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K Molne

Publications and source records attributed to K Molne.

At least 19 recordsLinked to original sources
PubMed2001

[Incidents connected to pregnancy and labor].

In the period 1993-2000 the Norwegian Board of Health investigated 70 cases of claimed professional misconduct in relation to pregnancy or delivery. There were two maternal deaths, 38 perinatal deaths and 17 cases of cerebral damage. The Board of Health found reason to criticize midwives in 11 cases, obstetricians in 39 cases, and the hospital for lack of routines in 18 cases. Many of the mishaps were connected to false interpretation of fetal signs of distress (clinical signs or cardiotocography), and the investigation concluded that Caesarean section was delayed too long. The number of patient complaints has been constant through the period, in contrast to the widespread belief that misconduct and complaints are steadily increasing. The health authorities and the Norwegian Association of Gynaecologists have focused on quality and standards in obstetrics through committees for investigation of perinatal deaths, national guidelines in obstetrics, and improved national statistics.

Diagnostic Errors↗
PubMed1994

[The new medical curriculum in Trondheim. Organization and planning of a new curriculum].

In autumn 1993, the Faculty of Medicine in Trondheim will be able to offer complete undergraduate medical education to 60 students per year, after 18 years of 3 1/2 years' education, based only on the clinical part of undergraduate medical school. The entire new curriculum is based on problem-based learning with the preclinical and the clinical part of the study totally integrated for 5 1/2 years. Throughout the curriculum any health care problem will be analyzed in terms of three perspectives: the biological, the environmental and the behavioural. The new medical curriculum was planned as a project during which both teachers and students took part in planning groups organized on several levels. Through clinical demonstrations and a course on the doctor-patient-relationship, the 60 students will meet patients as a natural part of their study from day one. In the Family Practice and in the Skills Lab they will acquire clinical skills during the first two years. In the fourth and fifth years the students spend two 8-week clerkship periods in community hospitals and community health practices.

Curriculum↗
PubMed1993

[Fertilization in vitro--how large a proportion of couples will have a child?].

In Norway, the efficacy and the efficiency of IVF treatment for infertile couples have been questioned. Information about this topic is important for the general public, the infertile population, the gynaecologists and the health authorities. We have followed a cohort of 485 infertile couples accepted for in vitro fertilization treatment. During a 14 month period starting 1 January 1989 a total of 214 women have either delivered or are pregnant in the second or third trimester. This number represents 44% of the 485 women accepted for IVF treatment, irrespective of whether they were treated or not, and 50% of the couples who completed at least one IVF cycle. There was no difference in cycle efficiency (pregnancy rate) between the first to third cycle, but this was significantly lower in cycle 4-6. There was no difference in delivery rate between groups of patients with different diagnoses of female infertility, but an additional male factor reduced the delivery rate significantly. Replacement of cryopreserved/thawed embryos gave a 5% increase in the delivery rate per couple included in the study, and an increase of 13% in the number of deliveries.

Birth Rate↗
PubMed1993

The efficacy and efficiency of an in-vitro fertilization programme including embryo cryopreservation: a cohort study.

A cohort of 485 couples starting their first in-vitro fertilization (IVF) attempt between January, 1989 and February, 1991 inclusive, were followed until June 1, 1992. A total of 1086 treatment cycles were initiated (mean 2.2, range 1-6). Of these, 235 (21.8%) cycles were cancelled, giving a total of 851 embryo replacements (mean 1.7, range 1-5). After IVF treatment, 189 women have either delivered or have an ongoing pregnancy in the second or third trimester. This gives a baby take-home rate of 17.4% per started cycle and 22.2% per embryo replacement. For 91 (18.6%) of the couples, the treatment was abandoned prior to completion of the three scheduled IVF attempts and 57 (11.7%) of these had no completed IVF cycles. In the group of couples with reduced sperm quality, the delivery rate was significantly lower than that of the other groups. A total of 193 women had embryos cryopreserved in at least one IVF cycle; 124 of these women started a frozen embryo replacement cycle and 88 had at least one cycle with replacement of frozen/thawed embryos, resulting in 25 deliveries/ongoing pregnancies. Due to the Norwegian law on assisted procreation 65 (33.7%) of the women have had their frozen embryos thawed and discarded after 12 months of storage. The cryopreservation programme, with the limitations of the Norwegian law, gives a 5.2% increase in the baby take-home rate for women entering the IVF programme, an increase of 13.2% in the number of ongoing pregnancies/deliveries and an 11.6% increase in number of children/viable fetuses.(ABSTRACT TRUNCATED AT 250 WORDS)

Cryopreservation↗
PubMed1993

Fallopian tube sperm perfusion (FSP) versus intra-uterine insemination (IUI) in the treatment of unexplained infertility: a prospective randomized study.

