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Acta Obstetricia et Gynecologica Scandinavica

Mads Kamper-Jørgensen, Hilary S Gammill, J Lee Nelson
In a preliminary case-control study, women with scleroderma more frequently reported having had hypertensive complications during pregnancy compared with healthy women. To prospectively investigate this possible association, we conducted a nation-wide cohort analysis of a major hypertensive complication during pregnancy, namely preeclampsia, and later scleroderma. Analyses were based on Danish register-based birth and hospital contact data on preeclampsia and scleroderma. We followed 778,758 women from time of giving birth between 1978 and 2010 to end of follow-up, emigration, death, or scleroderma diagnosis, whichever occurred first...
January 18, 2018: Acta Obstetricia et Gynecologica Scandinavica
Penelope P Howards
Confounding is an important source of bias, but it is often misunderstood. We consider how confounding occurs and how to address confounding using examples. Study results are confounded when the exposure's effect on the outcome mixes with the effects of other risk and protective factors for the outcome. This problem arises when these factors are present to different degrees among the exposed and unexposed study participants, but not all differences between the groups result in confounding. Thinking about an ideal study where all of the population of interest is exposed in one universe and is unexposed in a parallel universe helps to distinguish confounders from other differences...
January 17, 2018: Acta Obstetricia et Gynecologica Scandinavica
Penelope P Howards
Confounding biases study results when the exposure's effect on the outcome mixes with the effects of other risk and protective factors for the outcome that are present differentially by exposure status. However, not all differences between the exposed and unexposed group cause confounding. Thus, sources of confounding must be identified before they can be addressed. Confounding is absent in an ideal study where all of the population of interest is exposed in one universe and is unexposed in a parallel universe...
January 17, 2018: Acta Obstetricia et Gynecologica Scandinavica
Christian Bamberg, Larry Hinkson, Wolfgang Henrich
We would like to thank the authors (1) for taking a keen interest in our recently published randomized controlled trial, where we examined the outcome of a single- vs. double-layer hysterotomy closure during cesarean delivery. In that study, we used ultrasound to assess the uterine scar niche incidence (2). Our results suggested that the risk of developing a cesarean scar defect and the niche depth were independent of the uterotomy closure technique, at six weeks and 6-24 months after surgery. However, the residual myometrium showed a trend (p=0...
January 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
George Daskalakis, Angeliki Papapanagiotou, Charalambos Siristatidis, Petros Drakakis, Ioanna Mole, Anastasia Barbouni, Athanasios G Papavassiliou, Vasilios Pergialiotis
The purpose of the present study was to compare the levels of tumor necrosis factor a (TNF-a), and interleukins (IL) 1, 6, 8 and 10 in the umbilical cord and neonatal circulation among neonates with early and late cord clamping MATERIAL AND METHODS: A consecutive series of 76 cases that had an uncomplicated pregnancy and an uneventful parturition was evaluated. In 40 cases delayed cord clamping was used and in the remaining 36 cases early cord clamping was practiced. Blood samples were collected from the umbilical vein immediately after cord clamping and at 24 hours from the median cubital or basilic vein of the neonate RESULTS: Significant differences were noted in the hematocrit and hemoglobin levels at 24 hours that favored delayed clamping...
January 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
Lisanne F de Graaff, Adriaan Honig, Mariëlle G van Pampus, Claire A I Stramrood
INTRODUCTION: Between 9 and 44% of women experience giving birth as traumatic, and 3% of women develop a posttraumatic stress disorder following childbirth. Knowledge on risk factors is abundant, but studies on treatment are limited. This study aimed to present an overview of means to prevent traumatic birth experiences and childbirth-related posttraumatic stress disorder. MATERIAL AND METHODS: Major databases (Cochrane; Embase; PsycINFO; PubMed (Medline)) were searched using combinations of the key words and their synonyms...
January 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
Charline Bertholdt, Sophie Menard, Pierre Delorme, Marie-Charlotte Lamau, François Goffinet, Camille Le Ray
INTRODUCTION: At the same time as survival is increasing among premature babies born before 26 weeks of gestation, the rates of cesarean deliveries before 26 weeks is also rising. Our purpose was to compare the frequency of intraoperative adverse events during cesarean deliveries at two gestational age groups: 24-25 weeks and 26-27 weeks. MATERIAL AND METHODS: This single-center retrospective cohort study included all women with cesarean deliveries performed before 28+0 weeks from 2007 through 2015...
January 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
Mette Østergaard Thunbo, Marianne Sinding, Anne Sofie Korsager, Jens Brøndum Frøkjaer, Lasse Riis Østergaard, Astrid Petersen, Charlotte Overgaard, Anne Sørensen
INTRODUCTION: Current knowledge of the fetoplacental vasculature in fetal growth restriction (FGR) due to placental dysfunction focuses on the microvasculature rather than the macrovasculature. The aim of this study was to investigate the feasibility of computed topography angiography to analyze the fetoplacental macrovasculature in normal and FGR pregnancies. MATERIAL AND METHODS: We included 29 placentas (22-42 weeks' gestation) from normal birthweight pregnancies and 8 placentas (26-37 weeks' gestation) from FGR pregnancies (birthweight < -15% and abnormal umbilical Doppler flow)...
