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Biomedical subjects

L Skibsted

Publications and source records attributed to L Skibsted.

At least 19 recordsLinked to original sources
PubMed2000

[Abnormal fetal ultrasound findings after maternal chickenpox infection].

Chicken pox infection in the first and early in the second trimester can lead to intrauterine infection and a 2% risk of developing congenital varicella syndrome (CVS). CVS is characterized by one or more of the following malformations: hypoplasia of a limb, scarring of the skin, microcephaly, cataract, microophthalmia, cerebellar dysplasia, gastrointestinal malformations and urogenital malformations. Most of these malformations can be seen by ultrasound. Foetal viral infection can also lead to intrauterine growth retardation, polyhydramnios and hydrops foetalis. This paper is a review of the literature with the focus on ultrasound findings in CVS. The options for performing prenatal diagnostic tests and the consequences of maternal varicella zoster (chickenpox) for prenatal care are discussed.

Abnormalities, Multiple↗
PubMed1999

[Twin to twin transfusion syndrome].

The incidence of multiple pregnancy has increased by 1.7 times from 1980-1994. Twenty-five percent of all twins are monochorionic diamnionic. The perinatal mortality of monochorionic twins is five times greater than that found in dichorionic twins and the morbidity is eight times greater. The increase in morbidity is due to prematurity, cerebral lesions and congenital malformations. One of the reasons for the increased morbidity is twin-twin transfusion syndrome (TTTS). TTTS occurs in 10-30% of monochorionic twins. TTTS can be treated by either amniocenteses or by lasercoagulation of anastomoses in the placenta. This paper describes the syndrome and reviews the literature. A multination randomized study is necessary to decide which treatment should be preferred.

Chorion↗
PubMed1999

[Selective foeticidium using YAG laser].

Twin-to-twin transfusion syndrome was found by ultrasound in monochorionic diamniotic twins in week 20. The donor had hydrocephalus and the recipient was normal. Selective foeticide was performed by coagulating the vessels of the umbilical cord of the donor with a YAG-laser. The pregnancy continued without complications and a healthy girl was born in week 34. The birth weight was 2935 g. Psychomotor development was normal at the age of six months.

Adult↗
PubMed1991

Salpingitis isthmica nodosa in female infertility and tubal diseases.

Salpingitis isthmica nodosa (SIN) is a condition of nodular thickening of the proximal Fallopian tube. The purpose of this study was to investigate the occurrence, distribution and frequency of SIN in Danish women salpingectomized because of tubal pregnancy or salpingitis and to correlate SIN with infertility, pregnancies, outcome of pregnancies, births, pelvic inflammatory disease and salpingitis. Sections from the isthmus were present in the specimens from 223 tubes from 193 patients and were analysed by the same pathologist. Originally, SIN was found in 12 patients but on re-examination, it was found in 24 patients. Ten women with SIN were bilaterally salpingectomized. Only one woman had SIN in both tubes. Women with SIN gave birth to as many children as women without SIN. After SIN had been diagnosed, no children were born, but this was not statistically different from the frequency of births in the non-SIN group after salpingectomy. Women with SIN had histological signs of salpingitis more often than women without SIN, but SIN complicated with salpingitis did not influence the number of children or tubal pregnancies. Women with SIN had a greater risk of two or more tubal pregnancies than women without SIN.

Adult↗
PubMed1991

Malignant placental site trophoblastic tumor. A case report and a review of the literature.

A clinicopathological and immunohistochemical study of a fatal case of placental site trophoblastic tumor (PSTT) is presented. PSTT is a rare variant of trophoblastic disease. Histologically the tumor is characterized by a monomorphic cell population, derived from the extravillous intermediate trophoblast. The tumor cells contain human placental lactogen (HPL) as the predominant marker, while human chorionic gonadotropin (HCG) is present only locally. PSTT has a malignant potential. In the case presented the tumor finally developed the biphasic pattern of choriocarcinoma. The clinical and pathological features of the malignant PSTT are reviewed. Establishing the diagnosis and predicting the biologic behavior of PSTT may be difficult. If metastases occur the prognosis is poor regardless of therapeutic intervention.

Adult↗
PubMed1990

[Acute iliofemoral venous thrombosis. 26 cases treated with thrombectomy, temporary arteriovenous fistula and anticoagulants].

During a period of two years, 26 patients with acute iliofemoral venous thrombosis were treated with venous thrombectomy, establishing of a temporary arteriovenous fistula and anticoagulants as thrombolytic treatment was not possible. Twenty-five patients were followed-up after an average of 20 months with clinical examination, phlebography, venous strain-gauge pletysmography and vein-pump examination. At follow-up examination, 68% of the patients were free from symptoms, in 54% vein-pump function was normal and 79% had normal venous strain-gauge pletysmographic findings. One patient had venous claudication. Thrombectomy with temporary arteriovenous fistula formation offers a possibility of ensuring normal venous drainage from the lower limbs in patients with contraindications to thrombolysis.