Prospective randomization of 60 couples with unexplained infertility was performed for treatment either with intrauterine insemination (IUI), using a volume of 0.5 ml of the inseminate, or Fallopian tube sperm perfusion (FSP), using a volume of 4 ml of inseminate. The protocols for ovarian stimulation and induction of ovulation were the same in the two groups. The two groups were similar concerning age of the female at the start of treatment and the number of follicles > 15 mm diameter, the serum oestradiol concentrations and the endometrial thickness on the day of human chorionic gonadotrophin (HCG) administration. The mean (+/- SD) number of motile spermatozoa inseminated was significantly higher in the FSP group than in the IUI group (52 +/- 5 x 10(6) and 28 +/- 3 x 10(6) respectively). In the FSP group, 30 women were given a total of 52 treatment cycles; 14 clinical pregnancies occurred in this group, giving a pregnancy rate of 26.9% per cycle and 46.7% per woman. In the IUI group, 28 women were given a total of 51 treatment cycles; five clinical pregnancies occurred, giving a pregnancy rate of 9.8% per cycle and 17.9% per woman. The pregnancy rates per cycle and per woman in the FSP group were significantly higher than in the IUI group (P < 0.05, chi-square test). This study indicates that in the treatment of couples with unexplained infertility, Fallopian tube sperm perfusion (FSP) is more successful than intra-uterine insemination (IUI).

Adult↗
PubMed1993

Formation of antisperm antibodies in women treated with fallopian tube sperm perfusion.

Fallopian tube sperm perfusion (FSP) is a combination of ovarian stimulation and intra-uterine insemination using a large volume (4 ml) of inseminate containing 10(7)-10(8) spermatozoa. The inseminate will flush the Fallopian tubes and some of it will end up in the pouch of Douglas. In the present study, we have investigated whether the FSP method will result in the formation of serum antisperm antibodies in the female. A total of 184 treatment cycles were given to 128 women. The indications for treatment were: unexplained infertility (n = 35), various infertility diagnoses (n = 28) and donor insemination (n = 65). Prior to treatment, 11 (8.6%) women had a positive tray-agglutination test (Friberg) and/or a positive immunobead test. After completing one to four treatment cycles, another six (4.7%) women had developed serum antisperm antibodies. The antibodies induced by the treatment were of isotype IgM and directed against the tail-tip of the spermatozoa. Two of the women, who prior to the treatment had antisperm antibodies, showed an increase in antibody titre during treatment. There was no statistically significant difference in the pregnancy rate between the women with antisperm antibodies and the women without. In our opinion, the small risk of developing antisperm antibodies is no contra-indication for treating infertile couples with FSP.

Adult↗
PubMed1993

Treatment of unexplained infertility. Fallopian tube sperm perfusion (FSP).

PATIENTS AND METHODS: Fifty-one couples with unexplained infertility were enrolled in the fallopian tube sperm perfusion (FSP) program. FSP is in short a combination of ovarian hyperstimulation, ovulation induction and intrauterine and intrafallopian tube insemination using a sperm suspension of 4 ml volume. RESULTS: One hundred cycles were started; 93 of these were completed, resulting in 27 pregnancies (29.0% per cycle). The pregnancy rate in the first treatment cycle (41.2%) was significantly higher than in the subsequent treatment cycles (14.3%, p < 0.01). Total pregnancy loss was 22.2% (2 ectopic pregnancies and 4 spontaneous abortions). The multiple birth rate was 14.2% (two sets of twins and one set of triplets). Twenty-two couples not conceiving following a maximum of three FSP treatment, were offered IVF treatment. Forty-three IVF cycles were started resulting in 27 embryo replacements in 15 patients. Seven pregnancies occurred in six couples. In 11 of the couples treated, IVF treatment revealed a possible explanation for the infertility; development of multiple small follicles following ovarian hyperstimulation, empty follicle syndrome and partial or total fertilization failure. Only in five of the couples who did not conceive, no cause for the infertility could be found. CONCLUSIONS: In the treatment of couples with unexplained infertility, the FSP procedure seems to give a birth rate of about 40% in less than two treatment cycles. FSP is less invasive and less expensive than alternative procedures such as GIFT, ZIFT and IVF and does not require the expertise and facilities for culturing of human oocytes and embryos.

