| 1. |
- Bauer, Margit, et al.
(författare)
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Assessment of the in vivo biomechanical properties of the human uterine cervix in pregnancy using the aspiration test A feasibility study
- 2009
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 144, s. S77-S81
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To date no diagnostic tool is yet available to objectively assess the in vivo biomechanical properties of the uterine cervix during gestation. Methods: We show the first clinical application of an aspiration device to assess the in vivo biomechanical properties of the cervix in pregnancy with the aim to describe the physiological biomechanical changes throughout gestation in order to eventually detect pregnant women at risk for cervical insufficiency (CI). Results: Out of 15 aspiration measurements, 12 produced valid results. The stiffness values were in the range between 0.013 and 0.068 bar/mm. The results showed a good reproducibility of the aspiration test. In our previous test series on non-pregnant cervices our repetitive measurements showed a standard deviation of > 20% compared to <+/- 10% to our data on pregnant cervices. Stiffness values are decreasing with gestational age which indicates a progressive softening of cervical tissue towards the end of pregnancy. Three pregnant women had two subsequent measurements within a time interval of four weeks. Decreasing stiffness values in the range of 20% were recorded. Discussion: This preliminary study on the clinical practicability of aspiration tests showed promising results in terms of reproducibility (reliability) and clinical use (feasibility). Ongoing studies will provide further insights on its usefulness in clinical practice and in the detection of substantial changes of the cervix in pregnancy indicative for threatened preterm birth or cervical insufficiency.
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| 2. |
- Borgström, Anna, et al.
(författare)
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Adverse mood effects of combined oral contraceptives in relation to personality traits
- 2008
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 141:2, s. 127-130
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Mood symptoms, such as depressed mood, anxiety and increased irritability, remain one of the major reasons for discontinuation of combined oral contraceptive (COC) pills. The aim of this study was to compare personality traits in women with ongoing or previous use of COCs and different experiences from these compounds with respect to adverse mood symptoms. STUDY DESIGN: Thirty women currently on COCs with no reports of adverse mood symptoms, 28 women currently on COCs and experiencing mood-related side effects, 27 women who had discontinued COC use for reasons other than adverse mood symptoms and 33 women who had discontinued COC use due to adverse mood effects were included. All participants were asked to fill out the Swedish universities Scales of Personality (SSP) to assess different personality traits. RESULTS: The women who were experiencing mood-related side effects on their current COC use exhibited higher scores on the somatic anxiety and stress susceptibility traits as compared to the women who did not experience any mood-related side effects from their current COCs. Women who had discontinued COC treatment because of adverse mood effects had higher scores of detachment and mistrust compared to women who had discontinued COC for reasons unrelated to mood effects. CONCLUSION: Higher scores on specific personality traits such as somatic anxiety and stress susceptibility are found in women with ongoing experience of adverse mood symptoms from COC. Higher scores of mistrust and detachment are more common among women who have discontinued COC treatment due to adverse mood effects.
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| 3. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Obstetric outcome of 6346 pregnancies with infants affected by congenital heart defects
- 2006
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 125:2, s. 211-216
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate whether pregnancies with infants affected by congenital heart defects are associated with adverse obstetric and perinatal outcome. Study design: In a prospective population-based cohort study from Sweden (1992-2001), 6346 singleton pregnancies with infants affected by congenital heart defects were, after suitable adjustments, compared to all delivered women. Results: The prevalence of cardiovascular defects was 9.1 per 1000 births. Among them, mothers of 6346 infants (71%) had information on maternal smoking habits and maternal height and weight in early pregnancy that enabled the calculation of BMI. All cases with known chromosomal abnormalities and/or maternal pre-existing diabetes were excluded. Eighty-four percent (n = 5338) had an isolated cardiovascular defect. Severe types occurred in 21.7% (n = 1378). In the group of pregnancies with infants affected by congenital heart defects as compared to all delivered women, there was an increased risk of the following outcomes (adjusted OR (95%Cl)): pre-eclampsia (1.21 (1.06-1.37)), cesarean section (1.91 (1.79-2.03)), instrurnental delivery (1.21 (1.10-1.34)), pre-term delivery (2.58 (2.39-2.79)), small-for gestational age (1.96 (1.77-2.16)), meconium aspiration (1.51 (1.28-1.77)), and fetal distress (1.38 (1.17-1.63)). Conclusions: Pregnancies with infants affected by congenital heart defects are associated with several obstetric and neonatal complications. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
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| 4. |
- Donders, G. G. G., et al.
