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Biomedical subjects

O Axelsson

Publications and source records attributed to O Axelsson.

At least 37 records · Page 2Linked to original sources
PubMed1997

A prospective comparative study on transabdominal chorionic villus sampling and amniocentesis performed at 10-13 week's gestation.

Women with single, viable pregnancies at 10 + 5 to 13 + 6 weeks, gestation who requested fetal karyotyping for maternal age, parental anxiety, or a previous history of chromosomal aberration were offered participation in this study. With a transabdominal ultrasound-guided technique, early amniocentesis (EA) was performed on 147 women and chorionic villus sampling (CVS) on 174. Spontaneous fetal loss occurred in 6.8 per cent in the EA group and 1.7 per cent in the CVS group. This difference was significant with a confidence interval (CI) of 0.6-9.6 per cent. There was also a significant difference in the need for repeat testing between the groups. In the EA group a repeat test was required in 19.0 per cent due to culture and sample failures, while 5.2 per cent of the women in the CVS group needed repeat testing because of ambiguous results. This prospective study comparing EA and CVS shows that the risk of fetal loss is higher and repeat testing is needed more after EA.

Abortion, Eugenic↗
PubMed1997

Perception of information, expectations and experiences among women and their partners attending a second-trimester routine ultrasound scan.

The aim of this study was to evaluate pre-scan counselling and the provision of information to parents-to-be, and their expectations before and experiences of a second trimester routine ultrasound scan. In the study, 303 pregnant women and their partners were asked to complete questionnaires before and after the scan. The main purposes of the examination were: dating, ascertaining fetal viability, and detection of multiple gestations. Although scanning for fetal malformations was not the purpose of the examination, 89% of the women and 84% of the men were concerned about this aspect. Even though it has been postulated that more women would not attend the examination if they knew it was for prenatal diagnostic purposes, the results of this study did not support this assumption. Only 57% of the women had received information at their antenatal care centers. A total of 88% of the women and 85% of the men said that they obtained sufficient information at the scan. Anxiety was low before the scan, both among women and men, with the exception of those women who had experienced problems at earlier scans. Positive feelings dominated during the scan and these feelings remained when experiences of the scan were reported by the parents-to-be after they had gone home. It is concluded that a routine second-trimester scan is a positive event for the majority of the participating women and men. In spite of this, we believe that certain measures should be taken to improve pre-scan counselling and the provision of adequate information.

Adult↗
PubMed1997

Routine ultrasound screening in pregnancy and the children's subsequent growth, vision and hearing.

OBJECTIVE: To test a hypothesis of no association between ultrasound exposure in early fetal life and growth or impaired vision or hearing during childhood. DESIGN: Follow up of eight to nine year old children born to women who participated in a randomised controlled trial on ultrasound screening during pregnancy. SETTING: Nineteen antenatal care clinics run by three central hospitals in Sweden from 1985 to 1987. POPULATION AND METHODS: Of 4637 eligible singleton pregnancies, 3265 (71%) were followed up through a questionnaire sent to their mothers. Analyses were performed both according to randomised groups and to ultrasound exposure. MAIN OUTCOME MEASURES: Parents' report of vision and hearing tests as recorded on child's record card. Parents' report of their child's weight and height at 1, 4 and 7 years of age. RESULTS: Reduced hearing was reported by 3.4% in the screening group compared with 3.5% in the nonscreening group (odds ratio [OR] 1.0; 95% confidence interval [CI] 0.67-1.41). The same prevalences were found when analysed according to ultrasound exposure (OR 1.0; 95% CI 0.67-1.42). Reduced vision was reported by 6.3% in the screening group compared with 7.8% in the nonscreening group (OR 0.8; 95% CI 0.60-1.03). Corresponding figures for ultrasound exposed and unexposed were 6.2% and 8.0%, respectively (OR 0.8; 95% CI 0.58-1.00). No statistically significant differences in body weight or height at 1, 4 or 7 years of age between screened and not screened children or between exposed and unexposed were found. CONCLUSION: This study found no association between ultrasound exposure in early fetal life and growth or impaired vision or hearing during childhood.

Adult↗
PubMed1996

Pregnancy, ultrasound screening and smoking attitudes.

This questionnaire study was performed to evaluate screening as a tool to help reduce smoking among pregnant women and their partners. Three hundred women and their partners coming for ultrasound screening were asked to participate. Twenty-two percent of the women and 21% of the men were smoking regularly before pregnancy. Fifty-four percent of the women changed their smoking habits after knowledge of the pregnancy and before the scan. The corresponding figure for men was 19%. Before the scan 54% of the women and 49% of the men estimated their ability to stop smoking later in pregnancy as higher than 50%. The scan itself did not increase this figure. Among women with high consumption of cigarettes, the estimated ability to stop smoking was low.

Attitude↗
PubMed1996

Second trimester routine ultrasound and abnormal findings.

