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- Östlund, Ingrid, et al.
(author)
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Gestational diabetes and preeclampsia
- 2004
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 113:1, s. 12-16
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Journal article (peer-reviewed)abstract
- Objective: To determine whether gestational diabetes mellitus (GDM) increases the risk for preeclampsia independent of other risk factors. Study design: The association between GDM and preeclampsia was analyzed in a population of women who had given birth to singletons registered in Swedish Medical Birth Register from 1992 through 1996 (n=430,852). Results: GDM occurred in 0.8% and preeclampsia in 2.9% of all pregnancies. The rate of preeclampsia was higher in the GDM than in the non-GDM group (6.1% versus 2.8%). High age, nullipara, chronic hypertension, kidney disease, and high body mass index (BMI) were all independently associated with increased risk for preeclampsia. Smoking was associated with decreased risk. Adjusted odds ratio for GDM as a risk factor for preeclampsia was 1.61 (95% confidence interval (CI) 1.39–1.86) when prepregnancy BMI, which was a true confounder, was included in the last step of the multiple logistic regression analysis. Conclusions: There is an independent and significant association between GDM and preeclampsia. Obesity is a major confounding factor but could not explain the total excess risk.
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- Ayres-de-Campos, D, et al.
(author)
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Can the reproducibility of fetal heart rate baseline estimation be improved?
- 2004
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 112:1, s. 49-54
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Journal article (peer-reviewed)abstract
- Objective: To evaluate the reproducibility of fetal heart rate (FHR) baseline estimation according to an objective and detailed definition presented in this article, by comparison with the FIGO guidelines' definition. Study design: Three hundred consecutively acquired FHR tracings, 150 from antepartum high-risk pregnancies and 150 from unselected intrapartum cases, were presented to nine experienced clinicians included in three different groups, for an estimation of the FHR baseline. The first group consisted of clinicians using the proposed definition, without previous training in its use. The second group consisted of clinicians using the proposed definition, where a previous training session was promoted. The third group consisted of clinicians using the FIGO guidelines' definition. Agreement in baseline estimation was evaluated using the kappa statistic, the proportions of agreement and the intra-class correlation coefficient. Results: Using the baseline definition proposed in this article, agreement was significantly higher in the group with prior training in its use. This group also showed a trend towards a higher agreement than the one using the FIGO guidelines. Conclusion: The FHR baseline definition proposed in this article provides an extremely reproducible estimation when associated with prior training in its use.
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- Dubiel, Mariusz, et al.
(author)
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Blood velocity in the fetal vein of Galen and the outcome of high-risk pregnancy
- 2001
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 99:1, s. 14-18
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Journal article (peer-reviewed)abstract
- BACKGROUND: Pulsation in the flow velocity waveform in the umbilical vein is related to perinatal mortality but the flow velocity waveform in the fetal vein of Galen is normally even and without fluctuation. OBJECTIVES: To establish whether blood flow velocity pulsations in the vein of Galen in high-risk pregnancies are related to outcome. STUDY DESIGN: The vein of Galen was located by colour Doppler ultrasound in 102 pregnancies complicated by severe pregnancy-induced hypertension. The blood velocity waveform was recorded by pulsed Doppler within 2 days of delivery and the presence pulsations related to pregnancy outcome, including emergency operative intervention and neonatal distress. Umbilical artery and vein and uterine artery blood flow velocity waveform were also recorded at the same time. The clinicians managing the women were unaware of the venous flow results. RESULTS: Pulsation were present in the vein of Galen in 68 cases and in the umbilical vein in 21. Both were significantly related to adverse outcome. Pulsations in the vein of Galen were seen in all seven perinatal deaths. CONCLUSIONS: Since umbilical venous pulsation are a late sign of fetal compromise, and pulsations in the vein of Galen seem to appear earlier, thus being an intermediate sign of fetal compromise that might be of great value for fetal surveillance.
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- Hjelm, AM, et al.