Fallopian Tubes↗
PubMed1993

Pre-pregnancy risk factors of small-for-gestational age births among parous women in Scandinavia.

To study the etiology and consequences of intrauterine growth retardation (IUGR), a prospective study was organized by the National Institute of Child Health and Human Development, NIH, with the Universities of Trondheim and Bergen in Norway, Uppsala in Sweden, and Alabama in the United States. This paper reports on the Scandinavian portion of the study. 6,354 women were referred to the study and 5,722 women, who were expecting their second or third child between January 1986 and March 1988, were eligible and made their first appointment for the study. Of these, 1,945 women and their births were selected for follow-up at four prenatal visits, delivery, and during the first year of life. This report analyzes the relative impact of various maternal pre-pregnancy risk factors associated with SGA birth. For example, mothers who smoked cigarettes around the time of conception, but who had none of the other major risk factors, nearly doubled their risk of SGA birth. A previous low birth weight (LBW) delivery increased the risk nearly two and a half times among non-smokers. If a mother both smoked and had a previous LBW, the relative risk rose to nearly five and a half. Low maternal pre-pregnancy weight (< 50 kg) increased the risk of SGA birth almost twofold among non-smokers, while low pre-pregnancy weight and smoking together increased the risk of SGA birth fourfold. A low weight mother who smoked and also had a previous LBW delivery, had a risk of SGA birth that was nearly six times that of a mother without those characteristics.

Adult↗
PubMed1993

[Trondheim's new curriculum. A "New Deal" medical study].

A new syllabus is to be introduced at the medical faculty at Trondheim University in the autumn term 1993. It is to take the form of an integrated studies model based on problem-oriented learning. The Trondheim syllabus is focused on environmental medicine, behavioural science and practical skills, but is also designed to provide a basis for continued work in scientific research.

Curriculum↗
PubMed1992

Routine ultrasonography in utero and subsequent vision and hearing at primary school age.

The study was performed to investigate any associations between routine ultrasonography during pregnancy and subsequent reduced vision and/or hearing among children. A follow-up was carried out of primary school children born to women who took part in two randomized, controlled trials of routine ultrasonography during pregnancy. Of 2428 eligible singletons, 2161 (89%) were followed up with a parental questionnaire and with information from maternal and child health centers. Parents assessed vision and hearing in their children and reported their observations in questionnaires. At the age of 7 years, the children were also screened with bilateral visual acuity tests and pure tone audiometry at public maternal and child health centers. No significant differences between ultrasound-screened children and their controls were found in the parental assessment of vision or hearing. The objective tests did not show any significant differences between children in the two groups with regard to visual acuity or hearing. The risk of reduced vision or hearing was no greater for children of mothers who had been offered routine ultrasonography during pregnancy than for those whose mothers had not received that offer.

Journal Article↗
PubMed1992

[Variations in the waiting time for sterilization and sterilization rate in Norway].

A comparison of data from independent sources on numbers of sterilized women indicates that figures for sterilization in Norwegian hospitals are incomplete. More than 50% of the sterilized women are outpatients and nearly 50% of the inpatients are sterilized in connection with other treatment. Permanent geographical differences in sterilization rates are observed, as well as a large variation in the waiting time. We have been unable to verify a simple relation between sterilization rate and waiting time or length of waiting list.

Adult↗
PubMed1992

Fallopian tube sperm perfusion: first clinical experience.

We have developed an insemination method using a large (4 ml) volume of the inseminate. This method incorporates ovarian stimulation, isolation of an optimal number of motile spermatozoa and, finally, Fallopian tube sperm perfusion (FSP). In a clinical study, 139 couples with various causes of infertility, had a total of 239 treatment cycles. The pregnancy rate per treatment in groups with endometriosis, ovulation disorders, tubal impairment, combined male and female factors and subnormal sperm quality were low, ranging from 2.7% to 7.7%. In patients with unexplained infertility, the pregnancy rate per treatment was 26.9% and for this group, the pregnancy rate in the first treatment cycle was 37.3%. In the cervical hostility group, two pregnancies occurred after five treatments. FSP seems to be a favourable treatment for couples with cervical hostility or unexplained infertility. About half of the women in these groups conceived after three treatment cycles. FSP is easier to perform and is less expensive than other methods of assisted procreation, such as in vitro fertilization and gamete intra-Fallopian transfer.