January 4, 2018: Acta Obstetricia et Gynecologica Scandinavica
Fiona McQuaid, Christine Jones, Zoe Stevens, Gretchen Meddaugh, Catherine O'Sullivan, Beverly Donaldson, Rhona Hughes, Carolyn Ford, Adam Finn, Saul N Faust, Diane Gbesemete, Helen Bedford, Stephen Hughes, Anu Susan Varghese, Paul T Heath, Matthew D Snape
INTRODUCTION: Maternal vaccination is increasingly part of antenatal care in the UK and worldwide. Trials of Group B streptococcus (GBS) vaccines are ongoing. This study investigated the attitudes of pregnant women and healthcare professionals towards antenatal vaccination, both in routine care and a clinical trial setting. MATERIAL AND METHODS: Survey of 269 pregnant women, 273 midwives/obstetricians and 97 neonatal doctors across seven sites in the UK assessing attitudes towards antenatal vaccinations, knowledge of GBS, a hypothetical GBS vaccine and participation in clinical vaccine trials...
January 2, 2018: Acta Obstetricia et Gynecologica Scandinavica
Antonino Giambona, Filippo Leto, Cristina Passarello, Margherita Vinciguerra, Valentina Cigna, Giovanna Schillaci, Francesco Picciotto, Salvatrice Lauricella, Kypros H Nicolaides, George Makrydimas, Gianfranca Damiani, Aurelio Maggio
INTRODUCTION: Currently, prenatal diagnosis of genetic disorders requires chorionic villus sampling or amniocentesis carried out after 11 and 16 weeks of gestation, respectively. Celocentesis is a procedure for prenatal diagnosis that could be used from as early as seven weeks. The present investigation evaluated the feasibility of performing diagnosis for monogenic diseases using celomic fluid containing cells of fetal origin. MATERIAL AND METHODS: Analysis consisted of 489 singleton pregnancies undergoing celocentesis for the prenatal diagnosis of hemoglobinopathies (n=367) or before surgical termination of pregnancy for social indications (n=122)...
January 2, 2018: Acta Obstetricia et Gynecologica Scandinavica
Hanna Ulfsdottir, Sissel Saltvedt, Susanne Georgsson
INTRODUCTION: The literature describes advantages for mothers giving birth in water, but waterbirth is controversial in Sweden and has not been offered at hospitals until recently. This study aimed to describe and compare the characteristics and outcome of waterbirths with spontaneous vaginal births at the same clinics. MATERIAL AND METHODS: A retrospective cohort study was conducted on all waterbirths at two maternity units in Sweden from March 2014 to November 2015 (n=306), and a consecutively selected comparison group of 306 women having conventional spontaneous vaginal births...
December 29, 2017: Acta Obstetricia et Gynecologica Scandinavica
Penelope J Teoh, Alexandra Ridout, Jenny Carter, Andrew H Shennan
There is a proven association between urinary tract infections (UTI) and preterm birth. There is a recognized link between genital and urinary anomalies (1); 30-50% of Mullerian duct anomalies are associated urinary tract defects (2). Given this association, we determined if certain women with uterine anomalies should be monitored more closely for UTI. This article is protected by copyright. All rights reserved.
December 27, 2017: Acta Obstetricia et Gynecologica Scandinavica
Marike Lemmers, Marianne A C Verschoor, Patrick M Bossuyt, Judith A F Huirne, Teake Spinder, Theodoor E Nieboer, Marlies Y Bongers, Ineke A H Janssen, Marcel H A van Hooff, Ben Willem J Mol, Willem M Ankum, Judith E Bosmans
Curettage is more effective than expectant management in women with suspected incomplete evacuation after misoprostol treatment for first trimester miscarriage. The cost-effectiveness of curettage versus expectant management in this group is unknown MATERIAL AND METHODS: From June 2012 until July 2014, we conducted a randomized controlled trial and parallel cohort study in The Netherlands, comparing curettage to expectant management in women with an incomplete evacuation of the uterus after misoprostol treatment for first trimester miscarriage...
December 20, 2017: Acta Obstetricia et Gynecologica Scandinavica
Anna M Gustafsson, Emma Fransson, Aurelija Dubicke, Anna K Hjelmstedt, Gunvor Ekman-Ordeberg, Sven-Arne Silfverdal, Stefan Lange, Eva Jennische, Kajsa Bohlin
INTRODUCTION: Anti-secretory factor is a protein that regulates secretory and inflammatory processes and preterm birth is associated with inflammation. Therefore, our hypothesis was that anti-secretory factor might play a role in immune reactivity and homeostasis during pregnancy. MATERIAL AND METHODS: Following spontaneous onset of labor and preterm or term delivery, placenta biopsies were collected. The levels of anti-secretory factor and markers of inflammation (CD68, CD163) and vascularization (CD34, smooth muscle actin) were analyzed by immunohistochemistry...
