PubMed Health⌕ Search

Biomedical subjects

H Söderberg

Publications and source records attributed to H Söderberg.

11 recordsLinked to original sources
PubMed1998

Selection bias in a study on how women experienced induced abortion.

OBJECTIVE: One third of the women who had an induced abortion at the department of gynecology and obstetrics in Malmö 1989 refused to participate in an interview a year later to explore their experience and the care they had received. Using data from the mandatory preoperative visit it was then possible to compare participants with non-participants with regard to socio-demographic characteristics. reproductive history and stated reason for abortion. By continued follow-up of medical records it has furthermore been possible to ascertain how many women conceived within a year, and how many of them applied for another abortion and how many elected to continue the pregnancy to term. SETTING: Department of Obstetrics and Gynecology, Lund University, University Hospital, Malmö Sweden. This is the sole referral hospital serving the population of Malmö (approx. 230000). SUBJECTS: All 1285 women who underwent induced abortion at the department in 1989. + STUDY DESIGN: In each case information on socio-demographic characteristics, reproductive history and stated reasons for abortion was collected at the mandatory clinical visit prior to the abortion. This information was used for comparison of participants and non-participants in the planned 1-year follow-up interview. RESULTS: Young, unmarried women of low educational status and without full-time employment or studying were overrepresented in the non-participant group. The proportion of women with children was however smaller in that group. Within 12 months after the abortion, 118 women 66 (7.7%) of the participants in the follow-up interview and 52 (12%) of the non-participants conceived again but elected to continue the pregnancy to term (P<0.05). whereas 124 of the women 80 (9.5%) and 44 (10.2%) of the respective subgroups again applied for abortion within 12 months. CONCLUSION: One third of the women who underwent induced abortion did not wish to be interviewed about their emotional and somatic experience of the abortion 1 year later. Non-participation at the follow-up interview was associated with socio-demographic factors which in studies about other medical problems have been shown to be associated with increased vulnerability and morbidity. Non-participation was also associated with an increased childbirth rate during the following 2 years. The large proportion of non-participants is a matter for concern as to some extent it reflects inability of the health care system to establish trustful relationships with these women. How the participants in the follow-up study experienced this relationship will soon be published in our next paper. Support from the women's surroundings and the adviser the women met at the public health care system clearly influenced the women's psychological reactions after the abortion. It is therefore important to ascertain to what extent the management of abortion applicants in fact fulfils their individual needs and expectations.

Abortion, Induced↗
PubMed1998

Emotional distress following induced abortion: a study of its incidence and determinants among abortees in Malmö, Sweden.

OBJECTIVE: To study incidence and determinants of emotional distress following induced abortion. SETTING: Department of Obstetrics and Gynecology, Lund University, University Hospital Malmö, Sweden. SUBJECTS: A series of 854 participants at 12-month postabortion follow-up, representing 66.5% of the 1285 women undergoing induced abortion at Malmö, 1989. METHODS: Analysis of data elicited at a semistructured interview 1 year after induced abortion, risk factors for emotional distress being determined in a "case" subgroup (n = 139) of women satisfying all the inclusion criteria (i.e., postabortion emotional distress, doubts about abortion decision, would not consider abortion again), as compared with a control group (n = 114) satisfying none of the inclusion criteria. The study design is a retrospective study. RESULTS: In the subgroup with emotional distress (duration ranging from 1 month to still present at 12-month follow-up), the following risk factors were identified: living alone, poor emotional support from family and friends, adverse postabortion change in relations with partner, underlying ambivalence or adverse attitude to abortion, and being actively religious. CONCLUSIONS: Thus, 50-60% of women undergoing induced abortion experienced some measure of emotional distress, classified as severe in 30% of cases. The risk factors identified suggest that it may be possible to ameliorate or even prevent such distress.

Abortion, Induced↗
PubMed1997

Continued pregnancy among abortion applications. A study of women having a change of mind.

OBJECTIVE: A certain proportion of women applying for legal abortion later change their minds. The present study was designed to ascertain whether such women differ from those who choose to terminate their pregnancy, with regard to age, civil status, other demographic characteristics, or reproductive history. SETTING: Department of Obstetrics and Gynecology, University Hospital Malmö, Lund University, Sweden. SUBJECTS: All 1,446 abortion applicants attending the abortion clinic at University Hospital Malmö, in 1989. STUDY DESIGN: A comparison of the women who continued the pregnancy and those who underwent abortion, with regard to the above mentioned factors. METHODS: Semistructured interviews and statistical analysis. RESULTS: Of this series of urban abortion applicants, almost one in ten underwent a change of mind. Women who chose to continue their pregnancy differed from those who held fast to their initial decision above all with regard to age and family situation. Less important was education, reproductive history, and stated reasons for abortion. CONCLUSIONS: To answer the question why some women continue an unwanted pregnancy after a closer consideration is not easy. The complexity of a woman's feeling in the matter seems to be moderated by the kind of support and stability she has in her life situation and also of the stability in relation to her partner. An equally important question is whether this change of mind is associated with a changed attitude to the expected baby (i.e., does an unwanted child become a wanted one?).

Abortion Applicants↗
PubMed1997

Abortions in Malmö--problems and prevention.

Since 1975, women living in Sweden have had after counseling, free access to legal abortion until the 18th week of pregnancy. During the past decade, the abortion number remained around 34-38,000 per year, but since 1989 it has been decreasing continuously. This means an abortion rate ranging from 19.8 to 21.5 per 1,000 women aged 15-44. The largest towns in Sweden have the highest abortion rates, Malmö leading with 26.5-30.4 per 1,000 women.

