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O Lidegaard

Publications and source records attributed to O Lidegaard.

At least 55 records · Page 3Linked to original sources
PubMed1994

Cervical incompetence and cerclage in Denmark 1980-1990. A register based epidemiological survey.

OBJECTIVE: To assess the incidence rate of cervical incompetence diagnoses in Denmark 1980-1990 according to maternal age, to analyse regional variations, to investigate how often cerclage is applied, and finally to estimate abortion rates among women with cervical incompetence with and without cerclage. DESIGN: A register-based retrospective cross section study. SETTING: All Danish gynecological departments. MATERIAL AND METHODS: Since 1977, all hospitalized patients in Denmark have been centrally recorded by diagnosis according to the ICD classification and by operation codes in The National Patient Register. From this database, all women with cervical incompetence (CI) and cerclage in the period 1980-1990 were identified. From the same database all cases of spontaneous abortions were registered. RESULTS: A total of 2756 cases of cervical incompetence were registered in the period 1980-1990, corresponding to an incidence rate of 4.6/1000 births. The risk of cervical incompetence increased from 2/1000 births among women 15-19 years old to 7.5/1000 births among women 35-39 years old. The incidence rate of the CI-diagnosis fell 44% from 1980 to 1990. The incidence rates in different counties ranged from 1.7/1000 births to 10.0/1000 births. The average length of stay in hospital among patients with cervical incompetence was three weeks. Among patients with cervical incompetence, 61% were treated with cerclage. This per cent increased from 29% among women 15-19 years old to 68% among women 35-39 years old. 13.5% of women with CI experienced spontaneous abortion. This percentage increased from 12% for women 15-19 years old to 17% among women 40-44 years old (p < 0.01). Among women with CI and cerclage, the abortion rate was 17.6%. CONCLUSION: In the period 1980-1990 the incidence rate of cervical incompetence in Denmark was on the average 4.6/1000 births. The incidence rate of the CI-diagnoses has fallen significantly during the last decade, and it increases four-fold with increasing age. Six out of ten patients with cervical incompetence were treated with cerclage.

Abortion, Spontaneous↗
PubMed1994

Technology use, cesarean section rates, and perinatal mortality at Danish maternity wards.

Fifty-eight Danish maternity units, managing 99% of Danish deliveries, participated in a cross sectional study to assess the relationship between use of birth-related technologies, cesarean section rates and perinatal mortality for births after 35 completed weeks of gestation. A regional technology index (0-10) was calculated for each maternity unit according to its use of ante and intra partum fetal heart rate monitoring (FHM), hormone analysis (human placental lactogen (HPL) and/or estriol (O3)), fetal blood samples (scalp-pH), intrauterine catheter and umbilical cord-pH. Maternity units using FHM had a 15% higher cesarean section rate (not planned) than units not using FHM (p < 0.05). The referral of potentially complicated deliveries to central units, which at the same time relatively often use FHM, is probably responsible for this association. Trying to encounter this selection bias a technology index was calculated for eight regions in Denmark, weighting the index of each unit in a region according to its number of deliveries. There was no association between the technology index in these eight regions in Denmark and their cesarean section rates. Use of FHM, technology index, and unplanned cesarean section rates in the eight regions were all without significant association to the perinatal mortality in the same regions. For births after the 35th completed week of gestation, this study could not confirm a relationship between different degrees of use of birth-related technologies and perinatal mortality.

Adult↗
PubMed1993

[Oral contraceptives and cerebral thromboembolism. A Danish case-control study].