December 19, 2017: Acta Obstetricia et Gynecologica Scandinavica
Carolyn E Cesta, Anna L Johansson, Julius Hreinsson, Kenny A Rodriguez-Wallberg, Jan I Olofsson, Jan Holte, Håkan Wramsby, Margareta Wramsby, Sven Cnattingius, Alkistis Skalkidou, Anastasia Nyman Iliadou
INTRODUCTION: Women undergoing fertility treatment experience high levels of stress. However, it remains uncertain if and how stress influences in vitro fertilization (IVF) cycle outcome. This study aimed to investigate whether self-reported perceived and infertility-related stress and cortisol levels were associated with IVF cycle outcomes. MATERIAL AND METHODS: A prospective cohort of 485 women receiving fertility treatment was recruited from September 2011 to December 2013 and followed until December 2014...
December 18, 2017: Acta Obstetricia et Gynecologica Scandinavica
Katja Haemmerli Keller, Gilliane Alder, Lennard Loewer, Monika Faeh, Susanne Rohner, Michael Von Wolff
Infertility treatments such as in vitro fertilization (IVF) impose substantial distress. However, the specific role of individual contributory factors remains unclear. We therefore compared treatment related psychological stress in IVF treatments with (cIVF) and without (NC-IVF) gonadotropin stimulation as cIVF includes potentially stressful factors such as ovarian stimulation, anaesthesia, embryo selection, cryopreservation etc. whereas NC-IVF does not. Material and Methods Women were offered to undergo cIVF or NC-IVF...
December 16, 2017: Acta Obstetricia et Gynecologica Scandinavica
Gernot Hudelist, Ayman Tammaa, Kristine Aas-Eng, Lisa Kirchner, Nadja Fritzer, Zoltan Nemeth, Michael Lamche
INTRODUCTION: To evaluate the accuracy of transvaginal sonography for preoperative detection of bladder endometriosis and surgical outcomes regarding fertility and pain symptoms of women with urinary tract endometriosis. MATERIAL AND METHODS: Retrospective cohort study of consecutive patients with urinary tract endometriosis undergoing laparoscopic partial cystectomy and/or ureterolysis/decompression, ureteric resection and end-to-end anastomosis or ureteroneocystostomy for ureteral stenosis and hydronephrosis...
December 8, 2017: Acta Obstetricia et Gynecologica Scandinavica
Marco Scioscia, Piergiorgio Iannone, Danila Morano, Giovanni Pontrelli, Pantaleo Greco
We read with interest a recent article published by Bamberg et al. (1) that takes up an interesting issue previously published on the same journal by Kataoka et al. (2) on uterine niche after a cesarean section (CS). These two prospective studies assessed the risk to develop a uterine wall defect at the site of cesarean scar according to the surgical closure technique. This article is protected by copyright. All rights reserved.
December 8, 2017: Acta Obstetricia et Gynecologica Scandinavica
Patricia Eckerdal, Marios K Georgakis, Natasa Kollia, Anna-Karin Wikström, Ulf Högberg, Alkistis Skalkidou
INTRODUCTION: Although a number of perinatal factors have been implied in the etiology of postpartum depression (PPD), the role of mode of delivery remains controversial. Our aim was to explore the association between mode of delivery and PPD, considering the potentially mediating or confounding role of several covariates MATERIAL AND METHODS: In a longitudinal-cohort study in Uppsala, Sweden, with 3888 unique pregnancies followed-up postpartum, the effect of mode of delivery (spontaneous vaginal delivery, vacuum extraction, elective cesarean section, emergency cesarean section) on self-reported PPD symptoms (Edinburgh Postnatal Depression Scale ≥12) at six weeks postpartum was investigated through logistic regression models and path analysis RESULTS: The overall prevalence of PPD was 13%...
December 7, 2017: Acta Obstetricia et Gynecologica Scandinavica
Per Olofsson, Håkan Norén, Ann Carlsson
The updated intrapartum cardiotocography (CTG) classification system by FIGO in 2015 (FIGO2015) and the FIGO2015-approached classification by the Swedish Society of Obstetricians and Gynecologist in 2017 (SSOG2017) are not harmonized with the fetal ECG ST analysis (STAN) algorithm from 2007 (STAN2007). The study aimed to reveal homogeneity and agreement between the systems in classifying CTG and ST events, and relate to maternal and perinatal outcomes MATERIAL AND METHODS: Among CTG traces with ST events, 100 traces originally classified as normal, 100 as suspicious and 100 as pathological were randomly selected from a STAN database and classified by two experts in consensus...
December 7, 2017: Acta Obstetricia et Gynecologica Scandinavica
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