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[Birth asphyxia and hypoxic ischemic encephalopathy, incidence and obstetric risk factors]

https://arctichealth.org/en/permalink/ahliterature83480
Source
Laeknabladid. 2007 Sep;93(9):595-601
Publication Type
Article
Date
Sep-2007
Author
Palsdottir Kolbrun
Dagbjartsson Atli
Thorkelsson Thordur
Hardardottir Hildur
Author Affiliation
Kvennadeild Landspítala, Iceland.
Source
Laeknabladid. 2007 Sep;93(9):595-601
Date
Sep-2007
Language
Icelandic
Publication Type
Article
Abstract
OBJECTIVE: Modern medical practice has changed dramatically during the past decades because of improved technology. Still, fetal surveillance during labor is relatively unchanged since 1960 s when fetal heart rate monitoring (FHR) became standard practice. Newborn infants are still suffering from birth asphyxia and in severe cases leading to hypoxic ischemic encephalopathy (HIE) which sometimes results in permanent neurological damage. The incidence of birth asphyxia and HIE in Iceland is unknown and so are the risk factors for severe asphyxia. The objective of this study was to assess the incidence, obstetric risk factors and the sequela of severe asphyxia at Landspitali university hospital (LSH). MATERIAL AND METHODS: All term infants born at LSH from 1.1.1997- 31.12.2001 with birth asphyxia, defined as five minute Apgar score %lt;6, were included in the study (n=127). Clinical information were collected retrospectively from maternal records on maternal diseases during pregnancy, cardiotocogram (CTG), type of birth, the presence of meconium and operative delivery rates. Information was also collected regarding birth asphyxia and HIE in the neonatal period. RESULTS: The incidence of birth asphyxia was 9.4/1000 live term births during the study period, with increasing incidence during the three last years. The incidence of HIE was 1.4/ 1,000 live term births. Severe maternal diseases during pregnancy were not a significant risk factor for asphyxia. The amniotic fluid was meconium stained in fifty percent of cases and the umbilical cord was wrapped around the fetal neck in 41% of cases. Abnormal CTG tracing was observed in 66% of cases in the study group and in 79% of the HIE cases. Operative deliveries were significantly more common in the study cohort compared with other deliveries at LSH at the same time: ventouse delivery 22% vs 6.8% (p
PubMed ID
17823499 View in PubMed
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[The effects of normal vaginal delivery on oxygen transport to the fetus]

https://arctichealth.org/en/permalink/ahliterature92087
Source
Laeknabladid. 2008 Sep;94(9):583-8
Publication Type
Article
Date
Sep-2008
Author
Thorkelsson Thordur
Bjarnason Anton Orn
Hardardottir Hildur
Thorsteinsson Adalbjorn
Haraldsson Asgeir
Dagbjartsson Atli
Source
Laeknabladid. 2008 Sep;94(9):583-8
Date
Sep-2008
Language
Icelandic
Publication Type
Article
Keywords
Adult
Carbon Dioxide - blood
Case-Control Studies
Cesarean Section
Delivery, Obstetric
Erythroblasts
Erythrocyte Count
Erythropoietin - blood
Female
Fetal Blood - metabolism
Hemoglobins - metabolism
Humans
Hydrogen-Ion Concentration
Infant, Newborn
Lactic Acid - blood
Oxygen - blood
Partial Pressure
Pregnancy
Surgical Procedures, Elective
Abstract
OBJECTIVE: To evaluate the effects of normal vaginal delivery (NVD) on oxygen transport to the fetus. Study group and methods: Fifty newborn infants born by NVD and as a control group 50 infants born by elective Cesarean section (ECS) were studied. Factors reflecting oxygen transport to the fetus were measured in venous and arterial cord blood: pH, partial pressure of oxygen (pO2) and carbon dioxide (pCO2), oxygen saturation (SO2), blood oxygen content, base deficit, and lactic acid concentrations, erythropoietin concentrations, number of nucleated red blood cells and haemoglobin concentrations. RESULTS: There was no significant difference in venous blood oxygen content between the two groups of infants. However, arterial blood oxygen content was significanlty lower in the infants born by ECS than in those born by NVD (p
PubMed ID
18784384 View in PubMed
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Trends in prevalence and characteristics of cerebral palsy among Icelandic children born 1990 to 2003.

