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F R Jensen

Publications and source records attributed to F R Jensen.

11 recordsLinked to original sources

MULTISCAN--a Scandinavian multicenter second trimester obstetric ultrasound and serum screening study.

AIM: To study the detection rates of second trimester ultrasound screening for neural tube defects (NTD), abdominal wall defects (AWD) and Down's syndrome (DS) in low risk populations at tertiary centers, and to compare the ultrasound screening detection rates with those that were obtainable by biochemical serum screening (double test: alpha-fetoprotein/human chorion gonadotrophin/age test). STUDY DESIGN: Prospective multicenter study with a three year inclusion period: 1/1/1989-31/12/1991. SUBJECTS: 27,844 low-risk women at 18-34 years of age who had a second trimester ultrasound screening examination. Of these, 10,264 also had a serum test. METHODS: An ultrasound malformation scan and a serum test were carried out at 17-19 weeks of gestation. Risk calculations regarding DS were based on alpha-fetoprotein, human chorion gonadotrophin and maternal age; performed retrospectively for the first two years. RESULTS: In total 73 cases were identified in the study population: NTD (n=34), AWD (n=7) and DS (n=32). The detection rates, (%, with 95% confidence interval) for ultrasound screening were: NTD: 79.4 (62.1-91.3); AWD: 85.7 (42.1-99.6); DS: 6.3 (0.8-20.8). In the subgroup of women who had both tests, the detection rates for ultrasound screening vs double test were: NTD: 62.5 (24.5-91.5) vs 75.0 (34.9-96.8); AWD: 66.7 (9.4-99.2) vs 100 (29.2-100.0); DS: 7.7 (0.2-36.0) vs 46.2 (19.2-74.9). The false positive rates (%) for ultrasound screening vs double test were: NTD: 0.01/3.3; AWD: 0.01/3.3; DS: 0.1/4.0. CONCLUSION: Second trimester ultrasound screening in a low risk population gave a low detection rate for fetal DS (6.3%) and an acceptable detection rate for NTD (79.4%) and AWD (85.7%). In the subgroup of women who had both tests, serum screening performed better than ultrasound as applied in the present study, especially regarding DS.

Abdominal Muscles↗

[The significance of psychosocial stress for pregnancy course and fetal development].

In a population-based study, 3021 women in a central Copenhagen district received a questionnaire on environmental and psychological factors during mid-gestation. Of these, 70 women were selected consecutively on the basis of moderate to severe stressful life-events (DSM-III-R categories 3 to 5), in combination with an inadequate social network. They were compared with 50 non-stressed women with an intact social network. Stress and smoking significantly affected birthweight and head circumference. When birthweight was corrected, stress remained a significant determinant of small head circumference, indicating a specific effect on brain development. Stress also led to a suboptimal Prechtl neonatal neurological score. These findings suggest the existence of a fetal stress syndrome with adverse effects on fetal development, including deficient brain development.

Birth Weight↗

Early sonographically guided amniocenteses with filtration technique: follow-up on 249 procedures.

Fetal and neonatal outcome is reported for 249 consecutive low-risk pregnancies in which early amniocentesis was carried out with filter technique, at a mean gestational age of 12.5 weeks, to improve the yield in cell cultures. Three pregnancies (1.2%) were terminated because of abnormal test results, four stillbirths (1.6%) occurred between weeks 33 and 38, and five pregnancies were lost spontaneously after sampling, corresponding to 2% of unintended fetal losses before 28 weeks of gestation. Of the live-born infants, 2.9% were delivered prematurely, all between weeks 32 and 37. Malformations and orthopedic postural deformities were not associated with leakage after amniocentesis and were found at expected rates. None of the cases was lost to follow-up. The increase in abortion rate caused by early amniocentesis with filter technique is likely to be within the same range as that seen after routine amniocentesis and transabdominal chorionic villus sampling, although the sample is too small for a proper risk evaluation.

Abortion, Induced↗

Feasibility study of a randomised trial of ovarian cancer screening.

OBJECTIVES: To assess the feasibility of a randomised trial of ovarian cancer screening by vaginal ultrasonography. SETTING: A population based study, recruiting a random sample of the female population aged 46 to 65 years living in Copenhagen, Denmark. DESIGN: Randomised controlled trial allocating 50% to the study group having vaginal ultrasonography, and 50% to the control group having no examination. (a) Acceptability of the study was evaluated by the proportion of eligible women willing to participate in the study. (b) The false positive rate was evaluated as the proportion of women without ovarian cancer referred for an operation because of abnormal ovaries detected by ultrasonography. RESULTS: 950 (64.3%) of the 1477 eligible women participated in the study. At the first scan abnormal ovaries were detected in 54 of 435 women (12%), significantly more frequently among younger women. Nine women were referred for an operation because of abnormal findings in the ovaries, giving a false positive rate of 2%. Ovarian size and morphology found at operation corresponded with those at ultrasonography; none of them was malignant. CONCLUSIONS: A randomised controlled trial of ovarian cancer screening using vaginal ultrasonography seems acceptable in the general population. The rate of abnormal ovaries at ultrasonography with the cut offs used in this study was quite high. Such a study is, therefore, feasible, but it is proposed that it is carried out in an older age group (50-64 years) and that the cut offs used for ovarian size and morphology are re-evaluated. Second line tests, such as colour Doppler flow, should be considered in order to reduce the false positive rate.

Aged↗

[Retrograde zygote intrafallopian transfer in the treatment of unexplained infertility].

The first Scandinavian pregnancy after retrograde zygote intrafallopian transfer is reported. The individual stages in the treatment are described. These consist of hyperstimulation, oocyte aspiration and fertilising of the oocytes and, finally, transfer through the cervix and uterus and retrogradely to the salpinx under ultrasonic guidance. Zygote intrafallopian transfer (ZIFT) is suitable only for couples with unexplained infertility in contrast to in vitro fertilisation (IVF) which is employed in cases in which the fallopian tubes have been removed or do not function in the female partner. The principles and the expenses involved are, by and large, similar for ZIFT and IVF.

Adult↗

[In vitro fertilization and embryo transfer. 2. The first 44 deliveries of 55 infants].

During the period 1.9.1985-21.2.1988, 143 patients commenced and completed treatment with in vitro fertilization and embryo-transfer (IVF-ET) in Rigshospitalet, Copenhagen. Forty-four out of the 143 patients were delivered of a total of 55 infants. There were 35 single deliveries, seven twin deliveries and two triplet deliveries. Seven women were admitted with threatened abortion and three women developed preeclampsia, one of these was severe. On an average, the deliveries occurred in the 38th week of pregnancy and the average weight of the singletons was 3,020 g. Ten women were delivered preterm and seven of the singletons had birth weights under 2,500 g. The frequency of caesarean section was 34% for singleton deliveries and 43% for all of the deliveries. Thirty-one boys and 24 girls were delivered, all of whom had normal karyotypes. One infant had a cleft lip but no other malformations. Three premature infants required brief respirator treatment. All of the infants were thriving on discharge. This material is still too limited to permit drawing of definite conclusions but it suggests, however, just as in other IVT-ET investigations, that the infants are born slightly earlier and weigh slightly less than average neonates, but that they are otherwise normal. In order to illustrate these problems further, the authors have commenced a more extensive prospective investigation with matched control persons.

Denmark↗