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Biomedical subjects

C Lundh

Publications and source records attributed to C Lundh.

7 recordsLinked to original sources

The prevalence of violence investigated in a pregnant population in Sweden.

All women registered for antenatal care within a Swedish municipality during a 6-month period were assessed regarding acts of violence. The Abuse Assessment Screen was used on two occasions during pregnancy, and once between 4 and 20 weeks after delivery. The efficacy of repeated interviews was investigated, and characteristics of abused and non-abused women were compared. The participation rate was 93% (1038 women). Physical abuse by a close acquaintance or relative during or shortly after pregnancy was reported by 1.3%, and by 2.8% when the year preceding pregnancy was included. The lifetime prevalence of emotional, physical or sexual abuse was 19.4%. Repeated questioning increased the detection of abuse. Women abused during pregnancy reported more preceding ill-health and more elective abortions than non-abused women. Intervention against sexual violence has been on the political agenda in Sweden for several decades. Even so, physical abuse is a risk factor comparable in frequency to obstetric complications such as gestational diabetes and pre-eclampsia. Routines need to be established to make questioning about violence an integral part of the standardized screening for risk factors during pregnancy.

Abortion, Induced↗

[Infant and child mortality in the Nordic countries before 1900].

The mortality decline in the Nordic countries started at the end of the 18th century with a decrease in infant and child mortality. It was not until the middle of the 19th century that adult mortality started to fall. Recent research shows that improvements in nutrient supply, medical care, sanitation and nursing, did not take place until the beginning of the 19th century, i.e. considerably later than the start of the decline in infant and child mortality. One possible explanation to the initial decline is that a change in virulence of pathogens did occur at the end of the 18th century, i.e. that the decline was caused by factors beyond human control. There is a general agreement that the decline that followed during the 19th century had multli-factoral causes. The importance of different factors is, however, still debated. To proceed with this debate there is an obvious need to construct more data series of age-specific mortality at the macro level and to make full use of family reconstitution data. The use of advanced statistical methods, such as life event analysis, will also be of crucial importance. Equally important is the quality of the data. Since the Nordic data are said to be very good, which they generally are, too little attention has been paid to the examination of its quality. One such problem is the under-reporting of infant deaths in the church books. It is vital to research on infant and child mortality, as well as on fertility, that those periods and parishes with good data are identified.

Child↗

Reliability of radiographic pelvimetry. A methodological study.

The purpose of this study was to assess the reliability of radiographic pelvimetry. 48 radiologists were asked to estimate the pelvic inlet and outlet diameters from copies of 20 pelvimetry radiographs. We found that every third patient will have the sum of her pelvic outlet over- or underestimated by at least 4 mm, and 3% by more than 10 mm. The random measurement error of the sum of the pelvic outlet is about four times greater than the systematic error. The random error of the sagittal outlet diameter contributes to almost half of the total measurement error of the pelvic outlet sum. The measurement values of radiographic pelvimetry are often expressed in mm, which may give an impression of exactness that is obviously not well founded. Only in a few cases where the measurements suggest a severe feto-pelvic disproportion is it justified to do an elective cesarean section on the basis of radiographic pelvimetry only.

Clinical Competence↗

Radiographic pelvimetry--its use and possible radiation risk.

Radiographic pelvimetry is widely used in obstetrics. Every fourth primapara in Sweden is submitted to this radiographic examination. The frequency of the examination in the United States is estimated to a mean of 6% of all deliveries. The use of radiographic pelvimetry is now under intense debate and the missing argument in this discussion is a prospective study of an unselected group of parturients where progress and outcome of labour is referred to known pelvic dimension. Since the value of the method is questioned the frequent use of radiographic pelvimetry is justified only by an almost negligible radiation risk to the mother and her baby. Such a low risk is also an indispensable condition to allow the correct scientific evaluation of radiographic pelvimetry mentioned above. This paper presents the measurement results of absorbed radiation dose with the only radiographic pelvimetry method used in Sweden. The estimated radiation risk of the method, based on these figures, is 1 case of childhood malignancy in 50 000 pelvimetries. This corresponds to 4 years routine use of radiographic pelvimetry in Sweden. The annual incidence of childhood malignancy in Sweden is 220. The maternal risk is estimated to one tenth of the fetal risk.

Female↗

Vaginal cleansing at vacuum aspiration abortion does not reduce the risk of postoperative infection.

Does a thorough vaginal cleansing with bactericidal solutions prior to induced first-trimester vacuum aspiration abortion reduce the frequency of postabortal pelvic inflammatory disease (PID)? To answer this question we compared the frequency of PID in 372 women where a thorough preoperative vaginal cleansing with a bactericidal solution was undertaken at abortion with that in 350 women where the upper part of the vagina was swabbed with a pad moistened with a 0.9% saline solution. A postoperative PID was recorded in 25 (6.7%) of the former women and in 23 (6.6%) of the latter women.

Abortion, Induced↗