| 1. |
- Bakken, Kjersti S., et al.
(författare)
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Obstetric Outcomes of First- and Second-Generation Pakistani Immigrants: A Comparison Study at a Low-Risk Maternity Ward in Norway
- 2017
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Ingår i: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 19, s. 33-40
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Tidskriftsartikel (refereegranskat)abstract
- © 2015, Springer Science+Business Media New York. This population-based study compares obstetric outcomes of first- and second-generation Pakistani immigrants and ethnic Norwegians who gave birth at the low-risk maternity ward in Baerum Hospital in Norway from 2006 to 2013. We hypothesized that second-generation Pakistani immigrants are more similar to the ethnic Norwegians because of increased acculturation. Outcome measures were labor onset, epidural analgesia, labor dystocia, episiotomy, vaginal/operative delivery, postpartum hemorrhage, preterm birth, birth weight, transfer to a neonatal intensive care unit, and neonatal jaundice. Compared to first-generation Pakistani immigrants, the second-generation reported more health issues before pregnancy, and they had a higher proportion of preterm births compared to Norwegians. Newborns of first-generation immigrants were more often transferred to a neonatal intensive care compared to Norwegian newborns. Few intergenerational differences in the obstetric outcomes were found between the two generations. A high prevalence of consanguinity in second-generation immigrants suggests the maintenance of a traditional Pakistani marriage pattern.
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| 2. |
- Lyng, Kristin, et al.
(författare)
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Fetal brain injury in experimental intrauterine asphyxia and inflammation in Gottingen minipigs
- 2006
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Ingår i: J Perinat Med. ; 34:3, s. 226-34
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine fetal brain injury in the Gottingen minipig following intrauterine asphyxia and infection/inflammation induced at 3/4 of gestational length. METHODS: We performed laparotomy after anesthesia in six pregnant sows. We randomized 29 fetuses to one of four groups: pretreatment with saline or endotoxin followed by 30 min of umbilical cord occlusion or no occlusion. After 48 h we performed a re-laparotomy and examined the fetal brains. RESULTS: After total asphyxia, brain stem injury was present in the group pretreated with saline (P < 0.01 vs. controls) and with endotoxin (P < 0.005 vs. controls). Microglia activation was more marked in the brain stem (P < 0.05) and posterior white matter (P < 0.05) in the asphyxia group than in controls. Two of five fetuses in the asphyxia group had white matter injury, while no white matter lesions were found in the asphyxia/inflammation or endotoxin only groups. CONCLUSIONS: In this Gottingen minipig model, a species closer to humans than animals commonly used in experimental studies of perinatal brain injuries, intrauterine asphyxia following pretreatment with saline caused brain stem and white matter injury. This model can be further developed to study the impact of other intrauterine exposures on brain injury.
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| 3. |
- Viberga, Ilze, 1963-
(författare)
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The Clinical Appearance of Pelvic Inflammatory Disease in Relation to Use of Intrauterine Device in Latvia : A Study with Special Emphasis on Factors Influencing the Clinical Course of PID in IUD Users
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The objectives of this case-control study, investigating 51 in-patient women with acute pelvic inflammatory disease (PID) and 50 healthy women attending for routine gynecological check-up, were to investigate the background and reproductive history of women, who are considered at low risk of sexually transmitted infection presenting with PID, to examine whether intrauterine device (IUD) use per se and long use affects the microbiology and clinical course of the disease, to identify risk factors for PID and to examine whether IUD use is an independent risk factor for PID.The most striking difference regarding the background and reproductive history between women with PID and healthy women over age 25 were related to socio-demographic factors and not to common risk factors for PID.There was little difference between healthy women and women with current PID with regard to single microbes. The finding of combinations of several anaerobic or aerobic/anaerobic microbes appeared to be associated with PID, particularly in women over 35. The pathogenesis of non-sexually transmitted PID appears to be associated with a synergistic effect between several pathogens, possibly facilitated by the presence of an IUD.IUD use per se was associated with an increased risk of PID in women 35 and older. There was an association between IUD use and complicated PID in women over 35, which was possibly influenced by long-term IUD use. Age over 35 and IUD use, independently of each other, were associated with an increased risk of failed conservative treatment, necessitating surgery in patients with PID.An observational study showed that Latvian obstetrician-gynecologists participate actively in contraceptive counseling and are very experienced with regard to IUD use. Physicians’ attitudes and perceptions towards IUD are generally positive and their clinical considerations are in good agreement with that of doctors in other countries. Antibiotics are widely used around IUD insertion by doctors, possibly driven by a liberal attitude towards IUD use in women with a potential risk of STI. The study could identify some possible gaps in the theoretical knowledge about the IUD and other methods.
