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Acta Obstetricia et Gynecologica Scandinavica

Benjamin P Jones, Paul Serhal, Jara Ben Nagi
We read with interest the response to our commentary on social egg freezing (SEF), by Levin et al 2018. We are encouraged to have proponents to our belief that single women should consider freezing their oocytes before the exponential decline in their ovarian reserve. We concur that there is irrefutable evidence demonstrating the clinical implications, including low response to controlled ovarian stimulation, of the exponential age related decline in ovarian reserve from the age of 37 onwards. This article is protected by copyright...
September 19, 2018: Acta Obstetricia et Gynecologica Scandinavica
Arianna Laoreti, Basky Thilaganathan, Andrea Kaelin Agten, Aris Papageorghiou, Asma Khalil, James Uprichard, Edwin Chandraharan, Amarnath Bhide
We thank Takahashi and Matsubara for the interest in our article in which it was demonstrated that the placental thickness in the lower uterine segment is increased in women with abnormally invasive, compared to those with normal placentation. Takahashi & Matsubara argue that measurement of the placental thickness can be difficult in cases of central placenta previa. To support their argument, they show MRI images of central placenta previa. This article is protected by copyright. All rights reserved.
September 15, 2018: Acta Obstetricia et Gynecologica Scandinavica
Vilma L Johnsson, Nina G Pedersen, Katharina Worda, Elisabeth Krampl-Bettelheim, Lilian Skibsted, Stefan Hinterberger, Isolde Strobl, Maria E Bowman, Roger Smith, Ann Tabor, Line Rode
INTRODUCTION: The aim was to examine the association between plasma hormone concentrations, cervical length and preterm delivery in twin pregnancies, including the effect of progesterone treatment. MATERIAL AND METHODS: This study included 191 women with a twin gestation from a randomized placebo-controlled trial. A baseline blood sample was collected at 18-24 weeks before treatment with vaginal progesterone (n=95) or placebo pessaries (n=96), and 167 (87.4%) women had a second sample collected after 4-8 weeks of treatment...
September 15, 2018: Acta Obstetricia et Gynecologica Scandinavica
Henriette Odland Karlsen, Synnøve Lian Johnsen, Svein Rasmussen, Gro Trae, Hilde M Tveit Reistad, Torvid Kiserud
INTRODUCTION: The human yolk sac provides the embryo with stem-cells, nutrients and gas exchange. We hypothesize that more maternal resources reflected in body size and body composition would condition a larger yolk sac ensuring resources for the growing embryo. Thus, we aimed to determine the relation between maternal size in early pregnancy and yolk sac size. MATERIAL AND METHODS: This subsidiary study was embedded in the multinational WHO fetal growth project that included healthy women with BMI 18-30, reliable information of a regular last menstrual period and singleton pregnancies...
September 15, 2018: Acta Obstetricia et Gynecologica Scandinavica
Ann-Lisbeth Liest, Ahmed Shaker Omran, Rasmus Mikiver, Per Rosenberg, Srinivas Uppugunduri
INTRODUCTION: Our primary objective was to test the hypothesis that human epididymal protein 4 (HE4) and risk of ovarian malignancy index (ROMA) outperform CA125 and risk of malignancy index (RMI) in categorizing a pelvic mass into high or low risk of malignancy in a Swedish population. Further, cut off values needed to be defined for HE4 and ROMA in pre- and postmenopausal women prior to introduction into clinical practice. A tertiary objective was to investigate the correlation between HE4 levels in serum and urine...
September 14, 2018: Acta Obstetricia et Gynecologica Scandinavica
Berit Schei, Hege Hølmo Johannessen, Astrid Rydning, Abdul Sultan, Siv Mørkved
INTRODUCTION: Uncertainties remain as to whether cesarean section is protective for short and long term development of anal incontinence. Our aim was to explore whether women who had only delivered vaginally were at greater risk of anal incontinence compared to nulliparous women and women who had undergone caesarean sections only. MATERIAL AND METHODS: Background information, medical history and data on anal incontinence (defined as fecal or flatus incontinence weekly or more) reported by women participating in a large population-based health survey in Norway (HUNT 3) during the period October 2006-June 2008, was collected and linked to data from the Medical Birth Registry of Norway...
September 11, 2018: Acta Obstetricia et Gynecologica Scandinavica
Tom Tanbo, Jan Mellembakken, Sverre Bjercke, Eva Ring, Thomas Åbyholm, Peter Fedorcsak
We thank Levin and Rottenstreich for their interest in our article on ovulation induction strategies in polycystic ovary syndrome (PCOS). We suggested as a second line treatment after life style changes, the combination of inositol isomers and metformin or metformin only. The use of inositol was primarily based on the results of a systematic review by Pundir et al., although other small studies not included in the systematic review have also indicated a possibly beneficial effect on ovulation in anovulatory PCOS...