(författare)
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Variability in diagnosis of clue cells, lactobacillary grading and white blood cells in vaginal wet smears with conventional bright light and phase contrast microscopy
- 2009
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 145:1, s. 109-112
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Study the reproducibility of wet smear interpretation of clue cells, lactobacillary grades and leukocyte dominance with conventional bright light and phase contrast microscopy. Study design: Sets of vaginal specimens were taken from unselected consecutive women attending an outpatient gynaecology clinic. Air-dried vaginal fluid on a microscope slide was rehydrated with isotonic saline before examination by six independent international investigators. Some investigators initially used a conventional bright light microscope, followed by phase contrast technique. Results: Using phase contrast microscopy, an excellent inter-observer agreement was obtained among all investigators for clue cells detection (Kappa values from 0.69 to 0.94) and lactobacillary grades (Kappa 0.73-0.93). When conventional light microscopes were used, poor agreement was obtained for these criteria (Kappa index 0.37-0.72 and 0.80, respectively), but switching to phase contrast microscopy by the same investigators, improved Kappa to 0.83-0.85 and 0.88, respectively. The inter-observer agreement for estimation of the leukocyte/epithelial cell ratio (Kappa index 0.17-0.67) was poor, irrespective of the type of microscopy applied. Intra-observer agreement of clue cell detection and lactobacillary grading was also found to be excellent if phase contrast microscopy was used (Kappa 0.87-0.93), and poor with conventional bright light microscopy (Kappa 0.45-0.66). Conclusion: Clue cells and the lactobacillary grades are reliably identified by phase contrast microscopy in wet smears, with excellent intra- and inter-observer reproducibility agreement, and better than when simple bright light microscopy was used. Evaluation of leukocyte grading, on the other hand, was inconsistent among the different microscopists, irrespective of the type of microscope used. We propose to grade the leukocytes in a different way than searching for leukocyte dominance over epithelial cells, namely by counting them per high power field and per epithelial cell. (c) 2009 Elsevier Ireland Ltd. All rights reserved.
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| 5. |
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| 6. |
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| 7. |
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| 8. |
- Gollub, Erica L, et al.
(författare)
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Effectiveness of health education on Toxoplasma-related knowledge, behaviour, and risk of seroconversion in pregnancy.
- 2008
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 136:2, s. 137-45
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Tidskriftsartikel (refereegranskat)abstract
- We conducted a bibliographic literature search using MEDLINE to review the effectiveness of health education on Toxoplasma-related knowledge, behaviour, and risk of seroconversion in pregnant women. We pre-selected studies that used comparative study designs (randomized clinical trial, quasi-experimental design or historical control), that were conducted among pregnant women, and which employed specific, Toxoplasma-related outcome measures: knowledge, behaviour, or Toxoplasma infection rate. Four studies met the inclusion criteria. All had serious methodological flaws. A Belgian study reported a significant decrease in the incidence of Toxoplasma seroconversion after the introduction of intensive counselling for pregnant women about toxoplasmosis. In Poland, a significant increase in knowledge was observed after a multi-pronged, public health educational program was launched. In Canada, an increase in knowledge and prevention behaviours was reported in the intervention group receiving counselling by trained facilitators compared with the control group. In France, no significant changes in risk behaviour were observed following a physician-delivered intervention. This review highlights the weakness of the literature in the area and the lack of studies measuring actual seroconversion. There is suggestive evidence that health education approaches may help reduce risk of congenital toxoplasmosis but this problem requires further study using more rigorous research design and methodology.
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| 9. |
- Holmgren, Corinne, et al.
(författare)
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Frequency of de novo urgency in 463 women who had undergone the tension-free vaginal tape (TVT) procedure for genuine stress urinary incontinence-A long-term follow-up
- 2007
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 132:1, s. 121-125
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Tidskriftsartikel (refereegranskat)abstract
- Background To determine risk factors for the appearance of de novo urgency symptoms, and subsequent accompanying problems, after the tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence. Method A structured preoperative analysis of the incontinence symptoms was made. A mailed questionnaire was distributed to 970 women that underwent the TVT procedure between 1995 and 2001. Average follow-up was 5.2 years (range 2–8 years). The questionnaire included specific questions on current urinary symptoms and incontinence. The disease-specific quality of life instruments IIQ-7 and UDI-6 were used to compare women with, and those without de novo urgency. Results Seven hundred and sixty women (78.3%) responded and 463 of those were identified as genuine stress incontinence preoperatively. De novo urgency occurred in 67 (14.5%) of the women. The frequency was similar irrespective of duration since the TVT procedure. The women that reported de novo urgency symptoms were compared with those without symptoms. Risk factors for occurrence of de novo urgency symptoms were older age (64.7 years versus 60.9 years; p=0.01), parity (2.6 versus 2.3; p=0.05), history of cesarean section (9.5% versus 2.5%; odds ratio 5.4), and history of recurrent urinary infections (29.7% versus 18.8%; odds ratio 1.6, but non-significant. De novo urgency had a severe impact on quality of life, as compared to the remaining study population. Conclusion Old age, parity and history of cesarean section were risk factors for de novo urgency after TVT surgery. Postoperative de novo urgency symptoms are as bothersome for the patient as the preoperative stress urinary incontinence.