OBJECTIVE: To estimate the detection rate of abnormal findings, especially fetal anomalies, at second trimester ultrasound screening performed in a way representative of Swedish antenatal clinics. DESIGN: A prospective study carried out over two years in Uppsala county, Sweden, including 8,228 unselected pregnant women (8,345 fetuses). The ultrasound scans were performed by specially trained midwives. MAIN OUTCOME MEASURES: The number of abnormalities suspected by the midwives and the number of abnormalities confirmed by the obstetricians were registered, as was pregnancy outcome for these cases. RESULTS: Midwives reported suspected abnormalities at the screening procedure in 59 cases (0.7%), abnormalities were confirmed by obstetricians in 42 cases (0.5%, of which 0.36% were fetal malformations). Seventeen of these 42 pregnancies were terminated and 11 ended with miscarriages or intrauterine fetal deaths. Fourteen of the 42 pregnancies ended with a live born infant, of which two died postnatally. CONCLUSIONS: The described ultrasound screening procedure led to suspected abnormalities in 0.7% of the scanned cases and to confirmed abnormalities in 0.5% of the cases. The outcome for the confirmed abnormalities was poor, as 71% were either terminated or ended with miscarriage or perinatal death.

Abortion, Induced↗
PubMed1995

The length of human pregnancy as calculated by ultrasonographic measurement of the fetal biparietal diameter.

Pregnancy length was calculated from ultrasonic measurement of the fetal biparietal diameter (BPD) in the second trimester and compared with the corresponding length calculated from the last menstrual period (LMP) in 865 women with exactly 28-day cycles and spontaneous onset of labor. The effects of maternal age, parity, smoking and sex of the child on BPD-based pregnancy length were evaluated in 1998 women with spontaneous onset of labor. The mean pregnancy length was 280.6 days when based on BPD and 283.6 days when based on LMP. The corresponding median values were 281 days and 284 days, respectively. Probably because of more preterm deliveries, women below 20 years of age had a significantly shorter pregnancy length than women 20-34 years of age. Women carrying girls had a significantly shorter pregnancy length than women carrying boys. There was a tendency to shorter pregnancy lengths among multiparae and among smokers.

Adolescent↗
PubMed1995

Ki-67 immunostaining of endometrial biopsies with special reference to hormone replacement therapy.

BACKGROUND: The purpose of this investigation was to evaluate the Ki-67 immunostaining method on formalin-fixed, paraffin-embedded endometrium and to use the method on endometrial biopsies from 30 postmenopausal women treated with 2 mg estradiol and different doses of natural micronized progesterone (50, 100 or 200 mg). METHODS: Two technicians prepared the immunostaining of slides from each of 12 endometrial specimens and 3 different observers estimated the Ki-67 immunostaining. One observer estimated all the slides 3 times on different occasions. The percentage of immunopositive nuclei in glandular epithelium was evaluated. RESULTS: The dominating component of variation for this method was between observers, with a median standard deviation of 20%. A total median variation including all components rendered a standard deviation of 23%. No significant effects of different technicians, preparations, or from the same observer on different occasions were found. In the major part of the biopsies from women on hormone replacement therapy (HRT), only 0-10% of the glandular epithelium was Ki-67 stained. CONCLUSION: Ki-67 immunostaining is an adequate technique to use when evaluating the effects of HRT on the endometrium. The main source of variation is between observers and not the technique of preparing the slides.

Biopsy↗
PubMed1995

Umbilical artery velocimetry may influence clinical interpretation of intrapartum cardiotocograms.

BACKGROUND: In a previous prospective randomised trial on pregnancies complicated by small-for-gestational-age fetuses fewer operative deliveries for fetal distress were found after antenatal surveillance with umbilical artery Doppler velocimetry (Doppler group) than after surveillance with cardiotocography (CTG group). Despite that, the neonatal outcome was similar in both groups. This raised the question whether the knowledge of the antenatal Doppler results had influenced the obstetric management of labor. METHODS: In this retrospective study 242 intrapartum cardiotocogram tracings, obtained from the above mentioned prospective trial, were re-interpreted by an expert without knowledge of the results in the original study. The re-interpretation was then compared to the original interpretation. RESULTS: The expert interpreted 18 intrapartum tracings in the Doppler group and 18 in the CTG group as abnormal, whereas the clinicians interpreted only 8 tracings as abnormal in the Doppler group and 18 tracings in the CTG group. CONCLUSIONS: The results of this retrospective study lend support to our hypothesis that the obstetricians in clinical practice are influenced by the knowledge of a normal umbilical Doppler velocimetry when interpreting an intrapartum CTG. This finding may partly explain why there were fewer emergency cesarean sections for fetal distress in the Doppler group than in the CTG group in the original prospective study.

Blood Flow Velocity↗
PubMed1995

Pharmacological profile and anti-ischemic properties of the Ca(2+)-channel blocker NS-638.