(author)
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Changes of the uterine proteoglycan distribution at term pregnancy and during labour
- 2002
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 100:2, s. 146-151
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Journal article (peer-reviewed)abstract
- Objective: To characterise uterine proteoglycans and changes therein during pregnancy and labour. Study Design: Uterine samples were collected from 6 non-pregnant, 10 term-pregnant and from 10 women in active tabour. The proteoglycans were extracted by 4 M guanidine hydrochloride and precipitated with Alcian Blue. They were separated by electrophoresis and identified by Western blotting. Results: Decorin was the dominating proteoalycan and smaller amounts of biglycan was found. A considerable amount of heparan sulphate proteoglycans wag also detected. Decorin and biglycan decreased by 40% until term. The amount of heparan sulphate proteoglycans increased by 46% during active labour. Conclusion: Our data indicate that a considerable remodelling of the uterine connective tissue occurs during pregnancy and labour. The decrease of decorin and biglycan and the increase of heparan sulphate proteoglycans may be important for normal myometrial contractions during tabour. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
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- Krebs, L, et al.
(author)
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Long-term outcome in term breech infants with low Apgar score--a population-based follow-up
- 2001
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 100:1, s. 5-8
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate the relation between low Apgar score in breech infants and handicap in childhood. STUDY DESIGN: A case-control study. A questionnaire to mothers of 323 non-malformed, singleton infants delivered in breech presentation at term, 105 cases with Apgar score below 7 at 5 min and 218 controls. RESULTS: Four cases (4.6%) and one control (0.5%) had cerebral palsy. In infants without cerebral palsy, speech/language problems were more frequent than controls (10.6 versus 3.2%) (P=0.02). There were no differences in rates of deficits in attention, motor control and perception (DAMP), epilepsy, cognitive developmental delay or learning disabilities. Absence of any handicap or disability was reported in 65 cases (75%) compared to 172 controls (92%) (OR: 3.9; 95% CI: 1.9-7.9). CONCLUSION: Even though low Apgar score indicates an increased risk of neurological sequelae, most (75%) breech infants with low Apgar score are without a handicap/disability at follow-up.
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| 10. |
- Medda, Emanuela, et al.
(author)
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Genetic amniocentesis:a risk factor for preterm delivery?
- 2003
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 110:2, s. 153-158
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Journal article (peer-reviewed)abstract
- Objective: To determine whether genetic amniocentesis performed in the second trimester of pregnancy is associated with the risk of preterm delivery. Study design: Case–control study performed in several departments of obstetrics and gynaecology of nine European countries. Three thousand and ninety-one preterm births and 5298 controls randomly selected from singleton births born at term during 1994–1997 were analysed. Logistic regression models were used to compare preterm births altogether and, separately, spontaneous preterm delivery and induced preterm delivery. Results: An increased risk of preterm delivery was found in women having second trimester genetic amniocentesis after taking account of other risk factors and confounding variables (odds ratios (OR)=1.59, 95% confidence intervals (95% CI): 1.31–1.92). The association was statistically significant and similar for spontaneous preterm delivery and induced preterm delivery. Conclusion: The study shows an association between preterm delivery and genetic amniocentesis. In view of the wide use of amniocentesis, further research on the etiologic role of this prenatal diagnostic technique is needed.
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- Olofsson, Per
(author)
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Current status of intrapartum fetal monitoring: cardiotocography versus cardiotocography + ST analysis of the fetal ECG.
- 2003
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 110 Suppl:Suppl. 1, s. 113-118
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Journal article (peer-reviewed)abstract
- Two randomized controlled trials (RCT) on intrapartum fetal monitoring with cardiotocography (CTG) only versus CTG combined with automatic ST segment waveform analysis of the fetal ECG have been performed. In altogether 6826 randomized cases, the odds ratio for operative delivery for fetal distress (ODFD) was 0.65 (95% confidence interval 0.53-0.78) and for metabolic acidosis at birth 0.39 (0.21-0.72). in favor of the CTG + ST method. CTG combined with ST analysis increases the ability of obstetricians to identify fetal hypoxia and to intervene more appropriately, resulting in an improved perinatal outcome. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
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| 13. |
- Saldeen, Pia, et al.