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| 10. |
- Lindström, Håkan, et al.
(författare)
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Ethically acceptable prioritisation of childless couples and treatment rationing : "accountability for reasonableness"
- 2008
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 139:2, s. 176-186
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: With in vitro fertilisation serving as a specific case, an intervention was aimed at investigating the potential for applying prioritisation theories and methods in a real-life situation to form an evidence-based proposal that met the standards of the "Accountability for Reasonableness" Model. In turn, this case would serve as a basis for public decision on rationalisation, prioritisation and rationing, whereby given resources are allocated with respect to the ethical template of the Swedish Parliament's decision on priorities in health care. STUDY DESIGN: Management representatives of the overall county council as well as the gynaecologic-obstetric department levels, infertility treatment professionals and a patients' organisation representative worked together to create guidelines building on the ethical principles of human dignity, needs/solidarity and cost-effectiveness, on evidence of treatment effect, epidemiology and economic resources availability. Also quality improvement techniques were used. RESULTS: Due to new guidelines for priority setting, it is expected that more childless couples in the studied health care region will get publicly financed IVF treatment. IVF treatment outcome is expected to be more cost-effective in terms of pregnancies for a given amount of resources. A balance between needs - as defined by the guidelines' criteria - and resources is expected and thus waiting lists are expected to vanish. The patients' organisations representative accepted the guidelines. They were also accepted by all obstetric clinics and formally agreed upon by the political boards of all county councils in the region. CONCLUSION: Use of a deliberative decisions model, structured quality improvement methodology and an accepted model for prioritisation helped create a system for legitimate prioritisation of couples and rationing of treatment regarding a group of patients where differentiation has been considered difficult.
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| 11. |
- Mobini Far, Hamid Reza, et al.
(författare)
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Administration of the anabolic androgenic steroid nandrolone decanoate to female rats causes alterations in the morphology of their uterus and a reduction in reproductive capacity
- 2007
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 131:2, s. 189-197
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of the present investigation was to characterize the effects of supraphysiological doses of the anabolic androgenic steroid nandrolone decanoate (ND) on the fertility of female rats, as well as on the morphology of their uterus. STUDY DESIGN: Female Wistar rats (n=15) received a subcutaneous injection of ND (15 mg/kg) once daily during a 2-week period, while the control animals (n=10) were administered vehicle alone (arachidis oleum) in the same manner. Estrus behavior was evaluated 4 weeks after termination of this treatment and in cases where signs of receptivity were present, the female rat was given the opportunity to copulate with a male. After breeding, the female animals were sacrificed and their uteri examined histomorphologically. RESULTS: All ND-treated animals exhibited abnormal vaginal smears, whereas all of the control smears were normal. Most (73%) of the treated females demonstrated normal estrus behavior (i.e., willingness) on the day of mating, but none got pregnant; whereas all of the control rats became pregnant. The female rats receiving the ND showed an enhanced rate of weight gain and the myometrium thickness of their uteri was significantly increased, while the endometrium was significantly thinner. Furthermore, ND caused a significant proportion of the treated animals to display tortuous and irregularly branching endometrial glands, as well as a lack of the physiologically normal infiltration of eosinophilic leukocytes into the endometrium (endometrial eosinophilic homing), a finding that has not been reported previously. CONCLUSION: The present findings indicate that high doses of ND cause morphological and physiological alterations in the uterus of female rats that are associated with a suppression of their reproductive capacity.
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| 12. |
- Nystedt, Astrid, et al.
(författare)
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Low psychosocial resources during early pregnancy are not associated with prolonged labour.
