Browsing by Subject "Delivery"

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  • Seppänen, P.M.; Sund, R.T.; Uotila, J.T.; Helminen, M.T.; Suominen, T.M. (2020)
    Background: The objective of this study was to evaluate the course of pregnancy and delivery of obstetric patients admitted for intensive care, and determine the health status of their infants. Methods: This was a retrospective register-based study. Four university hospitals in Finland participated. Obstetric patients admitted to the intensive care unit in any trimester of pregnancy, during delivery or up to 42 days post partum were identified from clinical information systems over a five-year study period. Parturient and infant data were collected from the Medical Birth Register. Results: During the study period (2007-2011), 283 obstetric patients were identified from the clinical information system. The most common reason for admission was hypertensive complications (58%), followed by obstetric haemorrhage (25.1 %). Advanced maternal age, nulliparity and multiple pregnancies were associated with obstetric intensive care unit admissions. Of patients admitted to intensive care, 68.9% delivered by unscheduled caesarean section. Nearly 60% of neonates were born preterm, 56.1% needed treatment in a neonatal intensive care unit or an observation unit and 4.6 % died within one week. Conclusion: Advanced maternal age, nulliparity and multiple pregnancy were more common among intensive care unit-admitted women than in the general obstetric population. The main causes for admission were hypertensive complications and obstetric haemorrhage. Compared with the general obstetric population, neonates of intensive care unit-admitted mothers were eight times more likely to require treatment on a neonatal ward and their risk of neonatal death was also eight times greater. (C) 2019 Elsevier Ltd. All rights reserved.
  • Simoila, Laura; Isometsä, Erkki; Gissler, Mika; Suvisaari, Jaana; Halmesmäki, Erja; Lindberg, Nina (2018)
    Background: This national register-based study assesses obstetric and perinatal health outcomes in women with schizophrenia and their offspring. Methods: Using the Care Register for Health Care, we identified Finnish women who were born in 19651980 and diagnosed with schizophrenia. For each case, five age-and place-of-birth-matched controls were obtained from the Central Population Register of Finland. They were followed from the day when the disorder was diagnosed in specialized health-care (the index day) until 31.12.2013. Information related to births was obtained from the Medical Birth Register and the Register of Congenital Malformations. We focused on singleton pregnancies that led to a delivery after the index day. We restricted the analysis of deliveries in controls to those that occurred after the index day of the case. Maternal age, marital status, smoking status, sex of the newborn, and parity were used as covariates in adjusted models. Results: We identified 1162 singleton births among women with schizophrenia and 4683 among controls. Schizophrenic women had a 1.4-fold increased risk of induction of labor, delivery by cesarean section, and delivery by elective cesarean section. Regarding offspring, the risk of premature birth and the risk of low Apgar score at 1 min ( Conclusions: Schizophrenia associates with some specific delivery methods, but delivery complications are rare and their prevalence does not differ from that observed among community women. Maternal schizophrenia associates with some negative perinatal health outcomes of the offspring. (c) 2018 Elsevier Masson SAS. All rights reserved.
  • Pajula, Susanna; Gissler, Mika; Kaijomaa, Marja; Jyränki, Janne; Tukiainen, Erkki; Koljonen, Virve (2021)
    Background: Obesity in fertile age women has increased worldwide leading to increased bariatric procedures. Lower body contouring surgery (LBCS) is one of the most commonly performed esthetic operations, mainly owing to massive weight loss. However, there is a paucity of data regarding pregnancy and delivery after LBCS. In this study, we examined whether LBCS influences pregnancy or delivery and mother and baby outcome. Methods: In this national registry-based study, we used data from the Finnish Institute of Health and Welfare and the Causes of Death registry. We included fertile age women, from 18 to 54 years who had LBCS with or without a bariatric procedure and who experienced pregnancy and delivery were compared to all deliveries in Finland during 1999-2016. Results: We identified 92 women who had LBCS before delivery. These 92 women had planned cesarean sections more often (P Conclusion: Pregnancy and delivery are safe for the mother and the baby after LBCS. The possible deviations from normal pregnancy and delivery should be discussed with fertile age women seeking LBCS. (C) 2020 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
  • Le Joncour, Vadim; Laakkonen, Pirjo (2018)
    Accounting for 16 million new cases and 9 million deaths annually, cancer leaves a great number of patients helpless. It is a complex disease and still a major challenge for the scientific and medical communities. The efficacy of conventional chemotherapies is often poor and patients suffer from off-target effects. Each neoplasm exhibits molecular signatures - sometimes in a patient specific manner -that may completely differ from the organ of origin, may be expressed in markedly higher amounts and/ or in different location compared to the normal tissue. Although adding layers of complexity in the understanding of cancer biology, this cancer-specific signature provides an opportunity to develop targeting agents for early detection, diagnosis, and therapeutics. Chimeric antibodies, recombinant proteins or synthetic polypeptides have emerged as excellent candidates for specific homing to peripheral and central nervous system cancers. Specifically, peptide ligands benefit from their small size, easy and affordable production, high specificity, and remarkable flexibility regarding their sequence and conjugation possibilities. Coupled to imaging agents, chemotherapies and/or nanocarriers they have shown to increase the on-site delivery, thus allowing better tumor mass contouring in imaging and increased efficacy of the chemotherapies associated with reduced adverse effects. Therefore, some of the peptides alone or in combination have been tested in clinical trials to treat patients. Peptides have been well-tolerated and shown absence of toxicity. This review aims to offer a view on tumor targeting peptides that are either derived from natural peptide ligands or identified using phage display screening. We also include examples of peptides targeting the high-grade malignant tumors of the central nervous system as an example of the complex therapeutic management due to the tumor's location. Peptide vaccines are outside of the scope of this review. (C) 2017 The Authors. Published by Elsevier Ltd.
  • Lauren, Patrick; Lou, Yan-Ru; Raki, Mari; Urtti, Arto; Bergström, Kim; Yliperttula, Marjo (2014)