September 10, 2018: Acta Obstetricia et Gynecologica Scandinavica
Seija Ala-Nissilä, Eija Laurikainen, Juha Mäkinen, Varpu Jokimaa
INTRODUCTION: Recently, it has been suggested that occurrence of post-hysterectomy vaginal cuff dehiscence has increased. Consequently, we evaluated the incidence of vaginal cuff dehiscence after different types of hysterectomies. Our hypothesis is that vaginal cuff dehiscence is more often associated with total laparoscopic hysterectomy (TLH) than other types of uterine removal. MATERIAL AND METHODS: A total of 13,645 hysterectomies from 1992 to 2015 were evaluated in the Turku University Hospital district, Finland...
September 10, 2018: Acta Obstetricia et Gynecologica Scandinavica
Sjur Lehmann, Elham Baghestan, Per E Børdahl, Lorentz M Irgens, Svein Rasmussen
Trial of labor (TOLAC) is an option in most pregnancies after a cesarean section. The objective of the study was to compare perinatal outcome in TOLAC and non TOLAC deliveries, in a population with high TOLAC rates MATERIAL AND METHODS: Cohort study, based on population data from the Medical Birth Registry of Norway. We included term, cephalic, single, second deliveries, 1989-2009, after a first cesarean section (n=43 422). TOLAC, TOLAC failure, and non TOLAC deliveries, after high and low risk pregnancies (no risk / any risk), were compared with regard to offspring mortality, five minute Apgar score < 7, five minute Apgar score < 4, transfer to a neonatal intensive care unit, and neonatal respiratory distress syndrome (NRDS) RESULTS: Statistically significant differences were observed (p < 0...
September 7, 2018: Acta Obstetricia et Gynecologica Scandinavica
Michael Due Larsen, Rikke Guldberg, Gunnar Lose
INTRODUCTION: The risk of perioperative cardiovascular complications following urinary incontinence and pelvic organ prolapse (POP) operations must be taken into consideration during surgical planning. The literature on the cardiovascular risk following urinary incontinence and pelvic organ prolapse operations shows conflicting results. Our aims were to provide an estimate of the mortality and the risk of cardiovascular complications following urinary incontinence and pelvic organ prolapse operations considering the women's preoperative cardiovascular comorbidity...
September 6, 2018: Acta Obstetricia et Gynecologica Scandinavica
Gunilla Sydsjö, Agneta Skoog Svanberg, Claudia Lampic
INTRODUCTION: Surrogacy is a controversial method for assisted reproduction that is not permitted in many countries. While there is some evidence that families following surrogacy seem to fare well, there is limited knowledge about the experiences of parents who turned to cross-border surrogacy. The aim of the present study was therefore to investigate the experiences of heterosexual parents and gay fathers who chose cross-border surrogacy to have a child. MATERIAL AND METHODS: This cross-sectional survey describes the experiences of 30 families (18 heterosexual parent and 12 gay father families)...
September 3, 2018: Acta Obstetricia et Gynecologica Scandinavica
Sarah R Murray, Julius Juodakis, Jonas Bacelis, Anna Sand, Jane E Norman, Verena Sengpiel, Bo Jacobsson
INTRODUCTION: Preterm delivery is a major global public health challenge. The objective of this study was to determine how the preterm delivery rates differ throughout a country of very high human-development index and to explore rural versus urban environmental and socio-economic factors which might be responsible for this variation. MATERIAL AND METHODS: A population-based study was performed using data from the Swedish Medical Birth Register 1998 to 2013. Sweden was chosen as a model because of its validated routinely collected data and availability of individual social data...
August 31, 2018: Acta Obstetricia et Gynecologica Scandinavica
Jörg Kessler, Synnøve Lian Johnsen, Cathrine Ebbing, Henriette Odland Karlsen, Svein Rasmussen, Torvid Kiserud
INTRODUCTION: Fetal biometry is used for determining gestational age and estimated day of delivery (EDD). However, the accuracy of the EDD depends on the assumed pregnancy length included in the calculation. This study aimed at assessing actual pregnancy length and accuracy of EDD prediction based on fetal head circumference measured at second trimester. MATERIAL AND METHODS: Population based observational study with inclusion criteria: singleton pregnancy, head circumference dating in the second trimester, spontaneous onset or induction of delivery ≥294 days of gestation, live birth...