- 2006
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 125:1, s. 29-33
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine if a low level of psychosocial resources in early pregnancy is associated with the occurrence of prolonged labour. STUDY DESIGN: A cross sectional study of 644 women expecting their first child. Participants were asked to complete a questionnaire at their first antenatal visit, measuring psychosocial resources defined as social network and support, work-related psychosocial factors, control of daily life and health characteristics. Outcome was prolonged labour at the end of the pregnancy. RESULTS: A low level of psychosocial resources was not associated with prolonged labour. The majority of women reported that the degree of support was high in early pregnancy. CONCLUSIONS: A perceived low level of psychosocial resources in early pregnancy did not increase the risk of prolonged labour at the subsequent delivery.
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| 13. |
- Papadopoulos, N, et al.
(författare)
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Do patients want to see recordings of their surgery?
- 2008
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 138:1, s. 89-92
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Tidskriftsartikel (refereegranskat)
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| 14. |
- Persson, Pär, et al.
(författare)
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Factors associated with postoperative recovery after laparoscopic and abdominal hysterectomy
- 2008
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 140:1, s. 108-13
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine whether the day-by-day recovery of general wellbeing was faster in women undergoing laparoscopic hysterectomy than in total abdominal hysterectomy and to analyse the association between stress coping and sick-leave and the day-by-day recovery measured as general wellbeing. STUDY DESIGN: A randomised multicentre trial conducted in five hospitals in the South East of Sweden. Hundred and twenty-five women scheduled for hysterectomy for benign conditions were enrolled in the study and 117 women completed the study. Fifty-five women were randomised to abdominal hysterectomy and 62 to laparoscopic hysterectomy. Day-by-day recovery of general wellbeing was measured by a visual analogue scale 1 week preoperatively, 35 days postoperatively, and during 1 week 6 months postoperatively. Stress-coping capability was measured preoperatively using a specific psychometric measurement. Sick-leave was granted with an initial period of 14 days and prolonged on patient demand with 7 days periods. Effects of operating method and stress-coping ability on the day-by-day recovery adjusted for postoperative complications and analgesics were analysed by means of analysis of variance for repeated measurements. RESULTS: No significant difference was found in the day-by-day recovery of the general wellbeing between the operating methods. Stress-coping ability did significantly influence the day-by-day recovery of general wellbeing. Duration of sick-leave was associated with the occurrence of postoperative complications but not with stress-coping ability. CONCLUSIONS: The day-by-day recovery of general wellbeing is not faster in laparoscopic hysterectomy than in abdominal hysterectomy. Women with high stress-coping abilities have a better outcome in general wellbeing than women with low stress-coping capacity. Identification of women with low stress-coping abilities and prevention of complications might be of benefit for improving postoperative wellbeing.
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| 15. |
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| 16. |
- Bjartling, Carina, et al.
(författare)
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Deoxyribonucleic acid of Chlamydia trachomatis in fresh tissue from the Fallopian tubes of patients with ectopic pregnancy.
- 2007
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 134:1, s. 95-100
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The role of persistent chlamydial infection of the Fallopian tubes in ectopic pregnancy is still unresolved. Therefore, we examined tissue of the Fallopian tubes from patients with ectopic pregnancy for the presence of Chlamydia trachomatis. In addition, other markers of C. trachomatis infection implicated in the pathogenesis of tubal damage were studied including antibodies to heat shock protein 60 of chlamydial and human origin. Study design: Fresh frozen tubal tissue from 55 patients with ectopic pregnancy in a hospital setting were examined for the presence of C. trachomatis DNA by polymerase chain reaction (PCR) and blood sample were analysed for antibodies to C. trachomatis including heat shock protein 60 (hsp60). Results: Chlamydial DNA was not detected in any of the 55 tubal specimens using a commercial test, Cobas Amplicor, Roche, and an in-house real time PCR able to detect a few copies of the organism. Logistic regression showed that chlamydial IgG antibodies were more common in a subgroup of patients with previous PID than in controls (OR = 7.84, CI 1.78-34.6). Specific antibodies to hsp60 of chlamydial (OR = 7.00, CI 1.50-32.6) but not of human origin (OR = 2.13, CI 0.14-31.6) were associated with ectopic pregnancy in this group. Conclusions: No evidence of persistent infection of C. trachomatis in the fallopian tubes at the time of ectopic pregnancy was found in this study. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
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| 17. |
- Borgfeldt, Christer, et al.
(författare)
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Fertility-sparing surgery and outcome in fertile women with ovarian borderline tumors and epithelial invasive ovarian cancer.