(author)
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Structural, functional and circulatory placental changes associated with impaired glucose metabolism.
- 2002
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 105:2, s. 136-142
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate associations between structural, functional and circulatory placental changes in pregnancies complicated by impaired glucose metabolism. DESIGN: Umbilical artery (UA) blood flow resistance was measured by Doppler velocimetry in 21 gravidae with diabetes/impaired glucose tolerance (IGT) and 10 healthy gravidae. Umbilical and placental vessel segments were incubated for determination of prostacyclin and thromboxane synthesis, and tissues histologically examined. Non-parametric statistical tests at a two-tailed P<0.05 were used. RESULTS: Placental lesions were more common in diabetes/IGT and, although not being an uniform finding, in general associated with a higher vascular synthesis of thromboxane and/or lower prostacyclin/thromboxane synthesis ratio. As an exception, ischemic villitis was associated with a higher ratio and higher UA flow resistance. CONCLUSIONS: Placental lesions are associated with an altered vascular prostanoid synthesis in diabetes/IGT, but not until structural signs of ischemia develop is a rise of UA blood flow resistance detected.
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| 23. |
- Wanggren, K, et al.
(author)
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Severe jaundice in early IVF pregnancy
- 2004
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In: European journal of obstetrics, gynecology, and reproductive biology. - : Elsevier BV. - 0301-2115. ; 112:2, s. 228-229
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Journal article (peer-reviewed)
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| 24. |
- Brännström, Mats, 1958, et al.
(author)
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Uterine transplantation.
- 2003
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In: European journal of obstetrics, gynecology, and reproductive biology. - 0301-2115. ; 109:2, s. 121-3
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Research review (peer-reviewed)abstract
- Uterine factor infertility is either due to congenital malformation or acquired. Most women with uterine factor infertility have no chance to become genetic mothers, except by the use of gestational surrogacy. The logical but radical approach for treatment would be replacement of the unfunctional or absent uterus. Uterine transplantation could allow these women to become both genetic and gestational mothers. The present work reviews the existing literature on the history and recent development around this topic. We also briefly describe a newly developed model for heterotopic uterine transplantation in the mouse, in which pregnancies have been accomplished. Some specific issues that are required to be solved prior any further attempts to transplant the uterus in humans are also addressed.
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| 27. |
- Jacobsson, Bo, 1960
(author)
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Infectious and inflammatory mechanisms in preterm birth and cerebral palsy.
- 2004
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In: European journal of obstetrics, gynecology, and reproductive biology. - : Elsevier BV. - 0301-2115. ; 115:2, s. 159-60
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Research review (peer-reviewed)abstract
- In a thesis examine infectious and inflammatory mechanisms involved in preterm birth and cerebral palsy.Four cross-sectional studies and a case control study.Microbial invasion of the amniotic cavity and inflammation in this population of Swedish women in preterm labor and preterm prelabor rupture of membranes was similar to that reported in data from populations with a higher incidence of preterm birth. Our data support an association between antenatal infection/inflammation and cerebral palsy.Infectious and inflammatory mechanisms are involved in preterm birth and cerebral palsy in a population with low incidence of preterm birth.
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| 28. |
- Svedman, Cecilia, et al.
(author)
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Ulcus vulvae acutum, a rare diagnosis to keep in mind.
- 2004
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In: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 115:1, s. 5-104
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Journal article (peer-reviewed)abstract
- Genital ulceration is today often thought to be caused by herpes simplex. In this case report, a rare differential diagnosis, ulcus vulvae acutum is described, probably caused by Epstein–Barr virus (EB-virus).
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