Acute Disease↗
PubMed1990

Breast-feeding in a Danish alternative birth center compared with the obstetrical ward.

In 1984 an Alternative Birth Clinic (ABC) was opened at the Copenhagen County Hospital in Glostrup. The ABC was opened on a trial basis to evaluate the demand for a different and more peaceful birth and nursing environment. The study was performed to illustrate how the place of birth can influence the delivery and the duration of breast-feeding. During the observation period of seven months there were 125 uncomplicated births at the ABC, and 170 uncomplicated births at the obstetrical ward. It was not possible to perform this study as a randomized one as delivering at the ABC was on offer to all women in this part of Copenhagen County. The newborn children at the ABC were nursed during the first 30 min after birth by 73.1% of the mothers compared to only 48.1% of the mothers at the obstetrical ward. On the fifth day after delivery 79.7% of the mothers at the ABC breast-fed without supplementary infant formula, while 95.1% of the mothers at the obstetrical ward breast-fed without supplement. Fourteen weeks after delivery 68.4% of the mothers who delivered at the ABC were breast-feeding without supplement, compared to 51.8% of the mothers who delivered at the obstetrical ward. The success of breast-feeding was found to have a positive correlation to higher social groups, delivering at the ABC, the number of antenatal care visits and increasing maternal age. The significance of these factors was tested in a regression analysis which revealed that birthplace and social group were the two factors that could explain the differences in the course of breast-feeding. Women referred to the obstetrical ward because there were no vacancies at the ABC (ABC-refused) followed in all aspects the mothers at the obstetrical ward. In spite of the groups not being randomized we feel that we can conclude, especially taking into consideration the results from the ABC-refused group, that the differences in the success of breast-feeding can be explained by the place of birth, and that making the birthplace and the surroundings more inviting will be very profitable for the length of breast-feeding. If possible the staff should spend more time with the delivering women and later assist them in getting a good start of breast-feeding.

Adult↗
PubMed1990

The frequency of platelet alloantibodies in pregnant women and the occurrence and management of neonatal alloimmune thrombocytopenic purpura.

Neonatal alloimmune thrombocytopenic purpura (NAITP) is induced by maternal antibodies to fetal platelet alloantigens. The disease is rare, but is often responsible for intracranial hemorrhages leaving severe neurological damage. Although this occurrence is rare, its frequency may be underestimated. In order to determine the frequency of alloimmunization to platelet antigens, serum from pregnant women were investigated in platelet-ELISA and lymphocytotoxic test (LCT). Seventy-eight out of 556 pregnant women (14%) were found to have antibodies to platelet antigens in ELISA and/or LCT. In one case (0.18%) a platelet specific antibody, anti-Zwa(-PIA1), was found in the platelet-ELISA. In all of the other cases only HLA-antibodies were detected. The only mother who was delivered of a child with clinical NAITP was the woman with anti-Zwa(PIA1) in serum. Furthermore, in a review from the currently available literature the following items will be discussed: 1) human platelet antigens involved in NAITP, 2) clinical aspects and prognosis of NAITP, 3) immunological diagnosis of NAITP, and 4) prevention and treatment of the disease.

Autoimmune Diseases↗
PubMed1990

Splenic abscesses: a review of 20 cases.

Splenic abscesses are rare. We present 20 new cases diagnosed in Denmark from 1982 to 1987. Five cases were diagnosed at autopsy. 10 were initially treated with splenectomy, 1 died. Five were treated with drainage and antibiotics resulting in 1 treatment failure who survived after splenectomy, and 1 death. The incidence of splenic abscesses in Denmark was 0.056% per 1,000 somatic hospital discharges per year or for the 5 cases discovered at autopsy 0.0049% per year of all hospital deaths. Splenic abscess should be suspected in the febrile patient with left upper quadrant tenderness and splenomegaly and the diagnosis confirmed by ultrasonography or computerized tomography. Treatment of choice is still splenectomy and antibiotics although favorable results have been achieved with drainage procedures in combination with antibiotics.

Abscess↗
PubMed1989

[Delivery at an alternative clinic or a special department].

With the object of assessing the safety of deliveries in the Maternity Clinic in Glostrup Hospital, consecutive registration of all 196 deliveries which commenced in the clinic during a period of seven months was undertaken. On account of various complications, 36.2% of these were transferred to the Special Department during delivery. As a control material, 313 so-called "no risk" deliveries which occurred in the Maternity Department of the Special Department during the same period were employed. The corresponding number of "complicated" deliveries in this material was 45.7%. Interventions such as early rupture of the membranes and stimulation of contractions with intravenous oxytocin were employed significantly more frequently in the Special Department. Delivery with vacuum-extractor or caesarean section was employed in 12.3% of the deliveries which commenced in the Clinic as compared with 16.6% in the Special Department. This difference was not significant. No differences could be demonstrated in the conditions of the infants on delivery and in the neonatal period which could be attributed to the choice of place of delivery. It is concluded that, with the rules for referral, monitoring during delivery and transfer to the Special Department which hold for the Maternity Clinic, the safety for deliveries corresponds to that which the Maternity Unit of the Special Department can offer.

