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Biomedical subjects

C Lenstrup

Publications and source records attributed to C Lenstrup.

At least 19 recordsLinked to original sources
PubMed1993

[Neonatal pediatrics in Denmark. Referral and capacity, 1990].

A investigation on neonatal intensive care in Denmark was carried out in October 1990 based on a questionnaire. The eighteen paediatric departments in the country with neonatal intensive care units all answered the questionnaire. The neonatal capacity and its distribution in different parts of Denmark, the level of medical qualifications, the routines for transferral to departments with higher specialization and for certain treatment procedures are described. Several variations in diagnostic and therapeutic routines were found between departments with the same level of specialization. The results are compared to the findings of a similar investigation in 1984. It was found that the neonatal bed-capacity has been reduced since 1984. It was also found that this capacity is relatively smaller in the eastern part of Denmark than in the western part, and that neonatal intensive care is centralized in the eastern part and decentralized in the western part of Denmark. Compared to 1984 better access to radiological and biochemical service has been achieved, and neonatal care is to a greater degree performed by a specialist in paediatrics.

Cross-Sectional Studies↗
PubMed1993

[Neonatal pediatrics in Denmark. Therapeutic routines in care of very low birth weight infants and very premature infants, 1990].

A questionnaire on neonatal carried intensive care in Denmark was carried out in October 1990. The eighteen paediatric departments in the country with neonatal intensive care units all answered the questionnaire. The routines concerning transferral to a higher level of specialization, and the treatment procedures for children with a birthweight below 1500 grams and/or a gestational age under 32 weeks are described. Major regional variations were found in the degree of centralization of treatment, especially between the eastern and western part of Denmark. In an international perspective to neonatal intensive care Denmark seems to be modest with respect to initiation of treatment and the use of technology.

Cross-Sectional Studies↗
PubMed1987

Estimation of fetal weight in the third trimester by ultrasound.

A method to estimate the intrauterine fetal weight by use of ultrasound measurements of the fetal biparietal diameter (BPD) and the abdominal diameter (AD) is presented. From a consecutive series of single pregnancies the 238 pregnancies (3% of the hospital population) with ultrasound measurements obtained within 4 days before delivery were used in the estimation of birth weight. In addition, the estimated formula was applied on a test material consisting of 100 similarly selected pregnancies from the same hospital. To evaluate the expected selection effects, the birth weight for gestational age in the study group was compared with birth weight for gestational age in the total population. The weight could be estimated as 0.0351 X AD1.65 X BPD0.69 X exp(0.00196 X gestational age). Thus, the actual birth weight was within 83-120% of the estimated weight (95% prediction limits), with a residual coefficient of variation of about 9%. The gestational age could be omitted without major influence on the weight prediction. When applying the formula on the test material, 70% of the actual weights deviated less than 10% from the estimated fetal weight, but a tendency towards a slight overestimation of the weight for light for gestational age infants was found.

Birth Weight↗
PubMed1987

A randomized study of fetal abdominal diameter and fetal weight estimation for detection of light-for-gestation infants in low-risk pregnancies.

A total of 2771 pregnant women with gestational age estimated by ultrasound measurement of the fetal biparietal diameter (BPD) before the 22nd week of gestation were re-examined by ultrasound in the 32nd and 37th week of pregnancy at which time the fetal BPD and abdominal diameter (AD) were measured. An additional examination was performed at 34 weeks if the fetal weight in the 32nd week was estimated to be less than 95% of the expected mean weight. Light-for-gestational age (LGA) was suspected if the estimated birth-weight was less than 85% of the expected mean birthweight. This applied to 186 uncomplicated pregnancies in which there was no clinical suspicion of poor intrauterine growth. These pregnancies were randomly allocated to a treatment group (AD and estimated weight reported) or to a control group (AD and estimated weight withheld). Induction of labour was significantly more common in the treatment group (41%) than in the control group (15%). No statistically significant difference was found in the use of instrumental vaginal delivery or caesarean section. There was a suggestion of marginal benefit in terms of neonatal morbidity but this was not statistically significant.

Abdomen↗
PubMed1987

Warm tub bath during labor. Effects on plasma catecholamine and beta-endorphin-like immunoreactivity concentrations in the infants at birth.

In this study 13 women bathed in a warm tub bath during the first stage labor after a strictly normal pregnancy. The control group consisted of 9 women who did not want warm tub bath. Apgar scores at 1 and 5 minutes were recorded and plasma adrenalin, noradrenalin were measured in umbilical arterial blood at birth, together with pH, pCO2 and base excess and beta-endorphin-like immunoreactivity in umbilical venous blood. No differences were found between the groups. No beneficial effect was found on infant condition of a warm tub bath during labor.