Included in the sequence of events leading to neuronal death in ischemic tissue following stroke is an excessive and toxic rise in the intracellular Ca(2+)-concentration, predominantly due to an influx of Ca2+ through nonselective cation-channels as well as Ca(2+)-channels. In the present study we have characterized the pharmacological profile and anti-ischemic effects of 2-amino-1-(4-chlorobenzyl)-5-trifluoromethylbenzimidazole (NS-638), a small nonpeptide molecule with Ca(2+)-channel blocking properties. NS-638 dose dependently inhibited K(+)-stimulated [45Ca2+]-uptake in chick cortical synaptosomes and 2-amino-3-(3-hydroxy-5-methylisoxazol-4-yl)propionic acid (AMPA)-stimulated [3H]GABA-release from cultured cortical neurons with IC50 values of 2.3 and 4.3 microM, respectively. K(+)-stimulated intracellular Ca(2+)-elevation in cultured cerebellar granule cells was equipotently blocked with an IC50 value of 3.4 microM. At this concentration no effect on Ca(2+)-induced contractions in K(+)-depolarized guinea pig taenia coli was observed. The effect of NS-638 on neuronal Ca(2+)-channels was evaluated using whole cell patch clamp techniques. The compound reversibly blocked N- and L-type Ca(2+)-channels in cultured chick dorsal root ganglion cells in the concentration range of 1-30 microM. In the mouse middle cerebral artery occlusion (MCAO) model, NS-638 administered i.p. (50 mg kg-1) at 1 h and 6 h post-ischemia, and once a day for the next two days, resulted in a 48% reduction in total infarct volume. The compound did not show protection against ischemic neuronal damage in the gerbil model of bilateral carotid artery occlusion (BCAO). This data suggests, that neuronal Ca(2+)-channel blockers may have potential in ameliorating the pathological damage after focal ischemia.

Animals↗
PubMed1994

Outcome for fetuses with abdominal wall defects detected by routine second trimester ultrasound.

The outcome for 70 fetuses with abdominal wall defects detected by routine second trimester ultrasound during the years 1983-90 was investigated. In 65 of the 70 cases the prenatal diagnoses were correct. Thirty-two women had their pregnancies terminated by legal abortions. Thirty-eight pregnancies continued. Six of these ended with spontaneous abortion or intrauterine fetal death. Thirty-two infants were born alive. Nearly all cases with associated malformations and all cases with chromosomal defects were in the omphalocele group. The neonatal survival for infants with gastroschisis and infants with omphalocele without associated malformations or chromosomal defects was high (96%).

Abnormalities, Multiple↗
PubMed1993

Sonographic dating of pregnancies conceived after contraceptive pill therapy.

A total of 358 women succeeded in conceiving in the first cycle after stopping oral contraception. The estimated day of delivery was calculated from both an ultrasonographically measured fetal biparietal diameter, in the second trimester, and from the date of the withdrawal bleed. According to the biparietal diameter measurement, the estimated day of delivery was postponed more than 1 week in 138 cases (38.5%). For 304 women who delivered after the spontaneous onset of labor, the biparietal diameter estimate gave the best prediction of the day of delivery in 175 cases (57.6%), the date of the withdrawal bleed gave the best estimate in 91 (29.9%) (p < 0.001) and they were equally good in 38 (12.5%). The estimated day of delivery using a biparietal diameter measurement was within +/- 14 days of the day of delivery for 267 of these 304 women (87.8%). The corresponding figure for the withdrawal bleed date was 218 (71.7%) (p </= 0.001). According to the withdrawal bleed date estimate, 68 women (22.4%) delivered beyond the estimated 42 weeks, compared to only 2.6% according to the biparietal diameter estimate. The median length of a pregnancy from the first day of the withdrawal bleed was 286 days and from the biparietal diameter was 281 days.

Journal Article↗
PubMed1993

Comparison of ultrasonic measurement of biparietal diameter and last menstrual period as a predictor of day of delivery in women with regular 28 day-cycles.

Within a randomised trial, 1713 women with regular 28-day cycles were studied to evaluate whether the day of delivery is predicted best from the last menstrual period (LMP) or ultrasonic measurement of the fetal biparietal diameter (BPD). Among 727 women, with a spontaneous onset of labor, where the estimated day of delivery (EDD) was derived from BPD, 91.8% delivered within +/- 14 days and 61.8% delivered within +/- seven days of EDD. Corresponding figures for 741 women where EDD was derived from LMP were 91.6% and 61.1%, respectively. Comparison of EDDs calculated from BPD and LMP in the same woman showed that BPD postponed EDD more than seven days in 18.0% and advanced EDD more than seven days in 1.8%. When the difference in EDD between the two methods was more than seven days the BPD estimate was a better predictor of day of delivery.

Anthropometry↗
PubMed1993

Liver metabolism during treatment with estradiol and natural progesterone.

Serum concentrations of sex hormone-binding globulin (SHBG), corticosteroid binding globulin (CBG), ceruloplasmin, lipoprotein A and liver enzymes were measured in 30 postmenopausal women treated with 2 mg micronized 17 beta-estradiol daily and micronized progesterone orally in doses of 50, 100 and 200 mg daily, as progestogen supplementation. The treatment lasted for 4 months. The serum levels of SHBG and CBG increased during treatment and a weak association between progesterone dosage and CBG was observed. Levels of lipoprotein A and liver enzymes did not change. It is concluded that micronized natural progesterone is an attractive means of progesterone supplementation in postmenopausal hormone replacement therapy without any liver-related side-effects.

Adult↗