Acta obstetricia et gynecologica Scandinavica
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Acta Obstet Gynecol Scand · Oct 2013
The potential impact of new diagnostic criteria on the frequency of gestational diabetes mellitus in Sweden.
The International Association of Diabetes and Pregnancy Study Groups (IADPSG) has suggested new diagnostic criteria for gestational diabetes mellitus. Many centers in Europe still use the World Health Organization (WHO) criteria. In southern Sweden we use the 2-h threshold of the European Association for the Study of Diabetes criteria based on universal screening with a 75-g oral glucose tolerance test. ⋯ A complete repeat oral glucose tolerance test was performed directly after diagnosis in 120 women. When applying the current Swedish criteria, and the IADPSG and the WHO criteria to the material, gestational diabetes mellitus was confirmed in 67% (80/120), 84% (101/120), and 80% (96/120), respectively. Hence, 26% (101/80) more women were identified by the IADPSG criteria and 20% (96/80) more women by the WHO criteria, compared with the criteria presently in use.
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Acta Obstet Gynecol Scand · Sep 2013
The experience of pregnant women with a body mass index >30 kg/m² of their encounters with healthcare professionals.
To examine the experience of women with a pre-pregnant BMI >30 kg/m², in their encounters with healthcare professionals during pregnancy. ⋯ Pregnant women with obesity may experience prejudice from healthcare professionals. These women felt they were treated with a lack of respect, an accusatorial response, and the feeling that information which could have been helpful was not forthcoming. Communication between obese pregnant woman and healthcare professionals appears to be lacking. Improved training in communication skills, less judgemental behaviour and better dissemination of information from healthcare professionals working with pregnant women with obesity are needed.
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Acta Obstet Gynecol Scand · Aug 2013
ReviewNerve stimulation for chronic pelvic pain and bladder pain syndrome: a systematic review.
Chronic pelvic pain (CPP) and bladder pain syndrome (BPS) can have a negative impact on quality of life. Neuromodulation has been suggested as a possible treatment for refractory pain. To assess the effectiveness of tibial and sacral nerve stimulation in the treatment of BPS and CPP. ⋯ There were no reported data for sacral nerve stimulation. There is scanty literature reporting variable success of posterior tibial nerve stimulation in improving pain, urinary symptoms and quality of life in CPP and BPS. In view of the dearth of quality literature, a large multi-centered clinical trial investigating the effectiveness of electrical nerve stimulation to treat BPS and CPP along with the cost-analysis of this treatment is recommended.
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Acta Obstet Gynecol Scand · Aug 2013
Randomized Controlled TrialLidocaine-prilocaine (EMLA(®) ) cream as analgesia in hysteroscopy practice: a prospective, randomized, non-blinded, controlled study.
We investigated the efficacy of 5% lidocaine 25 mg-prilocaine 25 mg/g cream (EMLA(®) ) applied to the uterine cervix for reducing pain during diagnostic or operative hysteroscopy, using a visual analogue scale (VAS) for pain in a prospective randomized, non-blinded, controlled study in 92 successive patients. Patients were randomized to either 3 mL of EMLA cream or 3 mL of ultrasound gel (placebo), placed endocervically and exocervically, 10 min before hysteroscopy. ⋯ The number of women who wished to stop the procedure was significantly lower in the EMLA group compared with the control group (p = 0.013). We concluded that topical instillation of EMLA does not decrease pain during hysteroscopy, but does reduce a desire to abandon the procedure.
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Acta Obstet Gynecol Scand · Jul 2013
Evolution of diagnostic criteria for gestational diabetes mellitus.
The establishment of universal diagnostic guidelines for gestational diabetes mellitus has been a long time coming. The lack of consensus and uniformity in procedures for diagnosing this disease has been a problem ever since its existence was recognized. ⋯ Recently, the Hyperglycemia and Adverse Pregnancy Outcomes study demonstrated that maternal hyperglycemia is associated with perinatal risk in a linear way with no obvious threshold. The International Association of Diabetes and Pregnancy Study Group has translated these results into clinical practice by proposing new diagnostic criteria for gestational diabetes mellitus, based for the first time on perinatal outcome.