| 1. |
- Högberg, Ulf
(författare)
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Maternal deaths in Sweden 1971-1980
- 1986
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - Köpenhamn : Munksgaard Forlag. - 0001-6349 .- 1600-0412. ; 65:2, s. 161-167
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Tidskriftsartikel (refereegranskat)abstract
- Sixty-eight deaths during pregnancy, parturition and puerperium were recorded in Sweden during the years 1971–80, giving a maternal mortality of 6.6 per 100 000 live births. the figurese for abdominal delivery and vaginal were 45.0 and 2.5 per 100000 live births respectively. Am-niotic fluid embolism, pulmonary embolism and hemorrhage were the main causes of death within 24 hours after delivery, while pre-eclampsia/eclampsia and sepsis were predominant during the rest of the puerperium. Age and parity are highly important risk factors. Presumed avoidable factors were identified in 19% of the cases. 9% of the deaths were related to unwanted pregnancy.
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| 2. |
- Högberg, Ulf, 1949-
(författare)
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Maternal deaths related to cesarean section in Sweden 1951-1980
- 1989
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 68:4, s. 351-357
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Tidskriftsartikel (refereegranskat)abstract
- During the years 1951–1980 the cesarean section rate in Sweden increased from 1.7% to 11%. In connection with this procedure 103 maternal deaths were reported, of which 49% were related to age as risk factor. The overall fatality rate declined from 5.1 to 0.4 per 1,000 operations; cesarean section mortality decreased from 8.6 to 4.4 per 100,000 births. The altered age distribution amongst the parturients contributed to a decrease of 17% in mortality. Half of the deaths were attributed to the surgical procedure. During the 1970s these complications constituted a six-fold risk increase of abdominal over vaginal delivery, and complications attributed to the surgical procedure of abdominal delivery comprised 19% of the maternal mortality during the same period.
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| 3. |
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| 4. |
- Ingemarsson, Ingemar, et al.
(författare)
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Effects of isradipine, a new calcium antagonist, on postpartum uterine activity
- 1989
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 68:8, s. 725-730
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Tidskriftsartikel (refereegranskat)abstract
- The effects of a new calcium antagonist, isradipine (PN 200-110) on postpartum uterine activity and the maternal cardiovascular system were investigated. Uterine activity was recorded by a microtip transducer catheter inserted transcervically within 45 min of normal vaginal delivery. 0.5 mg of isradipine was given as a bolus injection during 5 min to 7 women with spontaneous uterine activity and 1 mg was given during a 15-min period to another 8 women with oxytocin-stimulated uterine activity. Matched controls with similar pre-injection activity (+/- 5%) but not given the drug were selected for comparison. The effects of the drug in 3 women (given 1 mg of isradipine) were compared with those in matched controls and in women given 0.25 mg of terbutalin i.v. as a bolus injection. Isradipine had a marked inhibitory effect on both spontaneous and oxytocin-stimulated uterine activity. The inhibitory effect of 1 mg of isradipine seemed comparable to that of 0.25 mg of terbutalin. The inhibition occurred within 1-2 min after the injection and was sustained throughout the study period (2 h). A transient reduction of the systolic (mean maximum decrease 10-15%) and diastolic blood pressure (mean maximum decrease 15-20%) was seen, particularly during the injection period. Hypotension (systolic blood pressure less than 80 mmHg) was not recorded. A moderate increase in pulse rate (mean maximum increase 22-27%) was seen in all cases. The results show that isradipine given as a bolus injection can inhibit early postpartum uterine activity, with minimal side effects.
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| 5. |
- Larsson, Hans, et al.
(författare)
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Studies on blood viscosity during the menstrual cycle and in the postmenopausal period in healthy women
- 1989
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 0001-6349 .- 1600-0412. ; 68, s. 483-486
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Blood viscosity was measured in 14 healthy, menstruating women, aged 17-51 years and in 10 healthy, postmenopausal women, aged 55-64 years. The fertile women were studied once a week during a normal menstrual cycle and the postmenopausal women twice with an interval of 2 weeks. Blood viscosity was measured at natural hematocrit as well as at hematocrit 45%. In the postmenopausal women no changes in blood viscosity were found. In the fertile women, blood viscosity at hematocrit 45% was lowest at the start of the menstrual bleeding and increased to a peak at day 7 (p < 0.01), with a similar pattern when measured at natural hematocrit. Plasma viscosity also had its lowest value at the onset of menstrual bleeding, increasing to a maximum at day 21. Changes in plasma triglycerides, but not in fibrinogen or cholesterol, seemed to contribute to this increase. Plasma factors only partly explained the variations in blood viscosity, and changes in red cell properties were also found to be of importance. The clinical significance of these rheological changes remains to be established, but at least theoretically there may be an increased risk for thromboembolism, e.g. at surgery, during days 5-15 of the cycle. In studies on blood flow and rheological conditions in fertile women, it seems advisable to standardize for time in the menstrual cycle.
