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Biomedical subjects

M Ahlgren

Publications and source records attributed to M Ahlgren.

At least 37 records · Page 2Linked to original sources
PubMed1991

Risk factors in ectopic pregnancy. Results of a population-based case-control study.

In a population-based case-control study, possible risk factors for ectopic pregnancy were compared in 119 patients with ectopic pregnancy and in 119 age-matched controls with intra-uterine pregnancy from each of the following categories: deliveries, spontaneous abortions and induced abortions. The following factors were found significantly more often in cases of ectopic pregnancy: a history of earlier ectopic pregnancy, a history of salpingitis, a history of earlier operation on the Fallopian tubes, a history of infertility, and a pregnancy that had occurred in spite of an intra-uterine contraceptive device. A history of appendectomy was also found significantly more often among the cases. There was no significant correlation between ectopic pregnancy and a history of no earlier pregnancy, earlier deliveries, earlier spontaneous or induced abortions or a history of other gynecological operations and increased risk of ectopic pregnancy. One or more of the risk factors were found in 76.5% of cases and 23% of controls.

Adolescent↗
PubMed1990

Acute massive pulmonary embolism treated with streptokinase during labor and the early puerperium.

Acute massive pulmonary embolism occluding 60-70% of the pulmonary circulation occurred in a young primipara during the 28th week of pregnancy. She was critically ill despite 40 h of heparin infusion and thrombolytic therapy with streptokinase was initiated. After a 10-h infusion she went into labor and streptokinase treatment was stopped. One hour later she gave birth spontaneously to a preterm infant in footling breech delivery. The infant did well neonatally. Streptokinase infusion was recommenced 8 h after delivery. Because of increasing blood loss on the second day after delivery, streptokinase was withdrawn after a total treatment time of 29 h. Total hemorrhage amounted to 8.9 litres. Serial perfusion lung scans showed complete resolution of the emboli and normal lung function was restored.

Acute Disease↗
PubMed1986

Identification of chorion villi in abortion specimens.

The incidence of ectopic pregnancy is rising. All patients with a diagnosis of spontaneous abortion should be observed until they have been proved not to have an ectopic pregnancy. To help in identifying patients with an ectopic pregnancy, sensitive human chorionic gonadotropin tests, ultrasound, and laparoscopy have been used, yet there has been a tendency to forget the simple method of looking for chorion villi. In material specimens of 272 patients with the initial diagnosis of spontaneous abortion, the gynecologist could identify villi in 50% and the pathologist could identify another 30%. Thus, only 20% had to be observed by other methods and one-third proved to have an ectopic pregnancy.

Abortion, Incomplete↗
PubMed1985

A sensitive urine pregnancy test as an aid in the diagnosis of ectopic pregnancy.

A highly sensitive 2-hour tube test for the detection of human chorionic gonadotropin (hCG) in urine was compared with the more resource-demanding radioimmunoassay for hCG in serum as an aid in the diagnosis of ectopic pregnancy. In a first series of 107 patients with the possibility of ectopic pregnancy, the urine test was positive in 31 patients, including all 15 patients shown to have an ectopic pregnancy. In a second series of 113 consecutive patients with ectopic pregnancy, the highly sensitive test was performed in 94 patients. It was positive in 90 (96%). The median time of amenorrhea at diagnosis was 7 weeks, and only 15 patients suffered a rupture of the fallopian tube. A highly sensitive urinary test for hCG is recommended as a screening method for patients giving even the smallest indication of ectopic pregnancy.

Chorionic Gonadotropin↗
PubMed1985

Ectopic pregnancy and antibodies to Chlamydia trachomatis.

Ectopic pregnancy is one of the most serious sequelae to acute salpingitis. Chlamydia trachomatis seems to be the most common etiologic agent of acute salpingitis. In the present study, we tested whether women with ectopic pregnancy had serologic evidence of a current or past chlamydial infection. Sixty-five percent of the women with ectopic pregnancy had IgG serum antibodies to C. trachomatis, and 21% of women pregnant in utero had such antibodies. Eleven percent of women with infertile husbands, 42% of women with cervicitis, and 69% of women with salpingitis had IgG serum antibodies to C. trachomatis. In women with ectopic pregnancy, there was a correlation between the occurrence of IgG antibodies and a history of salpingitis or gross evidence of a previous tubal inflammation. We conclude that previous chlamydial salpingitis may be a major etiologic factor leading to ectopic pregnancy.

Adult↗
PubMed1984

Interfimbrial adhesions. Detection and treatment of an easily overlooked cause of infertility.