- 2007
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 134:1, s. 110-114
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to evaluate the outcome of fertility-sparing treatment in ovarian borderline tumors and early invasive ovarian cancer. Materials and methods: All women diagnosed with an ovarian borderline tumor or early invasive ovarian cancer who were treated with fertility-sparing surgery at the University Hospital in Lund between 1988 and 2002 were identified and included in the study (n = 23). Results: During the follow-up period of a median 92 months, range 11-185 months, no relapse was found in the patients with Stage 1a tumors, including both borderline tumors (n = 12) and invasive well-differentiated (n = 9) and moderately differentiated (n = 1) ovarian cancers. One patient with poorly differentiated ovarian cancer Stage 1c was 13 weeks' pregnant at the time of the primary operation. Although, unilateral oophorectomy was performed she insisted on continuing the pregnancy. At 37 weeks she had a cesarean section and the ovarian cancer was disseminated. Chemotherapy was given but she died less than a year later. None of the other patients received chemotherapy. In total, 30 children were born to 15 patients. Prophylactic removal of the remaining ovary hysterectomy was accepted in only in six of the women after fulfilling their desire to have more children. Conclusions: Young women with Stage 1a epithelial ovarian cancer and borderline tumors do not have to give up their fertility in order to receive successful and safe treatment of their disease. However, several of these patients do not accept the recommendation of prophylactic oophorectomy of the contralateral ovary and hysterectomy after completion of childbearing. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
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| 18. |
- Cedergren, Marie I
(författare)
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Non-elective caesarean delivery due to ineffective uterine contractility or due to obstructed labour in relation to maternal body mass index
- 2009
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Ingår i: EUROPEAN JOURNAL OF OBSTETRICS and GYNECOLOGY AND REPRODUCTIVE BIOLOGY. - : Elsevier BV. - 0301-2115. ; 145:2, s. 163-166
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess whether non-elective caesarean section due to obstructed labour and/or ineffective uterine contractility was associated with maternal body mass index (BMI). Study design: The prospective dataset from the Swedish Medical Birth Registry consisted of 233,887 nulliparous women with a spontaneous onset of labour categorized in six classes of pre-pregnancy BMI, who delivered in Sweden between, January 1, 1999 and December 31, 2005. The mode of delivery was classified as either vaginal or by caesarean section. The caesarean section was classified as either elective or non-elective. Adjusted risks for non-elective caesarean section due to ineffective uterine contractility, or obstructed labour or fetal distress were determined using Mantel-Haenszel technique. Results: The risk of a non-elective caesarean section due to obstructed about was not significantly associated with maternal BMI. However, ineffective uterine contractility was significantly associated with maternal BMI and the risk of non-elective caesarean delivery due to labour arrest disorders increased with increasing BMI, reaching a 4-fold increased risk among the morbidly obese women. The risk of non-elective caesarean section due to fetal distress also increased significantly with increasing maternal BMI. Conclusions: It appears that ineffective labour could be a factor leading to the increased risk of non-elective caesarean section among obese and morbidly obese women. These findings challenge obstetricians to learn more about how to manage oxytocin infusions during labour in relation to maternal BMI.
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| 19. |
- Chan, Jerry, et al.
(författare)
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Pragmatic comparison of beta(2)-agonist side effects within the worldwide atosiban versus beta agonists study
- 2006
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 128:1-2, s. 135-141
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Tidskriftsartikel (refereegranskat)abstract
- Objective: While beta(2)-agonists for the acute treatment of preterm labour unequivocally reduce the odds of delivery within 48 hand 7 days, they have been associated with substantial maternal and fetal side effects. We aimed to compare side effect profiles of beta(2)-agonist tocolytics. Study design: Pragmatic comparison of ritodrine, salbutamol and terbutaline from re-analysis of data obtained within three comparator arms of three simultaneous comparable randomised controlled trials of beta(2)-agonists against atosiban in 742 women in preterm labour. The prevalence of categoric side effects between treatment groups was analysed using a chi(2) test. The differences in continuous variables between treatment groups were analysed in analyses of covariance. Results: The prevalence of categoric side effects was similar with the three drugs, with the exception of the subjective symptom of palpitations (ritodrine 24.0%, terbutaline 9.3% and salbutamol 12.3%, P = 0.003). There were also some differences in maternal diastolic blood pressure (P < 0.001) and serum glucose levels (P < 0.001), although these were small (<3 mmHg and <= 2.8 mmol/L, respectively) and clinically unimportant. Conclusion: Side effects were common with all three drugs. Thus, choosing one beta(2)-agonist over the other to minimise side effects has little rationale, especially now that safer tocolytics are available. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
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| 20. |
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| 21. |
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| 22. |
- Hellsten, Charlotte, et al.