Baths↗
PubMed1987

Warm tub bath during delivery.

In a prospective study, 88 women bathed in a warm tub bath for 1/2-2 hours during first stage labor after a strictly normal pregnancy, ending with spontaneous onset of labor at term. A control group consisted of 72 women fulfilling the same criteria of normality during pregnancy and labor, but who did not want to take a warm tub bath during labor. Apart from the bath, the two groups followed the usual obstetric procedures of the Department. The cervical dilatation in the "bath group" was 2 1/2 cm/h compared with 1 1/4 cm/h in the "control group". Mean pain score in the bath group was higher at the start of the study, before the bath, and they experienced a pain relief during bath which was not observed in the control group. This difference may be due to bias. The use of morfica and the need for stimulation of labor contractions were both twice as high in the control group, but this difference was not significant. No differences were observed with regard to operative delivery, vaginal or perineal laceration or in bleeding during labor or postpartum. The total duration of labor was the same in the two groups and no differences in neonatal condition were observed. The bacterial contamination of the bath water was insignificant and there were no significant febrile episodes post partum.

Adult↗
PubMed1987

On the evaluation of routine ultrasound screening in the third trimester for detection of light for gestational age (LGA) infants.

Based upon 2194 consecutive pregnancies with known gestational age, formulas for weight deviation predicted in the 32nd and 37th gestational week were estimated by multiple linear regression on the measurements of the abdominal diameter (AD) and the biparietal diameter (BPD) of the first 64% of the pregnancies. The usefulness of the screening was evaluated on the remaining 36%. An attempt to diagnose light for gestational age (LGA) infants resulted in either a low sensitivity or a low predictive value of a positive test. The late third trimester screening was more sensitive than the early, indicating LGA as a late phenomenon in pregnancy. Knowing the result from the late scanning, the result from the early scanning contributed almost no further information about whether the infant would be LGA at birth. Basic epidemiological characteristics of other comparable investigations on high-risk pregnancies and non selected pregnancies are presented.

Birth Weight↗
PubMed1986

Controlled trial of ultrasound screening for light for gestational age (LGA) infants in late pregnancy.

The study included 3311 pregnant women: 1570 in the screened group and 1741 in the unscreened group. In the screened group, ultrasound was offered routinely in the 32nd and 37th week of pregnancy, at which time the fetal biparietal diameter (BPD) and the abdominal mean diameter (AD) were measured. If, after the first ultrasound examination, the estimated weight was less than 85% of the expected mean birthweight, a finding of light for gestational age (LGA) was suspected and the ultrasound examination was repeated in the 34th week. In the screened group 6.5% of the women were at risk at the final ultrasound examination (the sensitivity was 38%) and the predictive values of abnormal and normal weight deviation were 60% and 93%, with a specificity of 97% and a relative risk of 9. Ultrasound was offered to the unscreened group only in cases of clinical concern (23% of the women). In the unscreened group 34% of the 158 LGA infants had ultrasound performed before delivery because of clinical concern. By including pregnancies induced before ultrasound could be performed, 45% of the LGA infants in the unscreened group were suspected before delivery. No significant difference between the rate of induction, instrumental deliveries and caesarean sections was found between the two groups. No benefit in terms of decreased incidence of infants with low Apgar score and acidosis was achieved.

Clinical Trials as Topic↗
PubMed1986

Birthweight-for-gestational age charts based on early ultrasound estimation of gestational age.

Birthweight-for-gestational age charts were based on the analysis of 3888 consecutive births in which the gestational age was estimated by measuring the fetal biparietal diameter before the 20th week of gestation. The data showed, in contrast to previous studies, a linear relation between gestational age and birthweight without inflection after term. The regression parameters showed a strongly significant difference between girls and boys. Thus, boys were 1.5% heavier than girls at 190 days gestation and 3.6% heavier at 300 days gestation. The linearity in the birthweight-for-gestational age charts could be due to the more reliable gestational age based on early ultrasound.

Birth Weight↗
PubMed1985

High maternal serum alpha-fetoprotein and low birthweight. A study concerning possible correlation between maternal weight, smoking, and serum alpha-fetoprotein and subsequent birthweight and gestational age.

