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Staffan Bergström

Publications and source records attributed to Staffan Bergström.

30 records · Page 2Linked to original sources
PubMed2003

Infection-related morbidities in the mother, fetus and neonate.

Only partially understood host defense mechanisms operate against infections affecting maternal and fetal morbidity. Subclinical ascending infections through the lower female genital tract are predominant worldwide. Important micronutrient deficiencies may prevail in low-income countries where these infections are much more common than in high-income countries. Important morbidities related to poor perinatal outcome both for the mother and for the fetus and newborn comprise preterm birth, prelabor rupture of membranes, placental abruption (predelivery detachment of the placenta), postpartum sepsis and maternal anemia. In the fetus, sepsis and intrauterine growth retardation are suspected to be consequences of ascending maternal infections. In the newborn, septicemia and respiratory disorders as well as some neurological disorders seem to be consequences of such ascending genital infections in the pregnant woman. It is concluded that much more attention should be given to efforts to elucidate the host defense mechanisms and antimicrobial barriers from the vagina through the cervix, fetal membranes and amniotic fluid including the early fetal immunocompetence in the second and the third trimester of pregnancy.

Female↗
PubMed2003

Use of cholera beds in the delivery room: a simple and appropriate method for direct measurement of postpartum bleeding.

Abundant obstetric bleeding is a predominant cause of maternal death, with the immediate postpartum period being the most critical time. Visual estimation of postpartum haemorrhage (PPH) often leads to severe underestimation and delay in treatment. Various methods have been developed in order to measure blood loss accurately, but none has proved appropriate in poor settings. The aim of this study was to present a method which is appropriate for measuring postpartum blood loss in a setting with limited resources. Parturient women (n = 814) with active management of third stage of labour in Luanda, Angola were studied. Vaginal bleeding immediately after birth and during the first 2 hours postpartum was collected using a combination of a plastic sheet and a bucket belowa cholera bed, in which the women rested during postpartum observation. Monitoring postpartum blood loss in the same way as cholera patients are monitored for loss of stool fluid was found to be a useful and practical way of measuring haemorrhage of parturient women after childbirth. The method described here is simple and appropriate, which makes it a good alternative to more costly methods in detecting and quantifying PPH.

Angola↗
PubMed2002

Quality of registration of maternal deaths in Mozambique: a community-based study in rural and urban areas.

Maternal mortality is an important indicator used to assess the level of development of a country and particularly the coverage of health services. In Africa where the maternal mortality ratios are about 100 times higher than those of developed countries the situation is even worse due to problems of underregistration. In Mozambique the figures officially used are derived from the data of some hospitals in the main cities. This leaves out the 60% of pregnant women who do not attend health facilities. It was against this background that the present study was designed to be a prospective community-based study carried out in the central region of Mozambique involving a population of 207,369 inhabitants. The study covered a 12-month period, from 01/08/96 to 31/07/97 and found 214 deaths among women in reproductive age (15-49 yr) of whom 40 were classified as maternal deaths. Gross underregistration was revealed, as the health institutions failed by 86% in recording maternal deaths, the same happening with other official sources, like the Civil Register and the Funeral Services registering only 9% of the maternal deaths. This kind of study is however complex and labour intensive and a practical way of monitoring has to be found; for the region where the study took place close collaboration with private cemeteries appears to be a way to be further explored.

Adolescent↗
PubMed2002

Gestational diabetes mellitus and fetal death in Mozambique: an incident case-referent study.

BACKGROUND: Third trimester fetal death is a common problem in Mozambique, occurring in approximately 5% of parturient women. OBJECTIVE: To elucidate the magnitude of the gestational diabetes mellitus problem, and to estimate its prevalence in a group of women with unexplained late fetal deaths and in women with live fetuses (referents). METHODS: An incident case-referent study of 109 pregnant Mozambican women with fetal deaths and 110 women delivering liveborns, regarding fasting B-glucose, oral glucose tolerance test and glycosylated hemoglobin. RESULT: The difference in gestational diabetes mellitus prevalence in the two groups is not significant. The prevalence of gestational diabetes mellitus was high in both groups: 11% and 7%, respectively.

Adult↗
PubMed2002

Symphysis-fundal height growth chart of an obstetric cohort of 817 Mozambican women with ultrasound-dated singleton pregnancies.