August 31, 2018: Acta Obstetricia et Gynecologica Scandinavica
Antonio Travaglino, Antonio Raffone, Gabriele Saccone, Luigi Insabato, Antonio Mollo, Giuseppe De Placido, Fulvio Zullo
INTRODUCTION: Endometrial hyperplasia is differentiated into benign or premalignant. Two histologic classifications are used for this purpose: WHO classification, based on cytologic atypia, disregarding glandular complexity, and Endometrial Intraepithelial Neoplasia (EIN) classification, based on several different parameters. Bcl-2 loss has been studied as immunohistochemical marker with the aim of improving the differential diagnosis between benign and premalignant hyperplasia. We aimed to evaluate: 1) Bcl-2 loss as marker of endometrial precancer, by assessing it in proliferative endometrium, benign hyperplasia, premalignant hyperplasia and endometrial cancer; 2) the diagnostic accuracy of Bcl-2 in the differential diagnosis between benign and premalignant endometrial hyperplasia; 3) how the results changes according to the histologic classification and the thresholds of Bcl-2 expression used...
August 31, 2018: Acta Obstetricia et Gynecologica Scandinavica
Sarah M Sørensen, Tine H Schnack, Claus Høgdall
INTRODUCTION: The objective of this study was to determine the impact of residual disease (RD) size, type (carcinomatosis/tumor mass/both) and location (upper/lower abdominal/both) on overall survival in women with FIGO stage IIIB-IIIC vs. stage IV epithelial ovarian cancer who underwent primary debulking surgery. MATERIAL AND METHODS: 2092 women diagnosed with advanced epithelial ovarian cancer undergoing primary debulking surgery in Denmark during 2005-2016 were identified in the Danish Gynecological Cancer Database...
August 31, 2018: Acta Obstetricia et Gynecologica Scandinavica
Yi Guo
I read with interest the systematic review and meta-analysis by Yang et al. regarding the efficacy of low-molecular-weight heparin (LMWH) in assisted reproduction. There is currently insufficient research to elucidate the effects of heparin in assisted reproduction, making it difficult to obtain high-quality answers in the current meta-analysis. In the authors' analysis, only five studies were included, a fact that also highlighted the lack of research in this field. This article is protected by copyright...
August 30, 2018: Acta Obstetricia et Gynecologica Scandinavica
Susanne Hesselman, Lina Bergman, Ulf Högberg, Maria Jonsson
INTRODUCTION: There is paucity in data regarding the impact of organ injury on the long-term outcome after hysterectomy for benign indications. The aim of this study was to investigate fistula formation and patient reported long-term health outcomes after organ injury at the time of hysterectomy. MATERIAL AND METHODS: This was a population-based study of 22 538 women undergoing hysterectomy 2000-2014 in Sweden. Medical history, characteristics of surgery and patient reported outcomes were retrieved from Swedish National Health and Quality registers...
August 30, 2018: Acta Obstetricia et Gynecologica Scandinavica
Randi Sylvest, Emily Koert, Ida Vittrup, Kathrine Birch Petersen, Helene Westring Hvidman, Finn Hald, Lone Schmidt
INTRODUCTION: Men play an important role in couples' decisions about the timing of parenthood, and tend to delay parenthood. The reasons for delaying childbearing are multifaceted and complex. They may be making decisions to delay parenthood based on a lack of accurate information about the reproductive life span and the consequences of delaying parenthood. The aim of this study was to explore men's expectations and experiences of fertility counselling. MATERIAL AND METHODS: Data were collected through semi-structured qualitative interviews with 21 men attending the Fertility Assessment and Counselling Clinic in Copenhagen or Horsens, Denmark...
August 29, 2018: Acta Obstetricia et Gynecologica Scandinavica
Tanya Robbins, Andrew Shennan, Jane Sandall
Early Warning Systems (EWS) involve the routine monitoring and recording of vital signs or clinical observations on specifically designed charts with linked escalation protocols. There are criteria for abnormal physiological parameters that trigger a color-coded or weighted scoring system aimed to guide the frequency of monitoring, need for and urgency of clinical review. Color-coded systems trigger a clinical response when one or more abnormal observation is recorded in the red zone or two or more mildly abnormal parameters in the amber zone...
August 29, 2018: Acta Obstetricia et Gynecologica Scandinavica
Charlotte Lindblad Wollmann, Mia Ahlberg, Sissel Saltvedt, Kari Johansson, Charlotte Elvander, Olof Stephansson
INTRODUCTION: To consult women on best mode of delivery after a first cesarean section, more knowledge regarding risk for a repeat unplanned cesarean is needed. We investigated the association between indication of first cesarean and cervical dilation during labor preceding the first cesarean and risk of repeat cesarean in women undergoing trial of labor. MATERIAL AND METHODS: A population-based cohort-study using electronic medical records of all women delivering in the Stockholm-Gotland region, Sweden, between 2008-2014...
August 22, 2018: Acta Obstetricia et Gynecologica Scandinavica
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