Adult↗
PubMed1992

Fallopian tube sperm perfusion used in a donor insemination programme.

Ninety-six couples were enrolled in a programme of Fallopian tube sperm perfusion (FSP). FSP is a method combining ovarian stimulation, ovulation induction and intra-uterine insemination with a 4 ml volume of sperm suspension. Frozen/thawed donor semen was used in all cycles. A total of 196 treatment cycles were started and of these 172 were completed. Twenty cycles were cancelled because of maturation of too many follicles, a low ovarian response, or formation of ovarian cysts. Five of the women enrolled in the programme did not have any inseminations. Forty-eight pregnancies occurred (27.9% per cycle) among 45 women (49.5%). There were five spontaneous abortions and one ectopic pregnancy. Sixteen pregnancies are on-going (greater than 12 weeks) and 26 women have delivered (including two sets of triplets and one set of twins). The pregnancy rate declined from the first attempt (34.1%) to the fourth attempt (14.3%). The pregnancy rate was significantly higher in women with three to five mature follicles compared to women with two or fewer mature follicles (P less than 0.05). Cycles in which human chorionic gonadotrophin (HCG) was administered on day 11 or later had a higher pregnancy rate than cycles where HCG was administered on day 10 (P less than 0.01). There was no difference in pregnancy rates between insemination with 8-10 x 10(6) motile spermatozoa and insemination with greater than 30 x 10(6) motile spermatozoa. FSP used in a programme of artificial insemination by donor using frozen/thawed donor semen is relatively simple to perform and gives a high pregnancy rate per cycle.

Adult↗
PubMed1990

[Freezing, thawing and transfer of human embryos].

We present our experience of cryopreservation of human embryos from 1 July 1987 to 1 July 1989. During this period, 667 in vitro fertilizing cycles were completed. In 173 (26%) of these cycles, a total of 805 surplus embryos were cryopreserved. 516 embryos were thawed and 247 of these were transferred to the uterine cavity in a total of 110 replacement cycles. This resulted in 22 (20%) pregnancies in which a total of 28 gestational sacs could be verified by ultrasound. Seven of the pregnancies aborted spontaneously in the first trimester and one pregnancy was ectopic. By 1 July 1989, five singleton pregnancies were in progress and 13 babies had been born from nine deliveries (one set of triplets and two sets of twins). 25% of the patients whose embryos were cryopreserved became pregnant in the in vitro fertilizing cycle after replacement of fresh embryos.

Adult↗
PubMed1990

IVF in the Nordic countries 1981-1987: a collaborative survey.

This report concerns the development of in-vitro fertilization (IVF) in the Nordic countries from the start of 1981 to January 1, 1988. All the 24 clinics in the Nordic countries which treat infertile couples with IVF participated in the study. The number of IVF clinics in the Nordic countries has increased from four in 1981 to 24 in 1987. In the same period, the number of people who spent some of their professional time as a part of an IVF team increased from 17 to 150. The majority of the clinics (19) based their activity mainly on governmental funding, while five of the clinics were private. During the period from 1981 to 1987, the Nordic clinic changed their methods of oocyte retrieval. In 1981, all oocyte retrievals were done using laparoscopy. Transvesical, ultrasound-guided follicular punctures domainated in 1985 and transvaginal ultrasound-guided punctures were used in 81.5% of the retrievals in 1987. A total of 852 pregnancies were reported. Of these, 313 (36.8%) were miscarriages, including 66 (7.7%) ectopic pregnancies. At January 1, 1988, 433 babies had been born, including 48 sets of twins, 14 sets of triplets and two sets of quadruplets. This gave a multiple birth rate of 18.2%. Premature births (less than 36 weeks of gestation) were reported in 14.6% of the births. Five babies (1.1%) died in the neonatal period and five (1.1%) were born with various types of malformation. One hundred and eight-eight pregnancies were in progress at January 1, 1988.

Adult↗