A retrospective case control study was carried out in order to assess the risk of developing cerebral thromboembolism by use of low dose oral contraceptives (OC). The subjects were all the 794 women in Denmark aged 15-44 who had suffered a cerebral thromboembolic attack (CTA) during the period 1985-1989, and an age-matched randomly selected control population of 1588 women. CTA included occlusion of precerebral arteria (ICD 432), cerebral thrombosis (ICD 433), cerebral embolism (ICD 434), transitory cerebral ischaemia (TCI; ICD 435) and the unspecified group apoplexia cerebri (ICD 436). Of 692/1584 case/control questionnaires sent out, 590/1396 (85.1/88.1%) were returned. Among the cases, 15 refused to participate, 69 had a revised or unreliable diagnosis, 40 had previously had thromboembolic disease, 13 were pregnant, and 152 had a disease predisposing them for CTA, leaving 323 without known predisposition, of whom 320 reported use/non-use of OC. Among 1396 controls, eight either refused to participate, were mentally retarded or resident in foreign countries; 18 returned an uncompleted questionnaire, 17 had previously had thromboembolic disease, 31 were pregnant, and 130 had a disease predisposing them to CTA. Thus, 1198 non-predisposed controls were provided, among whom 1197 reported use/non-use of OC. Among 320 cases, 116 (36.3%) were OC users at the time of the CTA, vs. 191 users (16.0%) among 1197 controls, corresponding to a crude odds ratio (OR) of 3.00.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Use of oral contraceptives in Denmark 1980-1990 and smoking habits among fertile women in 1990].

The purpose of this study has been to chart the changes in usage of different types of oral contraceptives (the pill) throughout the 1980's, as well to estimate the extent to which these changes can be expected to influence the incidence of cerebral thromboembolic attacks amongst fertile women. The use of different types of the pill and smoking habits in different age groups are also investigated. The work is based om cross-sectional studies during the period 1980-1990; the use of the pill is documented by national sales statistics from 1980-1990 as well as from questionnaires answered by 1370 healthy women from 1990. The total sale of the pill has been fairly stable throughout the decade, corresponding to a theoretical user percentage of 23-26. The proportion of pills sold containing 50 micrograms oestrogen has fallen steadily from 51% in 1980 to 11% in 1990, while the proportion of pills containing 30-40 micrograms oestrogen (this group includes the mulit-phase pills) has doubled from almost 40% to almost 80% over the same period. Finally, the proportion of minipills has fallen from 10% to 5%. It is estimated that the changed distribution in use of the different types of the pill through the eighties can be expected to reduce the incidence of cerebral thromboembolic attacks among fertile women by 4.5%. Since the 95% confidence limits on the incidence of such attacks among fertile women in Denmark is +/- 14%, one cannot expect to show significant changes in the total incidence of cerebral thrombo-embolic attacks among these women as a consequence of the change in contraceptive pill profile.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Oral contraception and risk of a cerebral thromboembolic attack: results of a case-control study.

OBJECTIVE: To assess the risk of cerebral thromboembolism in women using low dose oral contraceptives. DESIGN: A retrospective case-control study. SETTING: All Danish medical, neurological, neurosurgical, and gynaecological departments. SUBJECTS: All 794 women in Denmark aged 15-44 who had suffered a cerebral thromboembolic attack during 1985-9 and 1588 age matched randomly selected controls. RESULTS: Of 692/1584 case/control questionnaires sent out, 590/1396 (85.3%/88.1%) were returned. Among the cases, 15 refused to participate, 69 had a revised or unreliable diagnosis, 40 had had thromboembolic disease previously, 13 were pregnant, and 152 had a disease predisposing to a cerebral thromboembolic attack. Of the 323 cases without a known predisposition, 320 reported use or non-use of oral contraception. Among the 1396 controls, eight refused to participate, were mentally retarded, or lived abroad; 18 returned an uncompleted questionnaire; 17 had had thromboembolic disease previously; 31 were pregnant; and 130 had a disease predisposing to a cerebral thromboembolic attack. Thus 1198 non-predisposed controls were available, among whom 1197 reported use or non-use of oral contraception. Among the 320 cases, 116 (36.3%) were oral contraceptive users at the time of the cerebral thromboembolic attack. By comparison there were 191 users (16.0%) among the 1197 controls, giving a crude odds ratio of 3.0. After multivariate analysis, including confounder control for age, smoking, years of schooling, and trend in use of different types of oral contraceptives during 1985-90, pills containing 50 micrograms oestrogen were associated with an odds ratio for cerebral thromboembolic attack of 2.9 (95% confidence interval 1.6 to 5.4), those containing 30-40 micrograms oestrogen an odds ratio of 1.8 (1.1 to 2.9), those containing progestogen only an odds ratio of 0.9 (0.4 to 2.4). The odds ratio did not change with increasing age or with duration of oral contraceptive use. A 50% increased risk of a cerebral thromboembolic attacks among cigarette smokers (after confounder control) was independent of oral contraception status and age. CONCLUSION: Low dose oral contraceptives are associated with an increased risk of cerebral thromboembolic attack. Combined or sequential pills containing 30-40 micrograms oestrogen are associated with a one third reduced risk compared with preparations containing 50 micrograms oestrogen. Progestogen only pills did not increase the risk of a cerebral thromboembolic attack.

