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Biomedical subjects

J Sundby

Publications and source records attributed to J Sundby.

16 recordsLinked to original sources
PubMed1998

Infertility in the Gambia: frequency and health care seeking.

In order to understand the problems of undesired infertility in the Gambia, where the desire for children and fertility is very high, a population based estimate of the frequency of sub-/infertility was undertaken. A survey was used in a representative random sample of the population. The study included an assessment of health care available for infertile couples in the different types and levels of the formal and traditional health system. Primary sterility was found to be fairly uncommon (3%), and secondary infertility to be more frequent (6%). Half of the infertile couples failed to seek formal health care, and they had to reach a certain level of care in order to be properly managed. As investigations are very basic and treatment possibilities scarce, many forms of alternative care are often sought. In addressing reproductive health in developing countries, a systematic primary health care approach to infertility in rural areas with limited resources should be developed.

Adolescent↗
PubMed1997

Infertility in the Gambia: traditional and modern health care.

In order to understand the problems of unwanted infertility in a country--the Gambia--where the desire for children and the fertility is very high, a population-based survey was undertaken. All infertile women in 24 randomly selected enumeration areas were assessed. The study included a review of the problems faced and coping mechanisms employed by infertility clients and types of health care available for infertile couples in the different types and levels of the formal and traditional health system. Half of the infertile couples failed to seek formal health care, and they have to reach a certain level of care in order to properly managed. Alternative care is often sought. Child fostering is also a frequent solution to childlessness. In-depth interviews revealed that traditional care like healers and spiritual leaders are frequently consulted long before formal health care. This delay could be a problem in those cases where infertility is caused by infections.

Adolescent↗
PubMed1996

Infertility and subfertility in Norwegian women aged 40-42. Prevalence and risk factors.

BACKGROUND: There are few population estimates of the prevalence of infertility that also include some information about medical conditions and social classification of study objects. This is a study of 4034 out of a total of 5139 (78% of all invited) women in one county of Norway. METHODS: All female inhabitants born 1950 to 1952 living in the county were invited to participate in a health screening. The screening comprised a clinical screening and two questionnaires; one about reproductive history and infertility. RESULTS: This survey found permanent primary infertility in 2.6% of the women. Subfertility, as at least one year's delay of pregnancy, was reported by 7.7%. A history of different reproductive problems was associated with impaired fertility. Thirty-two percent of primary infertile women had a history of PID, 13% had experienced amenorrhea and almost 40% reported premenstrual tension, compared with lower frequencies in women with normal fertility (11.0%, 3.3% and 29.4% respectively). CONCLUSIONS: Up to 10% of the female population may experience infertility at one stage in their reproductive career. Clinicians should pay special attention to women presenting any genital or reproductive disorder regarding risks for future fertility impairment.

Adult↗
PubMed1995

[Breech presentation--methods of delivery and risks].

Although perinatal mortality is steadily decreasing with the present relatively stable rates of cesarean section, babies born in breech presentation are at a higher risk of perinatal problems and mortality. The higher risk associated with breech delivery is more marked for preterm babies. Vaginal deliveries of term breech babies, however, present only a slightly higher risk than elective cesarean deliveries. Breech presentation is also associated with several inborn diseases or malformations. There is no standard set of general criteria for selecting route of delivery for breech presentations, but when several criteria are combined, they have been shown to reduce the risk when applied in a clinical setting. This article reviews the current knowledge of the management and outcome of breech deliveries, and concludes that vaginal breech deliveries at term are relatively safe if selected on the basis of specific criteria and performed in specialized units.

Abnormalities, Multiple↗
PubMed1994

Quality of care for infertility patients. An evaluation of a plan for a hospital investigation.

AIM OF STUDY: In this study we assessed the quality of health care for infertile patients as expressed by the patients themselves. The implementation of the existing structured plan for infertility investigation and treatment was also reviewed. DESIGN AND DATA: The sample consisted of all 361 women registered with an infertility diagnosis during 1982 at Rikshospitalet. Their medical records were reviewed in 1988. The process and outcome of the investigation as it appeared was analyzed for each individual patient. A structured questionnaire was distributed to the patients in 1988 and 72.6% responded. The questions included several items on outcome and personal experience of the treatment in the hospital. RESULTS: Data from the medical records show that the medical investigation lasted three years on average. The records often showed evidence of discontinuity of the process. The mean number of consultations was eight (range 1-28). An average of one new doctor for each consultation was involved in the investigation. One third of the patients left the investigation without a noted definite termination of the treatment process. According to the questionnaire around 40% had delivered at least one child, while 30% had adopted. Of those who got a biological child, two thirds were satisfied with the clinical treatment efforts of the medical staff. Less than half of those who did not become pregnant were satisfied. Independent of outcome, 70% were dissatisfied with the emotional support during the investigations, and nearly 90% felt that waiting lists were too long. More than half expressed a need for professional psychological counselling. CONCLUSIONS: The study shows that medical records and service organizations do not meet the need for continuity in treatment nor research and evaluation requirements. We suggest that more emphasis should be devoted to planning of the services. They should be improved with regard to quality in medical handling as well as emotional counselling.

