We sought to evaluate the impact of later menarche on the risk of operative delivery.
We studied 38,069 eligible women (first labors at term with a singleton infant in a cephalic presentation) from the Norwegian Mothers and Child Cohort Study. The main exposures were the age at menarche and the duration of the interval between menarche and the first birth.
Poisson's regression with a robust variance estimator.
Operative delivery, defined as emergency cesarean or assisted vaginal delivery (ventouse extraction or forceps).
A 5 year increase in age at menarche was associated with a reduced risk of operative delivery (risk ratio [RR] 0.84, 95%CI 0.78, 0.89; p?
The natural microflora of cold-smoked fish at the end of shelf-life are lactic acid bacteria (LAB). Some of these display a capacity to inhibit spoilage as well as several strains of pathogenic micro-organisms, e.g. Listeria monocytogenes which is isolated frequently from cold-smoked salmon (CSS). Eight batches of sliced vacuum-packed CSS from Norway, Scotland and Spain were collected at retail. Packs were stored at 5 degrees C and examined for chemical and microbiological characteristics, at purchase date and at expiration date. pH, water activity and salt content were similar to available data on lightly preserved fish products. There was a consistent pattern in the development of the microflora on CSS; the initial level of LAB was low on freshly produced CSS (10(2) cfu g(-1)); however, storage in vacuum packaging at refrigeration temperature was elective for LAB. At the end of the stated shelf-life these micro-organisms, represented mainly by Lactobacillus spp., attained ca.10(7) cfu g(-1) while Enterobacteriaceae counts were consistently lower (10(5) cfu g(-1)), which indicates the ability of LAB to grow and compete with few carbohydrates available and in the presence of moderate salt concentrations. L. monocytogenes was not found in any sample. Forty-one percent of LAB strains isolated exhibited inhibitory capacity against Listeria innocua, in a plate assay. A majority of the inhibitory effects were non-bacteriocinogenic, but nevertheless were very competitive cultures which may provide an additional hurdle for improved preservation by natural means.
Uterine rupture is a rare complication of pregnancy, occurring in 0.03% of deliveries in Denmark. This paper describes a case of asymptomatic uterine rupture in a 38-year-old woman. She was admitted with a history of excessive vaginal bleeding 14 days after a spontaneous delivery with the use of vacuum extraction. At the time of laparotomy, a complete uterine rupture was discovered and total hysterectomy was performed.
The aim of the present study was to investigate cognitive competence, as indicated by school performance, at 16 years of age, in children delivered by vacuum extraction.
This was a register study of a national cohort of 126,032 16 year olds born as singletons, with a vertex presentation, at a gestational age of 34 weeks or older, with Swedish-born parents, delivered between 1990 and 1993 without major congenital malformations. Linear regression was used to analyze mode of delivery in relation to mean scores from national tests in mathematics (40.2; scale, 10-75; SD, 14.9) and mean average grades (223.8; scale, 10-320; SD, 52.3), with adjustment for perinatal and sociodemographic confounders.
Children delivered by vacuum extraction (-0.51; 95% confidence interval [CI], -0.76 to 0.26) as well as by nonplanned cesarean section (-0.51; 95% CI, -0.82 to -0.20) had slightly lower mean mathematics test scores than children born vaginally without instruments, after adjustment for major confounders. Mean average grades in children delivered by vacuum extraction were -1.05 (95% CI, -1.87 to -0.23) and -1.20 (95% CI,-2.24 to -0.16) in children delivered by nonplanned cesarean section compared with children born vaginally.
Children delivered by vacuum extraction had slightly lower grades at age 16 years compared with those born by noninstrumental vaginal delivery but very similar to those delivered by nonplanned cesarean. This suggests that vacuum extraction and nonplanned cesarean are equivalent alternatives for terminating deliveries with respect to cognitive outcomes.
OBJECTIVE: To examine birth outcomes and pregnancy complications in women with a history of anorexia nervosa. DESIGN: Prospective cohort study. SETTING: Nationwide study in Sweden. POPULATION: All primiparous women--discharged from hospital with a diagnosis of anorexia nervosa during 1973 to 1996--who gave birth during 1983 to 2002 (n = 1000) were compared with all non-anorexia nervosa primiparous women who gave birth during the same years (n = 827,582). METHOD: Register study with data from Medical Birth Registry and National Patient Discharge Register. MAIN OUTCOME MEASURES: Pre-eclampsia, instrumental delivery, prematurity, small for gestational age, birthweight, Apgar score and perinatal mortality. RESULTS: Main birth outcome measures in women with a history of anorexia nervosa were very similar to the main population. The only observed differences were a slightly lower mean birthweight and lower adjusted odds ratios for instrumental delivery in the anorexia nervosa group compared with the main population. Neither severity of the disease nor a shorter recovery phase after first hospitalisation was related to pregnancy complications or birth outcomes. CONCLUSION: A history of anorexia nervosa was not associated with negative birth outcomes. Thus, special obstetric monitoring of pregnant women with history of anorexia nervosa does not seem to be warranted in a country with a satisfactory maternity surveillance.
An 18-year follow-up study was made of 62 males delivered by forceps and 38 by vacuum extraction in 1962-63. The obstetrical data are compared with the medical and psychological military draft board examinations. The mortality and morbidity rates were not significantly different from those of the total cohort of Norwegian conscripts, either in the forceps or in the vacuum group. Rotation of the fetal head with Kielland's forceps in midcavity extractions did not adversely affect the late results. A significantly elevated mean intelligence score was found in the forceps group, while the vacuum group did not differ from the national average.
In order to explore the possibility of converting a delivery unit at a small hospital to a maternity home, we examined the medical records of those women who delivered by Caesarean section, forceps or vacuum extraction at Lofoten hospital during 1995. How many of these women might it have been necessary to transfer to an obstetrical department if Lofoten hospital had been a maternity home caring for low risk deliveries (primipara and multipara)? Out of a total of 271 deliveries (primiparas 98), 49 women delivered by Caesarean section (n = 35), forceps (n = 5) or vacuum extraction (n = 9). Using risk assessment, 22 women (45%) would have been selected for antenatal transfer, and 20 (41%) for intrapartum transport. For seven women no transfer would have been possible. These women would have delivered locally by vacuum extraction. Primipara versus multipara had a relative risk of 2.8 for Caesarean section or assisted vaginal delivery. It is estimated that 8-9% of the women would be selected prenatally for planned delivery at a hospital unit and that 7-8% would be transferred in labour if primiparas delivered at the maternity home. If primiparas were excluded, the proportions would be 41% and 1-2% respectively. In 1997 the delivery unit at Lofoten hospital was temporarily converted to a maternity home for a period of two years.