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Biomedical subjects

S Albrechtsen

Publications and source records attributed to S Albrechtsen.

14 recordsLinked to original sources
PubMed1999

Manual removal of the placenta. Incidence and clinical significance.

OBJECTIVE: To determine the incidence and complications related to manual removal of the placenta. METHODS: Review of hospital medical records from 1990 throughout 1994. One thousand five hundred and two vaginal deliveries from 1984 1992 were used for comparisons. RESULTS: A total of 24,750 deliveries were registered during the five year study period. Placenta was removed manually in 165 women (0.6%). The use of general anesthesia for manual removal of placenta decreased from 74% in 1990 to 19% in 1994. Spinal analgesia was applied from 1993, and it was used in 42% of the women in 1994. Of 74 parous women, 12 (16%) had experienced retained placenta before. The average difference in the hemoglobin concentration between the prenatal and the postoperative values was 3.4 g/dl among the patients, and 10% required blood transfusion (1-4 units). Among the controls, there was no decrease in the average hemoglobin concentration, and only 0.5 needed blood transfusion. Endometritis following manual removal was detected in 1.8% of the patients and 1.5% among the controls. Despite manual removal, five women (3%) were considered to have retained placental fragments two days or later after delivery, which required curettage. CONCLUSIONS: Placenta needed to be removed manually in 0.60% of all deliveries in our department. It was associated with increased incidence of hemorrhage and consequently low hemoglobin values. Women with a history of retained placenta have an increased risk of recurrence of retained placenta in subsequent deliveries.

Anesthesia, Epidural↗
PubMed1998

Reproductive career after breech presentation: subsequent pregnancy rates, interpregnancy interval, and recurrence.

OBJECTIVE: To assess subsequent pregnancy rates and recurrence of breech, as well as interpregnancy interval after a breech presentation. METHODS: We conducted a national population registry-based study using data from 1967 to 1994, with maternal record linkage of sibships, comprising the first to the fourth birth of a mother. RESULTS: The subsequent pregnancy rate after a surviving breech birth was lower than after a surviving nonbreech birth. Women with two births, of which one was a perinatal loss, had a higher subsequent pregnancy rate, compared with those who had surviving infants. The subsequent pregnancy rate was lower after a cesarean delivery irrespective of presentation. The interpregnancy interval was shorter if the previous infant died, whereas presentation did not influence the interval. The adjusted odds ratio of recurrence of breech increased from 4.32 (95% confidence interval [CI] 4.08, 4.59) after one previous breech delivery to 28.1 (95% CI 12.2, 64.8) after three. CONCLUSION: Breech and cesarean delivery lowered the subsequent pregnancy rate, probably because of the women's decision not to reproduce. Thus, preconceptional counseling with information, support, and reassurance regarding future pregnancies and deliveries might reduce the discouraging effect. A high odds ratio of recurrence of breech suggests effects of recurring specific causal factors of either genetic or more permanent environmental origin.

Adult↗
PubMed1998

Perinatal mortality in breech presentation sibships.

OBJECTIVE: To compare perinatal mortality in breech presentation delivered vaginally and by cesarean in individual births and in sibships. METHODS: A national, population registry-based study, 1967-1994, was conducted, with maternal record linkage of sibships, comprising the first to the third birth of a mother. The main outcome was perinatal mortality. Odds ratios of perinatal mortality were calculated and adjusted by logistic regression analysis. RESULTS: The overall relative perinatal mortality was 4.3 (95% confidence interval [CI] 4.1, 4.5) in breech compared with nonbreech presentation and 5.4 (95% CI 4.7, 6.2) in vaginal compared with cesarean delivery. The relative perinatal mortality in breech compared with nonbreech presentation was lowest in birth order one compared with birth orders two and three. In breech vaginal delivery compared with cesarean delivery, the opposite effect of birth order was found. The highest perinatal mortality was found in a current breech presentation of a sibship with no previous breech births. In birth subsequent to breech births, perinatal mortality was more or less independent of current presentation, without respect to delivery method. The increased perinatal mortality in breech presentation is explained partly by its association with other risk factors for perinatal death. CONCLUSION: Women with recurring breech presentation represent a lower risk of adverse perinatal outcome. This might be explained by a biologic mechanism or by increased quality of antenatal care. An increased mortality in subsequent nonbreech siblings after a breech presentation was surprising.