Adult↗
PubMed1989

[The significance of the place of delivery and other factors for the course of breast feeding].

A prospective investigation of the course of delivery and postpartum period in the maternity clinic and special department in Glostrup Hospital was undertaken and data concerning establishing of breast feeding and its course were registered. In order to assess the significance of various factors for the course of breast feeding, two materials of 125 deliveries in the maternity clinic and 170 deliveries in the special department, respectively, were compared, all of which were characterized by uncomplicated deliveries. Fourteen weeks after delivery 78.6% of the women from the maternity clinic and 57.7% of the women from the special department breast fed their infants. Breast feeding without supplements was employed by 69.1% from the maternity clinic and 52% from the special department, respectively. The social status of the women and the place of delivery were the only variables investigated which could explain the statistically significant differences in the course of breast feeding. The differences in the physical and mental environments in the two places of delivery which may be considered to have contributed to the difference in the course of breast feeding demonstrated here are discussed.

Breast Feeding↗
PubMed1989

[The significance of the place of delivery for an uncomplicated delivery].

As part of an extensive prospective consecutive investigation of the course of delivery in the Maternity Clinic and Special Department in Glostrup Hospital, the results of the uncomplicated deliveries in both of these institutions are described in this article. Women who were delivered in the Maternity Clinic were, on the whole, a few years older and belonged to higher social groups than those who were delivered in the Special Department. Electronic monitoring was rarely employed in the Maternity Clinic, the parturient women were mobilized to a greater extent, the administration of analgesics was less and early rupture of the membranes was undertaken on fewer occasions. Patients appeared to be more satisfied with the physical surroundings in the Clinic than in the Special Department. It is not possible to isolate any single factor which was responsible for the differences encountered. However, there can scarcely be any doubt that the physical surroundings and the environment in the Maternity Clinic exerted a positive influence on the course of the delivery. The arrangements in the Maternity Clinic have probably also permitted the midwives to give the individual women more personal attention than is normally possible in a busy Special Department. Finally, differences in attitudes and knowledge in the parturient women may well have contributed to the differences encountered. Only randomized controlled investigations will be capable of revealing the roles played by the individual factors in the course of delivery.

Adult↗
PubMed1989

Thrombectomy of acute iliofemoral venous thrombosis during pregnancy.

Acute iliofemoral venous thrombosis is six times more frequent among pregnant than nonpregnant women. The disease is serious because of the risk of pulmonary embolism. The treatment of choice with regard to prevention of post-thrombotic disorders is controversial. Pregnant women represent a therapeutic problem because thrombolysis is hazardous to the fetus. We have performed thrombectomy and temporary arteriovenous fistula in combination with anticoagulant treatment upon all pregnant or recently pregnant women coming to our department with acute iliofemoral venous thrombosis from August 1985 to March 1987. In this period, eight pregnant women and one woman 12 days after cesarean section were admitted. This is an incidence of 0.83 per 1,000 deliveries. All of the women were evaluated with a mean follow-up time of 15 months. Six of nine patients were clinically asymptomatic. Six had a normal ambulatory strain gauge volumetry and seven, a normal occlusion strain gauge plethysmography. Two women delivered by cesarean section, one woman had an induced abortion because of the disease, two women delivered after partus provocatus and four delivered spontaneously. We conclude that thrombectomy and temporary arteriovenous fistula together with heparin is a safe treatment of acute iliofemoral venous thrombosis during pregnancy. There is no need to interrupt the pregnancies except for obstetric reasons.

Adult↗
PubMed1988

Influence of operations for stress incontinence and/or genital descensus on sexual life.

A variety of operations for stress incontinence or genital descensus are performed in gynecological department. The purpose of this study was to find out whether these operations influenced the patients' sexual life. In a prospective study of 55 women, all sexually active prior to the operation, various characteristics were evaluated by interview and gynaecological examination, immediately before and 6 months after the operation. We had adviced early resumption of sexual intercourse. Postoperatively, 13 of 55 (24%) patients experienced improvement in their sexual life, 37 of 55 (67%) no change, and 5 of 55 (9%) experienced a deterioration. Improvement often resulted from cessation of urinary incontinence. Deterioration was in all 5 cases due to dyspareunia and all 5 patients underwent a posterior colporrhaphy as part of the operation. We conclude that provided the patients are well-informed the prognosis for sexual life after these operations is good. However, colpoperineoplasty in combination with anterior colporrhaphy might cause dyspareunia in some patients.

Adult↗
PubMed1984

X long-arm deletions. A review of non-mosaic cases studied with banding techniques.

A woman with secondary amenorrhoea and an X long-arm deletion (pter----q21:) is described and compared with 30 adult non-mosaic, banded cases. Approximately 50% of the patients had gonadal dysgenesis associated with a higher frequency of short stature and "Turner stigmata" than in women with indication of ovarian activity. It is suggested that preservation of bands Xq26----28 may be decisive for normal ovarian function.

Adolescent↗