(författare)
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A longitudinal 2-year follow-up of quality of life in women referred for colposcopy after an abnormal cervical smear.
- 2009
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 147:2, s. 221-225
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the long-term impact on quality of life (QoL) in women referred for colposcopy after an abnormal cervical smear. STUDY DESIGN: One hundred consecutive women referred for colposcopy for the first time subsequent to receiving notification of an abnormal cervical smear. Women in the study group completed the Swedish Health Survey Short Form-36 (SF-36), the State/Trait Anxiety Inventory (STAI, Form Y), and the Montgomery Asberg Depression Rating Scale, Self-rate (MADRS-S). The women had follow-up visits at 6 months and 2 years. RESULTS: The baseline mean for the mental component summary score and for all mental subscale scores on the SF-36 were statistically significantly lower than Swedish normative data for women. At the end of 2 years, the mental component summary scale and vitality were still significantly lower than such data. There were no differences in QoL between women having had treatment with Large Loop Excision of the Transformation Zone (LLETZ) compared to those who did not. When studied separately, non-depressed women felt no impact on QoL whereas women with higher depression scores judged their mental health QoL worse. CONCLUSIONS: Women experienced long-lasting negative effects on their mental health, but not on their physical health after referral for colposcopy. LLETZ had no measurable influence on QoL at any of the visits. This indicates that it is not the severity of the lesions or the treatment itself that affects women but the fact of having had an abnormal cervical smear identified. Depressive mood may be a major variable for the perception of low QoL.
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| 23. |
- Herbst, Andreas, et al.
(författare)
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Influence of mode of delivery on neonatal mortality and morbidity in spontaneous preterm breech delivery.
- 2007
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 133:1, s. 25-29
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study the association between mode of delivery and neonatal outcome in singleton pregnancy with breech presentation and preterm birth, due to premature tabour (PTL) and/or preterm premature rupture of the membranes (pPROM). Design and methods: Information on preterm (gestational week 25-36) singleton births in breech presentation in Sweden during 1990-2002 was obtained from the Swedish Medical Birth Registry and the Swedish Hospital Discharge Registry. The study groups included 1975 caesarean and 699 vaginal deliveries with a diagnosis of PTL or pPROM, without pregnancy complications implying a high risk of fetal compromise. The rates of infant respiratory distress syndrome (IRDS), intraventricular haemorrhage (IVH), low Apgar scores, and neonatal deaths were compared between infants delivered vaginally and by caesarean section. Odds ratios were calculated with adjustment for gestational age, year of birth, maternal age and parity. Results: The risk of neonatal death and the risk of an Apgar score below 5 min postnatally were both lower after caesarean delivery (OR 0.4; 95% CI 0.2-0.7, and OR 0.4; 95% CI 0.3-0.7, respectively), whereas the risk of IRDS was increased (OR 2.1; 95% CI 1.4-3.2). A diagnosis of IRDS was not associated with mortality (OR 0.8; 95% CI 0.5-1.5). IVH was not associated with mode of delivery (OR 1.2; 95% CI 0.5-2.8). Conclusion: The lower neonatal mortality after CS supports a policy of caesarean delivery of the preterm breech. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
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| 24. |
- Hogan, Linda, et al.
(författare)
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How often is a low 5-min Apgar score in term newborns due to asphyxia?
- 2007
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 130:2, s. 169-175
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate how often low 5-min Apgar scores (AS(5-min)) at term are associated with asphyxia. Study design: A cohort- and case-control study, including all 183 term infants with AS(5-min) below 7 born at Lund University Hospital during 1993-2002, antepartum deaths excluded. The control group included 183 randomly selected term newborns with AS(5-min) 9-10. Cardiotocography (CTG) traces were assessed blinded to group and outcome. Obstetric and pediatric files were reviewed. Results: After excluding infants with severe malformations, indications of hypoxia were found at the following rates in cases with AS(5-min) below 4 (N = 30), scores 4-6 (N = 143), and controls (N = 182)-abnormal admission CTG: 38%, 8% and 0.6%; abnormal CTG before birth: 88%, 69% and 18%; obstetrical catastrophe: 28%, 6% and 0.6%; interventions for fetal distress: 83%, 48% and 9%; cord artery pH below 7.15: 69%, 54% and 7%; hypoxic ischemic encephalopathy or hypoxic death: 70%, 14% and none. All differences between each case group and controls were statistically significant (p < 0.0001). Conclusions: In the absence of severe malformations, the vast majority of AS(5-min) below 4, and at least half of scores 4-6 could be attributed to birth asphyxia. Signs of hypoxia usually appeared during labor, but were present at admission in 38% of cases with AS(5-min) below 4.
