Biomedical subjects

A Saari-Kemppainen

Publications and source records attributed to A Saari-Kemppainen.

5 recordsLinked to original sources

PubMed1996

Cost-effectiveness of one-stage ultrasound screening in pregnancy: a report from the Helsinki ultrasound trial.

The objective of this study was to evaluate, in a controlled clinical trial, the costs of standardized one-stage ultrasound screening in pregnancy in relation to the reduction in perinatal mortality. A trial population of 9310 pregnant women was randomly allocated to ultrasound screening or a control group. Two obstetric hospitals and 64 recruiting antenatal health centers were involved. The costs included actually realized costs, i.e. positive costs, and gains, i.e. negative costs, resulting from lower health-care use. Cost-accounting data were obtained by a questionnaire to all attenders and measurements at the screening, and later complemented by a questionnaire to a random sample of 534 screened women. Internal accounting and other hospital data, national statistics and health-market sources were also used. The actually realized cost of each avoided perinatal death was FIM 84 378 ($21,938), while the net overall estimate combining all positive and negative costs showed a cost saving of FIM 65 680 ($17,077). The total positive unit cost of ultrasound screening was FIM 393 ($102). Longer ultrasound examination time and more numerous advanced examinations were rewarded by clearly fewer perinatal deaths and a better cost-effectiveness ratio. One-stage second-trimester ultrasound screening is cost-effective when all significant costs and effects are taken into account.

Congenital Abnormalities↗

PubMed1995

Use of antenatal care services in a controlled ultrasound screening trial.

BACKGROUND: The purpose of the present study was to evaluate whether systematically organized ultrasound screening would have an effect on the uptake of antenatal care services. METHODS: A total of 9310 women were randomised to an ultrasound screening (4691) or to a control (4619) group. The screening group had an ultrasound examination between the 16th and 20th week of gestation, but otherwise both groups had identical antenatal care. RESULTS: Antenatal outpatient clinic visits were significantly fewer (2.3 compared to 2.6, p < 0.0001) in the screening group. On the other hand women in the screening group had more visits to maternal health centers than those in the control group (12.9 compared to 12.6, p < 0.0001). No difference was noted between the groups with respect to days in hospital, rest at home on sick leave and visits for medical check-ups. CONCLUSION: Ultrasound screening reduced the need for specialist services and increased the use of basic maternal health care services.

Female↗

PubMed1994

Fetal anomalies in a controlled one-stage ultrasound screening trial. A report from the Helsinki Ultrasound Trial.

The aim of the study was to compare whether systematic strictly timed screening of all pregnancies would improve the detection of major fetal anomalies. All pregnant women (95%) from a certain area were randomly allocated for one ultrasound screening examination between the 16th and 20th weeks of gestation. Otherwise the screening (N = 4691) and control groups (N = 4619) received the same antenatal care. Screening included a systematic search for fetal anomalies. In the screening group, 40% of major fetal anomalies were detected in the screening, and 11 abortions were induced because the malformation was either lethal or severely handicapping. In the control group, 77.0% of participants had ultrasound examination any time during pregnancy. By ultrasound 13 (27%) major fetal anomalies were detected, only two of these before the 21st week of gestation. Screening detected most of the anomalies of the central nervous system and genitourinary system and cases with multiple anomalies, but was less satisfactory in detecting the anomalies of the heart and gastrointestinal tract. The perinatal mortality rate was 4.2 per 1000 in the screening group and 8.4 per 1000 in the control group (p = 0.013). The detection of major fetal anomalies in ultrasound screening can reduce perinatal mortality. A systematic search for fetal anomalies should be included in the ultrasound screening of all pregnancies.

Abortion, Induced↗

PubMed1990

Ultrasound screening and perinatal mortality: controlled trial of systematic one-stage screening in pregnancy. The Helsinki Ultrasound Trial.

During a 19-month period, 95% of all pregnant women in the greater Helsinki area, Finland, entered a study to compare one-stage ultrasonography screening with selective screening according to antenatal hospital use, obstetric procedures, and fetal outcomes. Of 9310 women who entered the trial, 4691 were randomly allocated to ultrasound screening between the 16th and 20th gestational weeks and 4619 to follow-up only. Screened and control groups otherwise had the same antenatal care, which included ultrasonography according to usual practice. Screened women made fewer visits to the antenatal outpatient clinic than did women in the control group (2.3 vs 2.6). There were no differences in the number of labour inductions or mean birthweights in the two groups. Perinatal mortality was significantly lower in the screened than in the control group (4.6/1000 vs 9.0/1000); this 49.2% reduction was mainly due to improved early detection of major malformations which led to induced abortion. All twin pregnancies were detected before the 21st gestational week in the screening group compared with 76.3% in the control group; perinatal mortality in the small series of twins was 27.8/1000 vs 65.8/1000, respectively.

Evaluation Studies as Topic↗

PubMed1986

[Ectopic pregnancy].

In Finland there were 3 193 ectopic pregnancies registered during the years 1973-1976 (1,25% of the newborns) and 4 856 ectopic pregnancies (1,91%) during the years 1977-1980. Also in the State Maternity Hospital Helsinki the ectopic pregnancy rate rose from 0,8% to 1,4%. During the years 1977-1980 241 women were operated on. From 112 patients without postoperative contraception 48% gave birth, 33% remained infertile, 10% had a recurrent ectopic pregnancy and 9% had an abortion. The best results were achieved in the salpingectomy group. In cases of conservative operations expression was more favorable than salpingotomy. With the development of better diagnostic methods the possibility of conservative operations, partial resection of the tube, respectively, later followed by microsurgical anastomosis, will be increased.

Adolescent↗