Abortion, Induced↗
PubMed1996

Uteroplacental and luteal circulation in normal first-trimester pregnancies: Doppler ultrasonographic and morphologic study.

OBJECTIVE: Our purpose was to establish reference data representative of normal findings at transvaginal color and spectral Doppler ultrasonographic examination of the uteroplacental and luteal circulation in the first trimester and to relate the Doppler findings to morphologic data. STUDY DESIGN: A cross-sectional study was performed of 64 uncomplicated pregnancies of 5 to 11 completed gestational weeks terminated by legal abortion for psychosocial reasons. Doppler examinations of the main uterine arteries, subchorionic arteries, intrachorionic area, and corpus luteum were performed. Abortion material was examined morphologically. RESULTS: In the uterine and subchorionic arteries blood flow velocity increased and pulsatility index values decreased with advancing gestation. Arterial or venous Doppler shift spectra were recorded from the intrachorionic area in 91% (58/64) of the pregnancies. Intrachorionic arterial blood flow velocities and pulsatility index values were low and did not change with advancing gestation; the mean time-averaged maximum velocity, peak systolic velocity, and pulsatility index values were 4.6 cm/sec, 6.0 cm/sec, and 0.47, respectively. Morphologic examination showed trophoblast plugs in the spiral arteries to consistently manifest multiple spaces containing red blood cells at the choriodecidual junction. CONCLUSION: Blood flow velocity in the uteroplacental arteries increases and pulsatility index values decrease with advancing gestation, indicating a steady increase in uterine perfusion during the first trimester. Our findings suggest intervillous flow to be present as early as the first trimester.

Adolescent↗
PubMed1995

Effect of a prostaglandin E1 analogue (gemeprost) on uterine and luteal circulation in normal first trimester pregnancies. A Doppler velocimetry study.

OBJECTIVE: To evaluate the effects of gemeprost on utero-placental and luteal circulation and on the embryo/fetus in normal first trimester pregnancies. STUDY DESIGN: Sixty-seven women with a normal first trimester pregnancy requesting termination of pregnancy for psychosocial reasons were randomly allocated to pre-operative treatment with vaginal suppositories containing placebo or gemeprost. The women underwent transvaginal color and spectral Doppler ultrasound examination before the application of the suppository, 4 h after the application of the suppository but before the abortion, and on the seventh post-operative day. Blood flow velocities in the uterine and subchorionic arteries, the intrachorionic area and arteries in the wall of the corpus luteum and the embryonic/fetal heart rate were measured. RESULTS: The median value for pulsatility index (PI) in the dominant uterine artery was 2.4 before treatment with gemeprost and 8.5 4 h after treatment (P = 0.0006); the corresponding values for time-averaged maximum velocity (TAMXV) being 27 cm/s and 10 cm/s (P = 0.0006). Four (14%) of 28 embryos/fetuses in the gemeprost group were dead 4 h after treatment with gemeprost and the median heart rate of those still alive was significantly lower than before treatment (130 vs. 163 bpm; P = 0.003). In the placebo group, the results for the uterine arteries and the embryonic/fetal heart rate did not differ significantly between the first and second ultrasound examinations. The median values for PI and TAMXV in the arteries of the corpus luteum wall at the first ultrasound examination were 0.71 and 18 cm/s, respectively, in the placebo group and 0.71 and 20 cm/s, respectively, in the gemeprost group. These values remained almost unchanged at the second and third ultrasound examinations in both groups. CONCLUSION: Gemeprost has profound effects on utero-placental circulation in the first trimester and can induce embryonic/fetal bradycardia and sometimes embryonic/fetal demise. It has no unequivocal effect on luteal circulation.

Abortion, Induced↗
PubMed1993

Socio-demographic characteristics of women requesting induced abortion. A cross-sectional study from the municipality of Malmö, Sweden.

The aim of this study in an urban population has been to describe socio-demographic characteristics of women seeking an induced abortion. The 1,220 cases in the study correspond to an annual abortion rate of 26.0 per 1,000 women aged 15-44. There were substantial differences from 10.1 to 42.6 per 1,000 women in the 18 different urban areas. High rate areas had, in comparison with the municipal average, a higher percentage of people with low income, low education, foreign background, and people in need of social welfare. There was also a higher percentage of people living alone and a higher migration rate. Women applying for an induced abortion had similar socio-demographic characteristics. It is concluded that these associations should be considered in future family planning programs and that preventive efforts probably can be made more cost effective by concentrating on areas and individuals with these socio-demographic characteristics.

Abortion Applicants↗
PubMed1978

Further treatment after conization.

Conization was performed on 1,500 patients with carcinoma in situ of the uterine cervix. One hundred and seventy-five needed further treatment, 165 because of residual disease and 10 because of a recurrence. This finding indicates a recurrence frequency similar to the incidence of carcinoma in situ in a normal population.

Cervix Uteri↗
PubMed1976

Conization as only treatment of carcinoma in situ of the uterine cervix.

Knife conization was performed in 2,099 cases with abnormal vaginal smears. The frequency of complications was low. Carcinoma in situ was diagnosed in 1,500 cases and follow-up showed that conization was curative in 87%. The curative rate was depending on whether the resection margins were free of pathologic epithelium or not. If smears were repeatedly negative the first year after conization a new diagnosis of cancer was made in 0.4%. It was not possible to decide whether these lesions were residual changes or true recurrences. Treatment of carcinoma in situ by conization has so far reduced the frequency of invasive cervical cancer by 60%.

Adolescent↗