Adoption↗
PubMed1993

[Genital mutilation of women. A new challenge for the health service].

Female circumcision, or genital mutilation is practised around the world. Because of war, conflicts and poverty, many women from cultures involving this practice now enter European communities. Some of them demand circumcision for their children. Genital mutilation of women has serious health effects, and in our societies there is a strong demand for its eradication. The cultural reasons for genital mutilation are varied, but it is not a compulsory part of the Islamic faith. Health workers in Norway may lack knowledge on how to handle these women when they meet them in their daily work. Sometimes unnecessary interventions are performed, sometimes ignorance may cause traumatic experiences for both patient and doctor. This article describes some of the social and cultural background for continued exposure to female mutilation, the health effects and some suggestions for interventions.

Africa↗
PubMed1992

[Delivery at the parents' and children's premises].

Developed countries have reduced maternal mortality to a minimum, and there is a very low perinatal risk. This is still far from the reality in many developing countries. In the evaluation of health care for mother and child, all professionals involved should consider their focus. The use of technology, and the premises and information shared with the users should be open to revision, in order to provide services that are user-friendly, and to ensure low risk for parents and children.

Developing Countries↗
PubMed1990

Infertility, technology and the law. Patients' and future doctors' opinions.

The rectifying of infertility by application of modern technology has been a topic for debate in modern society over the past decade. Laws regulating the investigation and treatment of infertility have been passed in many countries, for instance in Norway and Sweden, while other nations await future developments. In this paper, some users of the technology--female infertility patients and future medical doctors--present their attitudes toward controversial issues of infertility, investigated by means of a survey questionnaire issued to them in 1987-88. Medical students have a more restrictive attitude than former patients, whereas religious beliefs influence the viewpoints of the patients. Both groups seem to have opinions that to a large degree accept the content of the Norwegian law.

Adult↗
PubMed1989

[Subfertility and infertility. A sample of Norwegian women].

Infertility is a major concern in Norwegian society. There is an increase in the demand for treatment of reproductive impairment in many countries today. It is not known if this is due to an increase in the frequency of subfertility. In this study the frequency of permanent unvoluntary childlessness among women participating in a case-control study on breast cancer is 3.2%. Infertility is experienced throughout the reproductive period by 9%, and 15% have sought medical services for infertility problems. These results agree with comparable results in other studies. We discuss the consequences for the amount of infertility health services that will be needed.

Adult↗
PubMed1989

[Psychosocial gynecology and obstetrics. A need for its own specialty].

Gynaecology and obstetrics are medical fields where knowledge about the psychological and social factors influencing the patient's situation is essential. Some of these factors are risk factors for complications and illness during pregnancy and childbirth, and for reproductive health. Treatment and diagnosis of women with gynaecological disorders and of mother and child during pregnancy strongly influence mental health and well-being. Individual ways of coping with life events vary. In the individual approach to the treatment of women, gynaecologists need to have a broad understanding of the intrapsychic and social aspects of women's lives. This article lists some important fields of future research. We also discuss the necessity for systematic education in psychosocial gynaecology and obstetrics for clinical gynaecologists.

Gynecology↗
PubMed1989

Methodological considerations in the study of frequency, risk factors and outcome of reduced fertility.

Infertility is a major health problem for many couples. Many clinicians believe that its prevalence is increasing. This may be attributable to greater concern about infertility in society and development of new treatment methods. Infertility is also a complex medical, social and individual problem. We do not know enough about the risk factors and their mechanisms of action. In the study of reduced fertility there is a need for clear definitions and careful selection of study populations. There are several sources of bias. One is selection bias in the ascertainment of infertility couples, others are recall bias and exposure assessment bias. Furthermore, medical classification of causes is difficult in population based studies. This paper will discuss problems in the interpretation of results of past studies and in methods already in use. Some new design options in future research are presented.

Cross-Sectional Studies↗