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Biomedical subjects

S Hebjørn

Publications and source records attributed to S Hebjørn.

11 recordsLinked to original sources

Herpes simplex virus IgA in pregnancy.

From 170 pregnant women, cervico-vaginal secretion, serum and amnion fluid were collected to determine concentrations of herpes simplex virus (HSV) IgA in different risk groups. We found a higher concentration of HSV IgA in cervicovaginal secretions in women with positive cultures, compared with women with negative cultures. Women with a prior history of genital HSV infections also had higher levels of HSV-IgA in cervico-vaginal secretions, compared with those with no HSV history, but the differences were not statistically significant. The concentrations of HSV IgA in cervico-vaginal secretions were not correlated to any other risk group defined in the study. An asymptomatic mother with no previous history of genital HSV infection, but belonging to the risk groups gave birth to an infant who developed neonatal herpes on the 4th day of life. Women at risk for viral shedding during gestation and at the time of delivery cannot be identified solely on the basis of grouping into risk groups and/or on concentration of HSV IgA in cervico-vaginal secretion.

Amnion↗

Outpatient treatment of cervical intra-epithelial neoplasia. The CO2 laser versus cryotherapy, a randomized trial.

In a randomized study, 204 patients were allocated to either laser or cryo treatment for cervical intra-epithelial neoplasia (CIN). The patients were treated on an outpatient basis without anesthesia unless other conditions requiring anesthesia had to be dealt with at the same time. Both the laser and the cryo method were highly acceptable to the patients. Slightly more patients experienced moderate or severe pain during laser treatment, compared with cryo treatment (P = 0.05). Peroperative hemorrhage did not exceed 25 cc except for one laser-treated patient. Postoperative vaginal discharge was more often seen after cryo coagulation, the discharge being malodorous in 36% of cryo-treated patients and in 17% of laser-treated patients. Pelvic inflammatory disease was found in one patient in each treatment group. Postoperative spotting occurred more often in laser-treated patients (49%) than in cryo-treated patients (22%). At follow-up colposcopy 3 months after treatment, the squamocolumnar junction was fully visible significantly more often in laser-treated patients (P less than 0.001). The cure rates after one laser or cryo treatment were 90% and 91%, respectively. Subsequent to 19 initial treatment failures, 8 patients have at present been retreated with the same method as initially used, and all 8 are cured. The cure rates after one or two treatments are 96% in the laser group and 93% in the cryo group. The rates are preliminary, due to the short observation time. Publications will appear when all patients have been followed for 2 and 5 years.

Adult↗

Sequelae of induced first-trimester abortion. A prospective study assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics.

A follow-up study was undertaken in 493 women who had participated in a clinical, controlled trial with the object of assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics in the development of sequelae. Information about dysmenorrhea, dyspareunia, chronic pelvic pain, episodes of pelvic inflammatory disease, infertility, births, induced and spontaneous abortions, and ectopic pregnancies were obtained from 382 of the women and from 38 of 40 women who had contracted postabortal pelvic inflammatory disease during the previous study. Significantly elevated rates in women with postabortal pelvic inflammatory disease compared with women without this disease were found for spontaneous abortion (22% versus 5%, p less than 0.0005), secondary infertility (10% versus 2%, p less than 0.05), dyspareunia (20% versus 5%, p less than 0.005), and chronic pelvic pain (14% versus 2%, p less than 0.001). Nonsignificant differences were observed for ectopic pregnancy and dysmenorrhea. A new episode of pelvic inflammatory disease within the first year after abortion was observed more often in women with postabortal pelvic inflammatory disease than in women without infection (41% versus 5%, p less than 0.0001). Prophylactic antibiotics decreased the rates of spontaneous abortion and dyspareunia (p less than 0.05 in both instances).

Abortion, Induced↗

Suprapubic versus transurethral bladder drainage after colposuspension/vaginal repair.

Ninety-two patients with preoperative sterile urine undergoing colposuspension or vaginal repair operation for stress urinary incontinence and/or genital descensus were randomized to either suprapubic or transurethral postoperative catheter drainage. The prevalence of significant bacteriuria on the fifth postoperative day was statistically significantly lower when using suprapubic catheter (20.8%) than with transurethral catheter drainage (45.5%). This applied especially to colposuspension. The rate of postoperatively impaired bladder emptying also tended to be reduced when using suprapubic catheter. At follow-up after one year, postoperative bacteriuria was closely correlated to increased rates of both clinical cystitis and asymptomatic significant bacteriuria. Thus it is recommended to use suprapubic bladder drainage not only after colposuspension but also after vaginal repair in an effort to avoid an increased risk of urinary infections.

Adult↗

Peroperative penicillins, bacteremia, and pelvic inflammatory disease in association with induced first-trimester abortion.

In a clinical, controlled trial including 474 women, 250 were randomised to prophylactic treatment with penicillin/pivampicillin and 224 to placebo treatment. Cervical, uterine, and blood cultures were obtained at abortion. In the treatment group, 13 percent developed bacteremia versus 14 percent in the placebo group. The distribution of species cultured from the cervix and uterus was not significantly different from that of the species recovered in the blood. A previous report found that women with a history of pelvic inflammatory disease (PID) carried a higher risk of contracting postabortal genital infection. However, the frequency of bacteremia in these women was not significantly different from the frequency in women without previous PID (p greater than 0.3). In women with and without postabortal infection, no significant differences were observed between the frequencies of bacteremia, either in the antibiotic group (p greater than 0.9) or in the placebo group (p greater than 0.7), suggesting that the release of bacteria into the blood stream from the instrumented tissues is without pathogenetic importance in postabortal infection.

Abortion, Induced↗

A follow-up study of the Marshall-Marchetti-Krantz vesicourethral operation for female incontinence.

A Follow-up study on 65 consecutive patients who underwent vesicourethral suspension (Marshall-Marchetti-Krantz' operation) in the period 1961-70 was carried out. Indications and results were evaluated. Forty-one patients completed the investigation. Twenty-five patients were operated on correct indication (pure stress incontinence). Twenty patients (80%) were cured and the vaginal examination were in accordance to this result.--Unfortunately several side-effects to this operation were observed (primarily infravesical obstruction, urge phenomenon and dyspareunia). Therefore posterior suspension of the bladder is recommendable. Carefully history, cystometry and colpo-cystourethrography seems necessary in the evaluation of female incontinence.

Adult↗

Risk factors in first-trimester abortion.

Among 238 women who underwent first-trimester abortion and who were randomized to the placebo group in a clinical controlled trial we studied the possible correlation of the variables age, parity, number of previous spontaneous and induced abortions, previous pelvic inflammatory disease (PID), gestational age, chronic pelvic pain, dyspareunia, dysmenorrhea, social status, and the application of an intrauterine device (IUD) at abortion - to the number of days with pain, bleeding, discharge, fever, absence from work, and day of first coitus after abortion. The ANOVA test of Kruskal-Wallis with the limit of significance p less than 0.05 was employed. Women with one or more previous spontaneous abortions had significantly more days with postabortive bleeding (p = 0.010). Women with previous PID and women with dysmenorrhea had significantly more days with pain after abortion (p = 0.011 and p = 0.001). Women at a gestational age of 11-12 weeks had significantly more days with fever (p = 0.009). Women who had an IUD inserted at abortion suffered more days with pain and bleeding (p = 0.038 and p = 0.043). No one group of women carried a risk of several severe complaints after abortion except those with a history of PID.

Abortion, Induced↗