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| 4. |
- Yli, Branka M., et al.
(författare)
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Intrapartum cardiotocography (CTG) and ST-analysis of labor in diabetic patients
- 2011
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Ingår i: Journal of Perinatal Medicine. - 1619-3997. ; 39:4, s. 457-465
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To determine the prevalence and types of intrapartum cardiotocography (CTG) patterns and investigate their relationship to moderate acidemia in term fetuses of diabetic mothers. Also, to assess if the combination of fetal electrocardiogram (FECG) and those CTG patterns strengthens the association with moderate acidemia. Material and methods: The material for this study is obtained from the Swedish randomized control trial and the European Union ST-analysis trial. We developed an analytical model for CTG patterns based on the progress in CTG changes, in a longitudinal periodic manner. The model was then combined with information regarding changes in ST interval that indicate threatening asphyxia, and the findings were analyzed to determine correlation with the presence of moderate acidemia at birth. Results: This study involved data of 413 diabetic mothers. A preterminal CTG was more common in the diabetes mellitus (DM) group (6/70, 8.6%) than in the gestational diabetes (GD) group (3/307, 1.0%; P=0.003). For diabetic mothers (i.e., DM+GD) with a normal CTG at the start of monitoring, the presence of FECG data indicating asphyxia significantly increased the likelihood of an umbilical artery pH < 7.15 at birth wodds ratio (OR) = 3.65, 95% confidence interval (CI) = 1.33-10.05]. Among labors where the CTG was non-reassuring at the start of monitoring, no significant association was found between pH < 7.15 and indication to intervene according to FECG information (OR = 1.51, 95% CI = 0.33-7.0). Conclusions: A preterminal CTG is more common in the fetuses of DM than GD mothers during labor. When CTG was normal at the start of recording, the addition of FECG information gave a significant add on information to predict moderate acidemia.
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| 5. |
- Yli, Branka M, et al.
(författare)
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Intrapartum fetal ECG and diabetes
- 2008
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Ingår i: Journal of Maternal-Fetal & Neonatal Medicine. - : Informa UK Limited. - 1476-7058 .- 1476-4954. ; 21:4, s. 231-238
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The objective of this study was to determine the prevalence and types of ST-segment changes of the fetal electrocardiogram (FECG) during labour in term fetuses born to mothers with diabetes mellitus (DM) or gestational diabetes. Methods. This was a retrospective case-control study involving populations from two multi centre trials: the Swedish Randomized Control Trial and the European Union ST-analysis (EU-STAN) trial. ST-segment changes were assessed in 104/309 cases and 207/468 controls from the Swedish and EU-STAN trials, respectively. Results. ST depression was present on the FECG in 22.1% of fetuses of mothers with DM compared to 12% of controls OR=2.6, 95% CI=1.4-4.7, p=0.002 after adjusting for trial, birth weight, and nulliparity. ST elevation was present in 47.1% of DM patients and 41.2% of controls (OR=1.4, 95% CI=0.9-2.3, p=0.18). Conclusion. ST depression on the FECG was significantly more prevalent in the fetuses of mothers with DM, probably not indicating hypoxia but an altered ability of the myocardium to respond to the stress of labour. Further studies into the mechanism of fetal compromise during diabetic labour, are required.
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