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| 6. |
- Löfgren, Mats, 1949-, et al.
(författare)
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Decrease in serum concentration of 5α-pregnane-3,20-dione prior to spontaneous labor
- 1988
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : wiley online library. - 0001-6349 .- 1600-0412. ; 67:5, s. 467-470
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Tidskriftsartikel (refereegranskat)abstract
- Serum 5α-pregnane-3,20-dione (5αDHP) and progesterone (P) concentrations before spontaneous labor were studied in 13 women whose pregnancy and delivery were uncomplicated. Blood samples were drawn twice weekly from the 36th week of gestation up to the onset of spontaneous labor. P and 5αDHP values were analysed by applying RIA methods. Mean serum 5αDHP concentrations declined significantly during the last week of pregnancy, from 135±12 nmol/l 5 days prior to spontaneous labor, to 111 ±10 nmol/l on the day spontaneous labor started (p < 0.005). No significant changes in progesterone concentration occurred during the observation period. These results suggest a change in 5aDHP production preceding the onset of spontaneous labor.
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| 7. |
- Montan, Sven, et al.
(författare)
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Placental grading with ultrasound in hypertensive and normotensive pregnancies. A prospective, consecutive study
- 1986
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 1600-0412. ; 65:5, s. 477-480
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Tidskriftsartikel (refereegranskat)abstract
- Placental grading was studied prospectively with real-time ultrasound in 654 consecutive pregnancies. The placental maturation was clearly demonstrated in both unselected and hypertensive pregnancies. No differences in placental grading were found between normotensive and hypertensive pregnancies. Fetal outcome was not associated with different placental grades and a grade III placenta was not predictive of an adverse outcome. The value of antenatal placental grading in unselective and hypertensive pregnancies could not be demonstrated.
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| 8. |
- Valentin, Lil, et al.
(författare)
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Subjective recording of fetal movements. II. Screening of a pregnant population; methodological aspects
- 1986
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 1600-0412. ; 65:6, s. 639-644
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Tidskriftsartikel (refereegranskat)abstract
- 1914 women were asked to count fetal movements for 15 minutes every evening from the 28th week of pregnancy until parturition. An individual lowest limit for number of fetal movements was calculated from the first five counts. The women were instructed to contact the maternity ward for fetal evaluation as soon as their count fell below the lowest limit on two consecutive evenings (alarm signal). 79% of the women did record fetal movements, the proportion of those who did so being significantly higher in nulliparae and women 20-35 years old than in multiparae, teenagers and women older than 35 years. The mean duration of the registration period was 11.4 (SD 3.2) weeks and the median interval from the end of the registration period to delivery was 0.32 weeks. 31% of the women with an alarm signal on their Fetal Movement Charts never reported the decrease in the fetal movements count. 30% of the women who did report a reduction in the number of fetal movements did so despite the absence of an alarm signal. We conclude that most pregnant women are willing and able to count fetal movements but that they have difficulty in following the instructions concerning when to report a decrease in number of fetal movements.
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| 9. |
- Valentin, Lil, et al.
(författare)
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Subjective recording of fetal movements. III. Screening of a pregnant population; the clinical significance of decreased fetal movement counts
- 1986
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 1600-0412. ; 65:7, s. 753-758
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Tidskriftsartikel (refereegranskat)abstract
- In order to determine the clinical significance of decreased fetal movement counts, pregnancy outcome was compared between women with decreased fetal movement counts on their Fetal Movement Charts (FMC) (n = 161) and women with normal fetal movement counts (n = 1,354). 1,515 women in the third trimester of pregnancy counted fetal movements for 15 min in the evening and noted the count on a FMC. An individual lowest normal limit for the number of fetal movements was calculated from the first five consecutive counts. A decrease in fetal movements was defined as two consecutive counts below the lowest limit (alarm signal). The alarm signal was associated with an increased risk of placental insufficiency (p less than 0.001) and imminent premature labor (p less than 0.001) and thereby indirectly with an increased risk of the birth of a baby with birth weight less than 2,500 g (p less than 0.05), preterm baby (p less than 0.05) or small-for-gestational age baby (p less than 0.05). The alarm signal was also associated with an increased risk of the birth of babies with congenital malformations (p less than 0.05), respiratory disturbances (p = 0.01) and hypoglycemia (p less than 0.05). The short-term method of fetal movement counting can be used to preselect a group of pregnant women whose unborn fetus is at particular risk.
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| 10. |
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