Acta obstetricia et gynecologica Scandinavica
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Stillbirth rates have decreased radically over the last decades. One reason for this is improved perinatal care. The aim of this study was to explore whether sub-optimal factors in stillbirths were more frequent among non-western than western women. ⋯ Non-western women constituted a risk group for sub-optimal care factors in stillbirths. Possibilities for improvements include a reduction of language barriers, better identification and management of growth restriction for both origin groups, and adequate intervention in complicated vaginal births; with increased vigilance towards non-western women.
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Acta Obstet Gynecol Scand · Jan 2007
Randomized Controlled TrialTen-year follow-up of endometrial ablation.
This paper presents a ten-year follow-up of a randomized, controlled trial which gives the long-term hysterectomy rate and patient satisfaction rate of transcervical hysteroscopic endometrial ablation in the treatment of heavy dysfunctional bleeding. ⋯ The long-term results show that an ablation for heavy dysfunctional bleeding is an excellent treatment. Overall 22% of patients had a hysterectomy. If the patient had no further intervention at the two-year clinical control, there was only a 6% risk of hysterectomy after a period of at least ten years.
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Acta Obstet Gynecol Scand · Jan 2007
Comparative StudyCost-minimisation analysis of vaginal wall repair in an inpatient or outpatient regimen.
The study's objective was to compare the cost of vaginal wall repair under local anesthesia, undertaken in either an inpatient or an outpatient regimen. The perspective used was that of a department of gynecology over the short and medium term. ⋯ Vaginal wall repair under local anesthesia, undertaken in an outpatient regimen, appears to be less costly than in an inpatient regimen.
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Acta Obstet Gynecol Scand · Jan 2007
Randomized Controlled Trial Comparative StudyOutpatient cervical ripening before first-trimester surgical abortion: a comparison between misoprostol and isosorbide mononitrate.
Vaginal administration of prostaglandin analogues as well as nitric oxide donors before first-trimester surgical abortion has been shown to induce effective cervical ripening. In addition, nitric oxide donors, such as isosorbide mononitrate and nitroglycerin, have been associated with a patient-friendly side-effect profile when administered 3 h before the surgical procedure. We wanted to compare the cervical ripening effect and possible side effects of isosorbide mononitrate and the prostaglandin analogue misoprostol when self-administered at bedtime the evening before surgical abortion. ⋯ Misoprostol induced a more pronounced cervical ripening than isosorbide mononitrate, but both regimens were associated with a high frequency of side effects.
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To assess the risk of uterine rupture of the scarred uterus according to mode of delivery in subsequent births recorded as spontaneous labour, labour induced by oxytocin, labour after ripening with prostaglandin E2, and planned cesarean section. ⋯ In women with a scarred uterus, prostaglandin E2 induction of labour is a risk factor for uterine rupture. The practice of a systematic cesarean section in cases with Bishop score<3, appropriate induction procedure, and rigorous monitoring of the labour, could make for a safer delivery.