During laparoscopy for investigation of infertility 68 women with no findings had their fallopian tubes catheterized. In 20 of these women small interfimbrial adhesions were found and divided. The subsequent pregnancy rate in this group was 14 (70%), which was significantly higher than that in the control group, 26 of 59 women (44%) who did not have their tubes catheterized during laparoscopy. These results indicate that interfimbrial adhesions, which are easily overlooked during routine laparoscopy but easily found when catheterization of the tubal ostia is performed, can be a contributing factor in infertility.

Catheterization↗
PubMed1983

Laparoscopy in female infertility. Diagnosis and prognosis for subsequent pregnancy.

Laparoscopy for the investigation of infertility was performed in 433 women. The rate of pathologic findings was 70%. No fewer than 55% of patients with no history of gynecologic disease and normal hysterosalpingography (HSG) were found to have pathologic findings. When comparing the patency of the Fallopian tubes at HSG and laparoscopy the overall agreement was 71%. Sixty-eight of the patents with no other cause for infertility had the abdominal tubal ostia catheterized at laparoscopy. In 20 of these, small adhesions that could interfere with ovum pick-up were found and divided. The pregnancy rate in this group was 70%, which is significantly higher than the pregnancy rate of 44% in 59 otherwise normal patients who did not have their tubes catheterized. The subsequent pregnancy rate for patients with different findings at laparoscopy is described. The role of HSG compared with laparoscopy is discussed. It is concluded that laparoscopy should be performed in all patients of female infertility, with the exception of those who have bilateral hydrosalpinges without patency on HSG. These patients are offered laparotomy for salpingostomy without laparoscopy. The catherterization of the Fallopian tubes at laparoscopy is a new method to find an easily treatable cause of infertility.

Adolescent↗
PubMed1977

Management of carcinoma in situ of the uterine cervix by selective local excision.

Local excision of severe dysplasia or carcinoma in situ of the uterine cervix by punch biopsies was the treatment in 366 cases. In 61%, cervical cytology reverted to negative or slight atypia. 153 patients have been followed from 1 to 7 years. Failures to remove the entire lesion were discovered within the first year of follow-up in all cases but 10. Complications were negligible and no patients have subsequently developed invasive cancer of the cervix. Selective local excision as an alternative to other minimally traumatic techniques, e.g. cryotherapy is discussed. Although the failure rate is slightly higher with local excision, an obvious advantage is the availability of all removed tissue for histopathologic diagnosis. Thus, the risk of overlooking microinvasive disease is reduced to a minimum.

Adult↗
PubMed1976

Outcome of pregnancy after clomiphene therapy.

Of 159 pregnancies conceived after clomiphene therapy, 141 ended in childbirth, including seven sets of twins. There was a probable increase in the number of infants born with major malformations. These were exclusively to women who had not previously borne a normal infant. The incidence of malformed infants compares well with that published after gonadotropin therapy. The possibly higher incidence of malformations seen after drug-induced ovulation would therefore seem to be due to the underlying subfertility state and thus not a direct drug effect.

Abnormalities, Drug-Induced↗
PubMed1975

Sperm transport to and survival in the human fallopian tube.

A review is given on sperm migration to and sperm survival within the human Fallopian tube. Sperm migration from the external os can be very fast. The survival time of spermatozoa in the oviduct has been demonstrated to be 85 h. Spermatozoa normally enter the abdominal cavity through the open fimbriated end. Laterally closed oviducts retain spermatozoa resulting in a larger number of spermatozoa than in the normal oviduct, where the number of sperm at the site of fertilization is very low. The morphology of spermatozoa reaching the ampulla of the oviduct is mostly normal, which seems to be based on the correlation between normal morphology and good motility. Spermatozoa within the abdominal cavity do not cause antibody formation of any importance for the fertility of the woman.

Antibody Formation↗
PubMed1975

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

A series of 343 consecutive cases with the preoperative diagnosis of carcinoma in situ of the uterine cervix treated by cervical conization is presented. In 93% of these patients cervical cytology returned to normal. The follow-up period ranged from 1 to 5 years. There was significantly greater chance for an apparent cure in cases in which histologic evaluation indicated free margins of resection (98%) than in those where the margins were involved by the neoplastic process (70%). Colposcopic evaluation to determine the site for punch biopsies and adequate resection margins could greatly enhance the success of therapeutic conization. The urgent need for conservative management of cervical intraepithelial neoplasia because of its predominance among young women is discussed.

Adult↗