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Biomedical subjects

T F Nielsen

Publications and source records attributed to T F Nielsen.

23 records · Page 2Linked to original sources
PubMed1984

Cesarean section and maternal mortality in Sweden 1973-1979.

During the years 1973-79, 704732 births took place in Sweden and 63 075 cesarean sections (CS) were performed. Within the study period there were 20 maternal deaths associated with delivery or puerperium. Thirteen of these patients were delivered by CS and 7 by the vaginal route. The hospital records of the 13 deaths associated with CS were closely analysed and it was found that 5 of the patients were critically ill before the beginning of surgery, and the CS per se was not responsible for these deaths. The 8 remaining maternal deaths gave a corrected (cesarean-attributed) maternal mortality rate of 12.7/100 000 cesarean deliveries. For vaginal deliveries the mortality rate was 1.1/100 000 deliveries. Thus, the risk of maternal death from CS in Sweden was twelve times as high as that from vaginal parturition. All maternal deaths except one, associated with CS, occurred after emergency operation. No deaths were ascribable to anesthesia complications. The most common causes of death after CS were pulmonary embolism, amniotic fluid embolism, coagulopathy and peritonitis. Time trends in the causes of maternal death in Sweden are discussed.

Adult↗
PubMed1984

The course of subsequent pregnancies after previous cesarean section.

The course of pregnancies subsequent to cesarean section (CS) was studied. During the years 1970-72, 543 women were delivered by CS at Borås Central Hospital. A questionnaire was sent to all 543 during the autumn of 1976 and the spring of 1977. The questions concerned further conceptions and the outcome of all subsequent pregnancies after CS. Of the 440 (81%) women who answered the questionnaire, 244 (55.5%) became pregnant, the total number of subsequent pregnancies being 306. The incidence of spontaneous abortion, extra-uterine pregnancy and legal abortion was not significantly higher than the corresponding rate for the total material for our department during the same period. Among the 215 women who completed a new pregnancy, an elective CS was performed in 81 cases (38%). Trial of labor occurred in 143 patients, 91 of whom (68%) gave birth per vaginam , while 43 (32%) were delivered by acute CS. In nearly half of the acute CS cases the indication was a narrow pelvis not detected until labor had started. This indicates that roentgenologic pelvimetry should be considered in certain cases, when planning delivery after a previous CS.

Abortion, Spontaneous↗
PubMed1983

Postoperative cesarean section morbidity: a prospective study.

During a 3-year period, 1,319 women delivered of their infants by cesarean section were prospectively studied to determine the type and rate of postcesarean complications and to identify risk factors which predispose to postoperative morbidity. The overall complication rate was 14.5% and the most common complication was infection (13.3%), in particular, endometritis (6.6%), urinary tract infection (3.1%), and wound infection (1.6%). A lower complication rate was seen in elective operations (4.7%) compared with emergency operations (24.2%). Four significant factors that predispose to postoperative morbidity were identified: duration of ruptured membranes prior to operation (p less than 0.001), duration of labor prior to operation (p less than 0.001), anemia (p less than 0.01), and obesity (p less than 0.01). Patients with a combination of risk factors had an increased complication rate, in some cases as high as 91%. The clinical relevance of these findings in trying to decide possible ways to reduce the complication rate by changing the delivery routines is discussed.

Adolescent↗