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| 25. |
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| 26. |
- Laudanski, P, et al.
(författare)
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Decreased serum level of macrophage inflammatory chemokine-3 beta/CCL19 in preterm labor and delivery
- 2006
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 124:1, s. 23-26
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Chemokines are small soluble molecules which mediate leukocyte migration and may be involved in the pathophysiology of preterm labor. We aimed to determine if serum concentrations of selected chemokines are changed in preterm labor and delivery. Study design: A novel array-based enzyme-linked immunosorbent assay was used to quantitate serum levels of nine chemokines from a single sample: MDC/CCL22, TARC/CCL17, ITAC/CXCL11, 1-309/CCL1, IP-10/CXCL10, MIP-1 alpha/CCL3, -1 beta/CCL4, -3 alpha/CCL20 and -3 beta/CCL19. Women in preterm labor who delivered (n = 17), women at preterm pregnancy not in labor (n = 13) and women in labor at term (n = 8) participated. Results: In the preterm delivery group of patients, the MIP-3 beta/CCL19 concentration was in mean (+/- S.D.) 70.4 +/- 31.7 pg/mL, which was significantly lower than that in preterm gravidas not in labor of 123 +/- 34 pg/mL (p < 0.001) and those in labor at term of 118 +/- 25.6 pg/mL (p < 0.01). The other measured chemokines did not differ significantly. Conclusions: Of a small number of examined chemokines, we were able to show that one of them, MIP-3 beta/CCL19 was significantly lower in women with preterm labor and delivery. Whether or not this chemokine has a potential as biochemical marker of preterm delivery remains to be determined. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
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| 27. |
- Liedman, Ragner, et al.
(författare)
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Endometrial expression of vasopressin, oxytocin and their receptors in patients with primary dysmenorrhoea and healthy volunteers at ovulation.
- 2008
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 137:2, s. 189-192
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate gene expressions for neurohypophyseal and ovarian hormones as well as their receptors in the endometrium of women with primary dysmenorrhoea and healthy subjects at ovulation. STUDY DESIGN: A group of eight women with moderate to severe dysmenorrhoea and eight healthy subjects were compared in parallel between 18 and 35 years of age, regularly menstruating, non-overweight and nulliparous. The study was performed at The Department of Obstetrics and Gynecology, University Hospital of Lund, Sweden. Endometrial biopsies were taken around the time of ovulation, which was determined by repeated ultrasound examinations. Receptor and gene expressions for oxytocin and vasopressin in the tissue were measured. RESULTS: The gene expression for oxytocin receptor was significantly lower in dysmenorrhoic than in healthy women, in median 1.21 and 3.44oxytocin-receptor/actin, respectively (p=0.048). The expressions for oxytocin peptide, vasopressin V(1a) receptor, oestrogen receptor alpha, beta and progesterone receptor did not differ between the two groups. Expression of vasopressin peptide was not detectable. CONCLUSION: A lower oxytocin receptor gene expression at mid-cycle could be involved in the aetiology of primary dysmenorrhoea. However, the importance of a paracrine effect of oxytocin and its receptor at ovulation warrants further investigation.
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| 28. |
- Lindqvist, Pelle, et al.
(författare)
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An easy-to-use method for detecting fetal hemoglobin-A test to identify bleeding from vasa previa.
- 2006
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 131:2, s. 151-153
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Tidskriftsartikel (refereegranskat)abstract
- Background: Vasa previa is a rare but potentially dangerous fetal condition that may occur during pregnancy. Ideally, all cases such cases are detected antenatally, but many present as late vaginal hemorrhaging. At the current time, there is no test for fetal hemoglobin (HbF) in general use. Methods: A modified method of identifying HbF is presented. Five milliliters of 0.14 M NaOH was combined with 50 mu l of a mixture of fetal and maternal blood. After 2 min, it was judged if the solution still had a red tone or not. The sensitivity of this method for detecting HbF was assessed. Results: All 15 clinical personnel could identify both 69% and 34% HbF mixed with adult hemoglobin (100% sensitivity), 14 out of 15 could identify 17% HbF (93% sensitivity), and 12 out of 15 could identify a mixture containing 8% HbF (80% sensitivity). Conclusion: Our rapid. simple test for HbF was at least as sensitive as slower, more cumbersome alkali denaturation tests in common use. It could prove to be a lifesaving toot in ruling out vasa previa bleeding in cases of unclear late pregnancy hemorrhages.