https://arctichealth.org/en/permalink/ahliterature89254
Source
Dev Med Child Neurol. 2009 May;51(5):356-63
Publication Type
Article
Date
May-2009
Author
Sigurdardóttir Solveig
Thórkelsson Thórdur
Halldórsdóttir Margrét
Thorarensen Olafur
Vik Torstein
Author Affiliation
State Diagnostic and Counselling Centre, Kopavogur, Iceland. solveig@greining.is
Source
Dev Med Child Neurol. 2009 May;51(5):356-63
Date
May-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Cerebral Palsy - classification - epidemiology - mortality - physiopathology - psychology
Child
Child, Preschool
Cognition
Female
Gestational Age
Humans
Iceland - epidemiology
Incidence
Intelligence Tests
Male
Motor Skills
Muscle Spasticity
Premature Birth
Prevalence
Retrospective Studies
Severity of Illness Index
Survival Rate
Young Adult
Abstract
AIM: To describe trends in cerebral palsy (CP) prevalence, severity, and associated impairments among 139 Icelandic children (65 males, 74 females) born from 1990 to 1996 (period one) and 1997 to 2003 (period two). METHOD: A population-based study using systematically collected data on motor functioning and associated impairments of children with CP. Mean age at assessment was 5 years 5 months (SD 7.68 mo) in period one and 5 years 5 months (SD 10.44 mo) in period two. Infants with postneonatal CP were excluded. RESULTS: Prevalence of CP per 1000 live births was 2.2 in period one and 2.3 in period two (p=0.862); it decreased from 1.5 to 0.9 for children born at term, was stable for preterm births, but increased from 33.7 to 114.6 for very preterm births (p=0.002). Concurrently, neonatal and infant mortality rates decreased in Iceland. The proportion of children born preterm increased over time (p=0.002), whereas improvements in gross motor function assessed with the Gross Motor Function Classification System were confined to term births (p=0.009). The proportion of children with diplegia increased, accompanied by a decrease in the proportion with quadriplegia (p=0.047). Furthermore, among term births there was a significant reduction over time in the proportion of children with epilepsy (p=0.030) and in the proportion with two or more associated impairments (p=0.030). INTERPRETATION: Although CP prevalence remained stable over 14 years, we observed a decrease in prevalence and severity of the disability among term births.
Notes
Comment In: Dev Med Child Neurol. 2009 May;51(5):33519379287
PubMed ID
19388148 View in PubMed
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[Vaginal birth after one previous cesarean section]

https://arctichealth.org/en/permalink/ahliterature92086
Source
Laeknabladid. 2008 Sep;94(9):591-7
Publication Type
Article
Date
Sep-2008
Author
Birgisdottir Brynhildur Tinna
Hardardottir Hildur
Bjarnadottir Ragnhildur I
Thorkelsson Thordur
Source
Laeknabladid. 2008 Sep;94(9):591-7
Date
Sep-2008
Language
Icelandic
Publication Type
Article
Keywords
Apgar score
Birth weight
Breech Presentation - surgery
Cesarean Section, Repeat
Emergency Treatment
Female
Fetal Death
Humans
Infant, Newborn
Live Birth
Perinatal mortality
Pregnancy
Retrospective Studies
Time Factors
Trial of Labor
Uterine Rupture - etiology - surgery
Vaginal Birth after Cesarean - adverse effects
Abstract
Objective: To evaluate the frequency of different modes of delivery after one previous cesarean section and those factors which may influence mode of delivery. Material and methods: During the study period (1.1.2001-31.12.2005) 925 women with a previous cesarean section and a following singleton pregnancy were identified and included. Information regarding mode of delivery, induction of labor, instrumental delivery, the urgency and indications for first and second cesarean section, birth weight and Apgar scores were collected retrospectively. Results: Trial of labor (TOL) was initiated for 564 women of which 61% were successful while 39% delivered by an emergent cesarean section. In total, 346 women delivered vaginally (37%), 341 women (37%) delivered with an elective cesarean section and 238 (26%) underwent an emergency cesarean section. The VBAC rate increased during the study period, from 35% to 46%. Women who underwent an elective cesarean section due to fetal malpresentation (most often breech) in their first pregnancy were significantly more likely to have a successful VBAC in their second pregnancy (53%) compared with women who had an elective cesarean section for any other indication (21%) (p4000 grams compared with
PubMed ID
18784385 View in PubMed
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