Adolescent↗
PubMed1992

[Oophorectomy per occasionem and ovarian cancer].

The mortality from ovarian cancer is responsible for 450-500 cancer deaths annually in Denmark. This high mortality rate has remained unchanged for decades. No effective screening method is available. Oophorectomy per occasionem may reduce the incidence of ovarian cancer. The literature suggests a reduction in the incidence of ovarian cancer of 5.7% which corresponds to approximately 30 women annually in Denmark when OPO is performed at the age of forty or later. OPO also avoids reoperation due to the Residual Ovarian Syndrome, which is detected in approximately 2% of women after pelvic surgery.

Denmark↗
PubMed1992

Description, evaluation and clinical decision making according to various fetal heart rate patterns. Inter-observer and regional variability.

At 10 Danish obstetrical departments, 116 residents (42 senior and 74 junior) participated in a study to assess inter-observer and regional variability in the description and evaluation of and clinical decision regarding 11 fetal heart rate patterns. The 11 traces included normal as well as pathological patterns, and normal as well as clinically asphyxiated babies. Five antepartum and six intrapartum patterns were included. A total of 1,276 descriptions and evaluations were obtained. The degree of agreement in description of fetal heart rate changes was high regarding the baseline and the presence of silent or sinusoidal pattern (87-94% on an arbitrary 0-100% scale), and low regarding the assessment of variability and type of deceleration (50-72%). The degree of agreement in interpreting heart rate patterns was 59% (on an arbitrary 0-100% scale). Senior residents generally interpreted the changes as indicative of less serious fetal stress than did their junior colleagues, explaining why junior residents 30% more frequently than their older colleagues found an indication for Cesarean section. Relatively low regional inter-observer agreement scores were primarily due to low agreement between departments, especially between departments far apart. It is concluded that we still need a scientific clarification of which specific heart rate changes are the best predictors of fetal stress. Artificial intelligence programs for interpreting fetal cardiotocograms and ECG signals constitute one promising prospect.

Cesarean Section↗
PubMed1990

[Technology use in connection with delivery in Danish maternity departments].

With the object of obtaining information about the technology use employed in Danish maternity departments, a questionnaire was sent to the 58 maternity departments which existed in Denmark in May 1989. These maternity departments covered 99% of the 55,660 births in Denmark (in 1987). Deliveries at home (a total of 511) and delivers in departments with less than four deliveries annually (a total nine) were responsible for the remaining 1%. 100% of the departments returned a completed questionnaire. The following percentages are based on the deliveries included in this investigation. The review revealed that 93.5% of Danish women are delivered in departments with access to carditocographic equipment (CTG), 34% in departments where this is offered routinely to all parturient women. Sixteen departments which did not possess CTG equipment all had fewer than 400 deliveries per annum and 12 of these stated that they wished they had had CTG. Only four of the 58 maternity departments (managing 3.4% of the deliveries in 1987) never employ human placental lactogen (HPL) or oestriol (O3) analyses. The most commonly employed hormone parameter is HPL which is undertaken on appropriate indications in 51 of 54 departments and routinely in the remaining three. Scalp-pH is carried out in 13 of the Danish maternity departments. Thus 41.7% of all the parturient women have access to this analysis. However, only 20% are delivered in maternity departments where this test is employed frequently. Cord-blood-pH is employed routinely in 31.7% of the neonates. Measurement of intrauterine pressure is employed in six out of the 58 maternity departments which are responsible for 25% of Danish deliveries. It is concluded that the slightly increased employment of technology use during delivery in 1989 as compared with practice in 1984 may primarily be due to the closing of several small maternity units during the past five years. In general, the use of technologies are less intensive than in England, Germany, France and the USA.