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| 29. |
- Lindqvist, Pelle, et al.
(författare)
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Risk and risk estimation of placental abruption.
- 2006
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 126:Sep 29, s. 160-164
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Several variables related to increased risk of placental abruption are also risk factors for venous thromboembolism. Prior second trimester-, third trimester, and repeated fetal loss are reported to be associated to thrombophilias. However, it is yet not known if they are also related to placental abruption. Study design: A retrospective case-control study of 161 women with placental abruption and 2371 unselected gravidae without placental abruption. The medical files were scrutinized and the selected variables were investigated in relation to the development of placental abruption. Results: As compared to controls, previous second trimester-, third trimester-, repeated fetal loss, and prior placental abruption were related to a 3-, 13-, 3-, and a 25-fold increased risk of placental abruption, respectively. Several other factors were associated with a roughly three-fold increased risk such as: preeclampsia, IUGR, high maternal age (>35), family history of venous thromboembolism, smoking, and multiple birth. A risk score was created and as compared with those with no risk factors present, the risk of placental abruption was increasing from 2.5-fold for those with risk score = 1, to almost 100-fold for risk score 4 or above. Conclusion: Easily obtainable information might be used to classify the risk of placental abruption. (C) 2005 Elsevier Ireland Ltd. All rights reserved.
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| 30. |
- Lindqvist, Pelle, et al.
(författare)
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Screening history of women in Malmö with invasive cervical cancer.
- 2008
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 137:1, s. 77-83
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Cervical cancer is one of the most common forms of cancer among women. Cytological screening and follow-up are potentially effective procedures for preventing the development of – and mortality from – cervical cancer. The purpose of this study was to investigate the screening history of women diagnosed with cervical cancer with the aim of improving the screening programme. Study design All of the 187 women diagnosed with invasive cervical cancer in Malmö between 1991 and 2000 were identified, and those below 61 years of age (n = 130) were included in the analysis. The cytological and histological screening history of these women prior to their diagnosis was scrutinized. We analyzed shortcomings related to the cervical screening with special attention to participation defined as having had a cervical smear within 1 year of the scheduled time. Results Of the non-participants who developed cervical cancer (n = 70), roughly one-third “never participated,” half were “sub-optimal participants,” and one-sixth were “decliners,” i.e., women who declined the recommended measures. Among participants (n = 60), 80% were either “unexplained” (n = 35) or “misread as normal” (n = 13). The 9.5% subgroup of non-participants was at an 11-fold increased risk of being diagnosed with invasive cervical cancer. Conclusion The greatest reduction in cervical cancer would be realized if non-participants could be brought into the screening program.
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| 31. |
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| 32. |
- Starck-Söndergaard, Marianne, et al.
(författare)
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Effect of vaginal delivery on endosonographic anal sphincter morphology
- 2007
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 130:2, s. 193-201
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Tidskriftsartikel (refereegranskat)abstract
- Objective To describe the effect of vaginal delivery with no clinically recognized sphincter tear on endosonographic anal sphincter morphology and sphincter pressure and to relate endosonographic results to anal sphincter pressure and anal incontinence score. Study design Thirty-two nullipara underwent anal endosonography and anal manometry in the third trimester of pregnancy, 2 weeks and 6 months post-partum. The sphincter defect scores (1–16) and the thickness and length of the sphincters were measured by endosonography, and sphincter pressures and manometric sphincter lengths were determined. The Wexner incontinence score (1–20) was used to classify anal incontinence 6 months post-partum. Results Five (16%) women had small endosonographic anal sphincter defects (score 3–4) before delivery. Eight women (25%; confidence interval 11–43%) had new defects detected post-partum, five small, one moderate (score 7), and two large (score 10–11). Six (75%) of eight women with new defects post-partum had undergone episiotomy versus five (21%) of 24 women with no new defects (p = 0.02). Six months after delivery 16 (50%) women reported anal incontinence, and there was a positive correlation between the endosonographic defect score 6 months post-partum and the Wexner incontinence score. The sphincter was significantly longer during pregnancy than 6 months post-partum. Conclusion New sphincter defects may arise after vaginal delivery without any clinically recognizable sphincter tear. There is a positive correlation between the endosonographic defect score 6 months post-partum and the Wexner incontinence score.
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| 33. |
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