Our aim was to construct a new symphysis-fundus height (SFH) growth chart, based on Mozambican women with ultrasound-dated singleton pregnancy, who represent the largest obstetric cohort in a developing country followed for this purpose. Two antenatal clinics were chosen in the suburban area of Maputo City. A cohort of 904 consecutively recruited antenatal clients was followed until delivery. The growth of the SFH was measured every second to third week. Gestational age was determined by ultrasound at enrolment. Women with multiple pregnancy or with gestational age > 21 weeks at enrolment were excluded. The average number of antenatal SFH measurements per woman was 7.8 (SD 2.4). The drop out rate was 9.6%. Mean birthweight was 2909 g. Pre-term deliveries occurred in 15% and low birthweight deliveries (< 2500 g) in 16%. Using proper longitudinal methods, we constructed an FH growth chart and compared it with various previously published SFH charts, which showed the Mozambican chart to be 0-3 cm below the others. Nulliparous women were 0.5 cm below multiparous women. We did not find any difference in the SFH growth charts between women with or without overt morbidity. Women with a body mass index (BMI) < 19 and women with a BMI > 27 had approximately 1 cm lower and 1 cm higher readings, respectively, than women with normal BMI. The Mozambican SFH growth chart is an example of an elaborated growth chart for a well-defined population in a low-income country. It constitutes the basis for further studies to predict the small-for-gestational age newborn from anthropometrical data obtained by use of appropriate technology.

Adult↗
PubMed2002

Violent deaths: the hidden face of maternal mortality.

OBJECTIVE: To review pregnancy-related deaths due to injuries, to identify the characteristics of these women and to compare the magnitude of injury-related maternal deaths to that of other causes of maternal death. DESIGN: A retrospective study was performed during a five-year period (1991-1995), covering deaths from injuries, including suicide, homicide and accidents in Maputo, Mozambique. SETTING: Department of Forensic Medicine at the Maputo Central Hospital, Mozambique. POPULATION: The pregnant or recently pregnant (post-abortion and postpartum) population of Maputo city, the national capital of Mozambique. Twenty-seven cases of pregnancy-related deaths caused by injuries were identified. MAIN OUTCOME MEASURES: Proportion of deaths due to homicide, suicide, and accidents in pregnant women or within 42 days after termination of pregnancy. RESULTS: Ten cases were due to alleged homicide, nine to alleged suicide and six to alleged accident. Fifty-nine percent (16/27) of women suffering an injury-related maternal death were younger than 25 years of age. Eighty-five percent of pregnancies were less than 28 weeks of gestational age. The magnitude of the problem of violence-related maternal deaths compares with the magnitude of pregnancy-induced hypertension as the fourth cause of maternal death at Maputo Central Hospital. CONCLUSION: The contribution of violence-related deaths tomaternal mortality is significant and must not be neglected.

Adolescent↗
PubMedDate not supplied

Primary infertility after genital mutilation in girlhood in Sudan: a case-control study.

BACKGROUND: In theory, infections that arise after female genital mutilation (FGM) in childhood might ascend to the internal genitalia, causing inflammation and scarring and subsequent tubal-factor infertility. Our aim was to investigate this possible association between FGM and primary infertility. METHODS: We did a hospital-based case-control study in Khartoum, Sudan, to which we enrolled women (n=99) with primary infertility not caused by hormonal or iatrogenic factors (previous abdominal surgery), or the result of male-factor infertility. These women underwent diagnostic laparoscopy. Our controls were primigravidae women (n=180) recruited from antenatal care. We used exact conditional logistic regression, stratifying for age and controlling for socioeconomic status, level of education, gonorrhoea, and chlamydia, to compare these groups with respect to FGM. FINDINGS: Of the 99 infertile women examined, 48 had adnexal pathology indicative of previous inflammation. After controlling for covariates, these women had a significantly higher risk than controls of having undergone the most extensive form of FGM, involving the labia majora (odds ratio 4.69, 95% CI 1.49-19.7). Among women with primary infertility, both those with tubal pathology and those with normal laparoscopy findings were at a higher risk than controls of extensive FGM, both with borderline significance (p=0.054 and p=0.055, respectively). The anatomical extent of FGM, rather than whether or not the vulva had been sutured or closed, was associated with primary infertility. INTERPRETATION: Our findings indicate a positive association between the anatomical extent of FGM and primary infertility. Laparoscopic postinflammatory adnexal changes are not the only explanation for this association, since cases without such pathology were also affected. The association between FGM and primary infertility is highly relevant for preventive work against this ancient practice.

Adult↗
PubMedDate not supplied

[Genital mutilation of children is an offence. Do health services have a sufficient knowledge to see the problem?].

There are contradicting opinions whether female genital cutting (FGC) takes place in Sweden. The results from several studies indicate, however, that FGC is practiced on girls residing in Sweden. Almost no research has been done on girls on how they are affected by FGC. Thus there is no scientifically based knowledge on signs and symptoms in girls related to the practice, which can lead to cases passing unnoticed. Many health professionals feel they have poor knowledge about FGC. It is important to teach about FGC at medical and nursing schools and to make guidelines based on paediatric aspects of FGC.

Adolescent↗