Maternal serum alpha-fetoprotein (AFP) levels between 15 and 19 weeks gestation were studied in relation to birthweight, gestational age, maternal weight, and daily cigarette consumption in 1739 pregnancies. All infants were born after the 28th week of gestation and all were without neural tube defects. Gestational age was estimated by early measurement of the fetal biparietal diameter. High maternal serum AFP, low maternal weight, and the number of cigarettes smoked per day were found to correlate with low birthweight, but not with gestational age. By testing the influence of the individual parameters on the subsequent birthweight, no significant correlation was found between the AFP levels and birthweight. Low birthweight was mainly a result of cigarette smoking and low maternal weight. Screening for AFP in the second trimester, therefore, seems to be of no value in predicting low birthweight when maternal weight is taken into consideration.

Adult↗
PubMed1985

Cervical intraepithelial neoplasia. Examination, treatment and follow-up.

In inflammatory cytology without suspicion of cervical neoplasia (Papanicolaou II) a pelvic examination is done in order to exclude a macroscopic visible tumor. After treatment of an inflammation a repeat cytology and a colposcopy is performed preferably 8 to 12 weeks later. If the cytology or the colposcopy is abnormal, or if the colposcopy is inconclusive, or if the inflammation is of viral origin, the patient is referred to colposcopy-directed biopsies and endocervical curettage like the patients with an initial cytology suspicious of cervical neoplasia (Papanicolaou III to V). A histologically verified CIN I is treated as soon as it proves itself stable, that is, if biopsies or ECC 3 to 6 months after the initial ones again show CIN I. In very young women treatment may be postponed another 3 to 6 months. Histologically verified CIN II and III are treated without postponement. In CIN I and II treatment by means of destruction is recommended if the neoplasia is located on the exocervix and the preoperative ECC is normal and if colposcopy can exclude (micro-)invasion. A CIN III fulfilling the same criteria may be destructed, too, preferably by the CO2 laser--partly because of the well defined and precise destruction especially with regard to the depth into the stroma and partly because the laser contrary to the cryoapparatus is very suitable of treating CIN involving large areas of the exocervix including neoplasias extending into the vagina. In this connection the combined excision and destruction by the laser should be mentioned, a treatment modality made accessible by the appearance of the laser.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma in Situ↗
PubMed1985

Predictive value of antepartum fetal heart rate non-stress test in high-risk pregnancy.

For antepartum evaluation of high-risk pregnancies the non-stress test (NST) was performed in order to predict favorable or adverse fetal outcome. Between January 1, 1980 and December 31, 1980, 4078 NSTs were performed on 454 women with high-risk pregnancies. The NSTs were evaluated for pathology by a CTG pathology score. The NST interpretation were normal 95%, slight pathological 4% and severe pathological 1%. The group of women in whom all NST results were normal gave birth to healthy babies. In tact with an increasing number of pathologica-NSTs and with worsening CTG pathology score, a significant increase was found for cesarean section rate, acute operative delivery, low Apgar score, low umbilical cord artery pH and infants born small for gestational age or clinically dysmature. The frequence of perinatal morbidity was almost the same, irrespective of whether the NSTs showed accelarations or not on one or more occasions. To identify fetuses suffering from retarded intra-uterine growth the predictive value of normal NST was 97.3% and the predictive value of pathological NST was 34.8%. To identify perinatal morbidity the predictive values were 87.4% and 55.1% respectively. The NST appears to be a reliable test for antepartum assessment of fetal well-being in high-risk pregnancies.

Female↗
PubMed1985

Induction of labor and cervical ripening by intracervical prostaglandin E2.

A randomized double-blind trial was conducted over 48 hours comparing the effectiveness of prostaglandin E2 gel administered intracervically with that of demoxytocin buccal tablets for induction of labor in 103 patients with unripe cervical status (Bishop score 5 or less). A statistically significant difference was found in success frequency between the two groups, both on the first day (54.7 and 34.0%, respectively) and on the second day (82.0 and 61.9%, respectively; P less than .05). Without being matched, variables influencing the course of labor in the two groups were comparable. There was no statistically significant difference in the induction-delivery interval between the two groups during the first and second days of the trial. In both the prostaglandin E2 and the demoxytocin groups, patients who had not gone into labor during the first day showed a statistically significant increment in the Bishop score on the morning of the second day (2.4 and 1.3, respectively; P less than .01). The frequency of instrumental deliveries and cesarean section was the same in both groups; neither hypertonic uterine contractions nor side effects were observed in any patient. It is concluded that prostaglandin E2 gel administered intracervically is particularly well suited for the induction of labor in patients with unripe cervical status because of its combined contraction-inducing and cervical-ripening properties.

Adolescent↗