others, had changed as a result of the AIDS epidemic, proved to be unsubstantiated in their behavior. Although contraceptive use was high, condom use with change of partner was infrequent. Alcohol played a significant role in impairing judgement. Despite a reasonably sound knowledge of STDs, the students exhibited a high degree of risk-taking behavior. The study has highlighted the dichotomy between knowledge and practice in student sexual behavior. Notable was the lack of perception among university students of their own risk of contracting STDs.
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| 12. |
- Walles, Bengt, et al.
(författare)
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Maternal health care program and markers for late fetal death
- 1994
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 73:10, s. 773-778
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE. To identify markers for late fetal death, a multicenter study was performed, based on routinely obtained data from maternal health care units. MATERIAL AND METHODS. Prospectively recorded data were obtained from maternal health care units belonging to five delivery units. In all, 233 consecutive cases of singleton pregnancy involving late fetal death (> or = 28 weeks) were identified between 1983 and 1989. As a control for each case, the next consecutive mother giving birth to a live infant at the same delivery unit was selected, the sole matching criterium being parity. RESULTS. After exclusion of pregnancies with lethal malformations or trauma, 205 cases remained for the statistical analysis. Two main subgroups were identified: mothers with placental abruption (n = 44), and pregnancies with no obvious reason for fetal death (n = 101). An increased risk for late fetal death was evident in expectant mothers > or = 40 years (10 vs 1; chi 2 = 7.6, p < 0.01), and in smokers where an association was seen to placental abruption. A significantly increased risk was also seen in women with medical treatment for essential hypertension (8 vs 1; chi 2 = 5.6, p < 0.05). On the other hand, we found no correlation between proteinuria, glucosuria, decreasing symphysis-fundal height, or changes in the Hb, on the one hand, and late fetal demise, on the other. There was no overrepresentation of post dated pregnancy (by ultrasound early in the second trimester) among the cases. Nor did post dated pregnancies (> or = 42 weeks) estimated from first day of last menstrual period (but not post dated by ultrasound) imply a higher rate of fetal death, as has been suggested in previous studies. CONCLUSION. In the present material, there was no sign of systematic error in the evaluation of data routinely obtained from the antenatal clinics and maternity units. Apart from placental abruption in smokers, a high maternal age, and medical treatment for essential hypertension, deviating data were recorded as often among controls as among cases. No correlation was evident between a post date pregnancy and fetal demise. A short symphysis-fundal height was recorded as often among controls as among cases and the even distribution of fetal birthweight in case pregnancies around the standard curve for the normal population is noteworthy.
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| 13. |
- Wide-Swensson, Dag, et al.
(författare)
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How Swedish obstetricians manage hypertensive disorders in pregnancy. A questionnaire study
- 1994
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 73:8, s. 619-624
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE. To study treatment of hypertension in pregnancy in Sweden and compare our results with a similar study published in 1981. METHODS. A multiple choice questionnaire was sent to 92 obstetricians throughout Sweden and 88% responded. RESULTS. Most Swedish obstetricians would treat a woman in the second trimester with blood pressure 140/95 mmHg without antihypertensive medication (83%) in the out-patient clinic (81%). The corresponding figures according to a similar study published in 1981 were 33% and 71% of obstetricians, respectively. Almost all obstetricians (95%) would give antihypertensive treatment if the blood pressure was 170/110 mmHg or more. Betablockers and hydralazine were the most commonly used drugs. Sixteen per cent of obstetricians would use calcium antagonists, drugs not available in the previous study. Treatment with diuretics, methyldopa or diazepam in hypertension was rarely used. Eight per cent of obstetricians would give low-dose aspirin to patients with mild hypertension and 20% to patients with severe hypertension. Fourteen per cent of obstetricians would stop all kind of antihypertensive medication and frequently observe patients with essential hypertension. CONCLUSION. Antihypertensive therapy and management of hypertensive disorders of pregnancy show a great disparity among Swedish obstetricians. National strategies might improve the morbidity and mortality associated with hypertensive disorders in pregnancy.
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| 14. |
- Wikman, Marianne, et al.
(författare)
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Ambivalence towards parenthood among pregnant women and their men
- 1993
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 0001-6349 .- 1600-0412. ; 72:8, s. 619-626
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Tidskriftsartikel (refereegranskat)abstract
- 369 pregnant women and 345 expectant fathers visiting antenatal clinics were examined by a questionnaire concerning attitudes towards pregnancy and parenthood. Data were processed by factor analysis and the degree of agreement to important factors was estimated. Attitudes were dominated by two conflicting views: children mean existential satisfaction and children mean restriction of freedom for women as well as for men. There was a tendency to deny the items concerning the disadvantages of having children. An important factor in the women's as well as in the men's analysis was the importance of own parents as models in parenthood. The findings from this unselected population of pregnant women and their men are consistent with earlier in-depth interviews. It can be concluded that ambivalence should be regarded as a normal constituent of the adaptation to pregnancy and parenthood. Experiences of own parents play an important role in the transition to parenthood. An important task for the medical profession should be to inform about ambivalence as a normal phenomenon as it, left unaccepted, may cause unnecessary anxiety and feelings of guilt.
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| 15. |
- Laurini, Ricardo, et al.
(författare)
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Placental histology and fetal blood flow in intrauterine growth retardation
- 1994
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 1600-0412. ; 73:7, s. 529-534
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE. To define the histological lesions in the placenta associated with abnormal blood flow findings and to evaluate their possible clinical significance. DESIGN. A prospective blind study. SETTING. A clinical study at a teaching hospital, Malmo General Hospital, University of Lund, Sweden, morphological studies of placentas being performed at the Institute of Pathology, University of Lausanne, Switzerland. MATERIAL. Thirty-seven pregnancies where intrauterine growth retardation (IUGR) was suspected. METHODS. Blood velocimetry of the fetal descending aorta, umbilical artery and vein, and the maternal arcuate artery, using 2.5 MHz pulsed wave Doppler ultrasound. Histological examination of at least five random samples from each placenta. MAIN OUTCOME MEASURES. Frequency of small-for-gestational age (SGA) newborns (birth weight < or = mean -2 s.d.) and of operative delivery for fatal distress. RESULTS. Only the presence of placental infarction was significantly associated with IUGR and with intrauterine findings of abnormal blood velocity in the fetal descending aorta and umbilical artery. CONCLUSION. Placental infarction would seem to be a valuable morphological marker of uteroplacental vascular disease related to IUGR and impaired fetal and umbilical blood flow.
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