Breech Presentation↗
PubMed1998

The occurrence of breech presentation in Norway 1967-1994.

BACKGROUND: To study the occurrence of breech presentation and its association with demographic and geographic variables. METHOD: Population based cohort study from the Medical Birth Registry of Norway comprising all singleton deliveries 1967-1994, a total of 1,592,064 deliveries. Of these, 45,921 in breech presentation. RESULTS: From 1967 through 1994, the breech presentation proportion increased from 2.2% (95% CI 2.1-2.3) to 3.4% (95% CI 3.2-3.5). Breech presentation was associated with high maternal age and low birth order, as well as low gestational age and birthweight. The secular trend was mainly due to demographic changes in terms of increasing proportions of births with low birth order and high maternal age. Breech presentation was most frequent in urban areas. CONCLUSIONS: Strong associations were observed between breech presentation and low birth order as well as high maternal age. The findings are compatible with both intrinsic as well as environmental mechanisms. A full understanding of the birth order effect necessitates further studies based on sibship data. Prevention of premature delivery would be an effective measure for reducing the breech presentation proportion.

Adult↗
PubMed1998

Factors influencing delivery method in breech presentation.

BACKGROUND: To study factors influencing delivery method in breech presentation. METHODS: Population based cohort study from The Medical Birth Registry of Norway, comprising all singleton deliveries in Norway, 1967-1994, 1,592,064 deliveries of which 45,921 (2.9%) were in breech presentation. RESULTS: The proportion of cesarean section in breech presentation increased from 3.6 per 100 in 1969 to 58.8 in 1994. The relative risk for delivery by cesarean section in breech presentation compared to the nonbreech population increased from 2.0 (95% CI 1.5-2.7) in 1967 to 5.9 (95% CI 5.6-6.2) in 1994. It declined by maternal age, increased by gestational age and was lowest among mothers with urban residence. A negative association was observed between the annual number of births at the delivery department and the cesarean section proportion. However, during the observation period, the centralization of breech deliveries to the largest departments was reduced. CONCLUSIONS: Vaginal delivery in breech presentation was particularly observed in large delivery departments and among mothers with urban residence. Since experience and practical competence are prerequisites for successful vaginal delivery, this centralization seems justified. Further centralization of all breech presentation births should be pursued. However, preparedness as to vaginal delivery should be established also at the smaller units, e.g. by a routine providing periodical centralized training for obstetricians working in smaller institutions.

Adult↗
PubMed1997

[Norwegian Society of Gynecology and Obstetrics--guidelines in obstetrics. Structure, process, results and evaluation].

This paper describes structure, process, results, and evaluation of the Norwegian Society of Gynaecology and Obstetrics' Guidelines in obstetrics. This work, which lasted for 2 1/2 years, involved almost all obstetrical departments in Norway and 1/4 of all members of the Norwegian Society of Gynaecology and Obstetrics. All members of the Norwegian Society of Gynaecology and Obstetrics were invited to answer 24 questions. Of the 63% who replied to the questionnaire, 44% and 48% respectively stated that the Guidelines in obstetrics were very good or good. The introduction of the Guidelines in obstetrics led to changes in routines in more than 70% of the hospitals, and the different categories of hospital physicians changed their routines as well (55-65%). 83% of the heads of the departments stated that the Guidelines in obstetrics served partly or totally as the model for the obstetrical management guidelines. The evaluation and the experience of this quality assessment handbook serve as perspectives for future work.

Evaluation Studies as Topic↗
PubMed1997

Evaluation of a protocol for selecting fetuses in breech presentation for vaginal delivery or cesarean section.