Cardiotocography↗
PubMed1990

[Medical informatics].

Medical informatics is the discipline concerned with information and information streams in health care. The development of information technology has been intensified in recent years and is now influencing the international development within the health care sectors. During the coming decade, integrated hospital networks will supple communication within and between hospitals. New productivity measures useful in administrative planning are being developed. Patient data are being digitalized and stored electronically, and interactive media are implemented in education. Primarily, however, chip-based technologies find application in the evaluation of the increasing quantity of paraclinical data. Internationally product development and research are actively underway. The EEC has established development programmes specifically stimulating these activities. Is Denmark going to take an active part in this development, formalized frames are required.

Denmark↗
PubMed1990

Pelvic inflammatory disease: the influence of contraceptive, sexual, and social life events.

In order to determine associations between pelvic inflammatory disease (PID) and contraceptive, sexual, and social life events, 620 Danish women aged 15-54 were invited to participate in an in-depth interview. Of 585 participating women, 459 were consecutive gynecological in- or outpatients, and 126 were randomly selected from visitors in general practice. Data were analyzed by multivariate test statistics. The mean number of PIDs thereby retrospectively assessed was 1.0. Two-thirds had never had PID, one third had had on average 3 PIDs. The sexual parameter which had the highest predictive value for later PID was the coital debut. Women with coital debut before the 16th year had double the number of PIDs, as women with sexual debut at age 18 or later. Likewise, the mean coital frequency was positively correlated to the number of PIDs. The number of sexual partners, on the other hand, was merely a risk-indicator without a direct influence on PID. Women who used barrier methods (condom and/or diaphragm) for 2 years or more had 23% fewer PIDs than women who had used barrier methods for less than two years. The small number of PIDs among women at high socioeconomic levels could be explained alone by a later coital debut and longer use of barrier methods than that among women at low socioeconomic levels.

Adolescent↗
PubMed1990

The relationship between menarche and sexual, contraceptive, and reproductive life events.

Relationships between menarche and sexual, contraceptive, and reproductive life events were investigated by structured interviews of 585 Danish women, aged 15-54 years. Data were analyzed by multivariate test statistics. The trend toward an earlier menarche was confirmed. No association was found between menarche and social class. Women with early menarche had an earlier coital debut. After correction for coital debut, no association was observed between menarche and coital frequency, number of sexual partners, or use of oral contraceptives. Menarche was not associated with number of births, spontaneous or induced abortions, or frequency of ectopic pregnancies. The results suggest that the predictive value of the menarche for sexual and contraceptive life events is conditioned primarily by the association between menarche and coital debut.

Abortion, Induced↗
PubMed1990

[Etiology and prevention of disease--theory and practice].

The prevention of diseases requires that their causes are known. The article presents central epidemiological concepts which relate to causality and demonstration of causal connections. It refers these to prophylactic medicine and to the future assignment of priorities as regards research funds.

Causality↗
PubMed1989

[Evaluation of quality in health services].

In recent years, the population and professional people have become increasingly aware of the need for a more systematic assessment of quality in health service. On basis of this, a Danish workshop was held in 1988 concerning scientific methods of assessing quality in the health sector. This review provides an introduction to the expressions "assessment of quality" and "insurance of quality" in the health sector. The main points from the workshop are quoted and concrete examples of assessment of quality in the Danish health service are given. It is concluded that after a couple of decades in which health political analyses and decisions have primarily been concentrated on productivity and efficacy, we may consider insurance of quality as an instrument for decision-making in the current adjustment of the health service to the changes in knowledge, attitudes and technology.

Denmark↗