OBJECTIVE: Our purpose was to evaluate, with respect to obstetric intervention and neonatal outcome, a protocol for selecting fetuses in breech presentation for vaginal delivery or cesarean section. STUDY DESIGN: A clinical follow-up study was performed between 1984 and 1992 of all term singleton deliveries in breech presentation. Each case selected for vaginal delivery had a matched control in vertex presentation. RESULTS: A total of 1212 infants presented as breech. Vaginal delivery increased from 45% to 57% (p = 0.004), and cesarean section for failure of vaginal delivery declined from 21% to 6% (p < 0.00001). None, however, died or had long-term sequelae because of a complicated or failed vaginal breech delivery. A total of 8.8% of those delivered vaginally in breech versus 5.0% of those in vertex presentation were admitted to the neonatal intensive care unit (p = 0.009). Among those with vaginal delivery, 2.5% in breech presentation were given the clinical diagnosis of birth asphyxia versus none in the vertex position (p = 0.0001). CONCLUSION: Breech presentation at term may be selected for vaginal delivery if properly managed.

Apgar Score↗
PubMed1995

Retinal detachment in association with preeclampsia and abruptio placentae.

Retinal detachment is a rare complication of preeclampsia, eclampsia and abruptio placentae. We report a case of bilateral retinal detachment in association with severe preeclampsia complicated with abruptio placentae, intrauterine fetal death and disseminated intravascular coagulation. In obstetric complications, placental thromboplastin may release into maternal circulation and activate the extrinsic coagulation system with resultant disseminated intravascular coagulation. This may be responsible for choroidal ischemia and consequent serous retinal detachment.

Abruptio Placentae↗
PubMed1994

[Breech presentation--classification and nomenclature].

In Norway the nomenclature used for the various types of breech presentation differs. In this paper the authors describe the common types of breech presentation and the nomenclature used in the Norwegian textbooks in obstetrics. Using different nomenclature can lead to misinterpretation of the different types of breech presentation which could influence the choice method of delivery. The authors propose an unambiguousness Norwegian nomenclature for the most common types of breech presentation.

Breech Presentation↗
PubMed1994

Outcome of pregnancy and childbirth following laryngectomy.

OBJECTS: Pregnancy and delivery in two laryngectomized women. RESULTS: One woman had a pregnancy complicated by hypothyroidism and stenosis of the tracheostoma, she was delivered by cesarean section. The other had an uneventful pregnancy and a spontaneous vaginal delivery. CONCLUSIONS: Individualized handling of the delivery. By modifying the technique of bearing down spontaneous vaginal delivery is possible.

Adult↗
PubMed1989

Proallergens of formaldehyde applied in patch testing of formaldehyde contact allergy.

The ability of the nonliquid, nonvolatile proallergen of formaldehyde, N-hydroxymethylsuccinimide, to test for contact allergy to formaldehyde has been investigated by in vitro penetration studies in human epidermis. Compared with the standard test, 1% formaldehyde in water, N-hydroxymethylsuccinimide equal to 0.8 mg formaldehyde gave a similar penetration profile. This is explained by cleavage of N-hydroxymethylsuccinimide into formaldehyde and carrier (succinimide) by transepidermal water on the surface of the skin. Results were confirmed by a guinea pig maximazation test on animals sensitized to formaldehyde and in a preliminary clinical study on nine patients with known allergy to formaldehyde.

Administration, Cutaneous↗
PubMed1988

Problems of interpreting integumental D-glucose fluxes by the integument of Schistosoma.

1. The parasitic trematode Schistosoma mansoni can take up glucose across its surface at a rate three times higher than the glucose uptake by the mucosal border of the rabbit ileum. 2. Washout of tritiated polyethylene glycol (M Wt 4000) indicated that it was being lost through the integument and that the gut contribution is very small. 3. There is a peripheral diffusion resistance that will profoundly influence any transepidermal solute transfer.

Animals↗