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  • 1
    Electronic Resource
    Electronic Resource
    Variation in obstetric care within and between hospital levels in Finland (1994)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 101 (1994), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective In obstetrics, both area and hospital variation has previously been documented for operative procedures, but not for other treatments or diagnostic procedures. This study investigated the extent of variation in care during pregnancy, at birth and after birth.Design and methods The variation was studied by hospitals (n= 52) by hospital level. To account for differences in women's background characteristics, logistic regression analyses were done. The data came from the 1991 Finnish Birth Register which records data on all births (n= 64 171).Results All interventions and care practices studied varied notably from one hospital to another, with the variation usually being greater within hospitals of the same level than between hospitals of different levels. Each of the seven non-operative interventions showed a larger variation than did each of the four operative interventions. Standardisation for mothers’ background characteristics did not eliminate this variation. Some interventions, but not all, were clustered in the same hospitals.Conclusions Such large variation indicates a need for further studies on the benefits of obstetric interventions and of care practices, and on better application of research results to obstetric care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1994.tb13545.x
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  • 2
    Electronic Resource
    Electronic Resource
    ROUTINE ADMINISTRATION OF IRON AND VITAMINS DURING PREGNANCY: REVIEW OF CONTROLLED CLINICAL TRIALS (1978)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 85 (1978), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The purpose of this review was to determine whether routine administration of iron and vitamins during pregnancy had beneficial effects on birth weight, length of gestation, infant morbidity and mortality, and maternal morbidity and mortality. We searched for controlled clinical trials done in developed Western countries and reported in English, German, Finnish, and Scandinavian languages. Seventeen trials were found. In one trial, women who received vitamin B6 developed less dental caries. In another trial women receiving several different minerals and vitamins had fewer deliveries before the 40th week and less pre-eclampsia. In a third study, women receiving polyvitamin concentrate had less pre-eclampsia. None of the studies reported any benefit for other outcomes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1978.tb14905.x
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  • 3
    Electronic Resource
    Electronic Resource
    PREVENTION AND TREATMENT OF PREMATURE LABOUR BY DRUGS: REVIEW OF CONTROLLED CLINICAL TRIALS (1978)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 85 (1978), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This review sought evidence from 18 controlled clinical trials about the benefits of drugs (hormones, ethanol or β-sympathomimetic agents) used to prevent premature birth. Of the 16 trials comparing drug with placebo, 13 were judged to be methodologically adequate. In eight trials, drugs were given prophylactically and in five they were given therapeutically. Two of the therapeutic trials found the drug more effective than placebo in postponing delivery. However, only one therapeutic trial and one prophylactic trial found the drug to affect favourably the outcome for the infant. The side effects of the drugs were not systematically studied. Additional clinical trials are needed to justify the use of drugs to inhibit labour.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1978.tb14906.x
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  • 4
    Electronic Resource
    Electronic Resource
    Births in Finland and Estonia from 1992 to 1996: convergent differences? (2000)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 107 (2000), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To describe the differences in childbearing, in prenatal and obstetrical practices, and in perinatal health outcome in Finland and Estonia.Design Registry study using the data from the Finnish and Estonian medical birth registries for years 1992 to 1996 (in total 324,021 and 74,297 newborns, respectively).Results In 1992 the birth rates were 51 per 1000 women aged 15 to 49 in Finland and 48 per 1000 in Estonia. The birth rate declined in the study period in both countries, but the decline was more rapid in Estonia (−26%) than in Finland (−6%). In the same period the rates of induced abortion declined in both countries (−34% and −6%, respectively), but the rate in 1996 was still much higher in Estonia (46/1000) than in Finland (8/1000). Compared with Finnish mothers, Estonian mothers were younger, had fewer multiple births, less prenatal care and fewer interventions during pregnancy and delivery. The intervention rates increased in both countries during the study period, but this increase was more rapid in Estonia. The infant outcomes were poorer in Estonia, but the differences between Estonia and Finland decreased during the 1990's.Conclusions The differences in prenatal and maternal care and in induced abortion rates have decreased between Estonia and Finland. Changes in maternal backgrounds, improved referral system for complicated pregnancies, improvements in prenatal care and in availability of appropriate equipment and technology may have caused improved maternal and infant health in Estonia, but this should be further investigated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2000.tb11688.x
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  • 5
    Electronic Resource
    Electronic Resource
    Time trends of ectopic pregnancies (1987)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 94 (1987), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Whether the increase of ectopic pregnancies could be explained by methodological problems or by changing age structure was examined in data from one hospital (Tampere, Finland) between 1972 and 1984. Numbers of ectopic pregnancies, births, and induced and spontaneous abortions were obtained by 5-year age-groups and county of residence from the hospital discharge register. Introduction of a more sensitive pregnancy test in 1979 was coincident with the most rapid increase in the role of ectopic pregnancies. Use of incomplete denominators and varying catchment areas and correction of changing age-distribution of pregnant women did not markedly influence the time trends. Our analysis suggests that the observed increase in ectopic pregnancies in this area was partly real and partly due to better diagnosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1987.tb03099.x
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  • 6
    Electronic Resource
    Electronic Resource
    Comparability of Reasons for Cesarean Sections in Patient Records and Mothers' Interviews (1990)
    Oxford, UK : Blackwell Publishing Ltd
    Birth 17 (1990), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: : Reasons for cesarean sections from three different data sources were compared. One hundred mothers were interviewed, their patient records were read, and the discharge diagnoses were noted. In about 70% of cases at least two of the data sources gave similar reasons for cesarean section, but when all three sources were compared, in only one-third was information similar. These figures cast doubt on the utility of recorded indications in studying reasons for cesarean sections.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1523-536X.1990.tb00023.x
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  • 7
    Electronic Resource
    Electronic Resource
    Pregnancy and Birth after Cesarean Section: A Survey Based on the Swedish Birth Register (1987)
    Oxford, UK : Blackwell Publishing Ltd
    Birth 14 (1987), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: : Two cohorts of healthy Swedish primiparae having a healthy child by cesarean section in 1973 (index women, N = 2592) and in 1976 (N = 3867) and matched vaginal delivery controls were identified from the Swedish Birth Register. The second births to these women occurring in the following five years were studied. The mean lengths of gestation were somewhat shorter and there were more problems during pregnancy, labor, and delivery among those with previous cesarean births (index women). Children born to the index women had a higher perinatal mortality and were smaller and less healthy. Comparison of the two cohorts suggests that the operation itself may have contributed to some of the problems. The decision to perform a cesarean section may have to take into account sequelae in a subsequent pregnancy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1523-536X.1987.tb01443.x
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  • 8
    Electronic Resource
    Electronic Resource
    Women's Experiences of Prenatal Serum Screening (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Birth 23 (1996), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Maternal serum screening is used to detect pregnancies at risk for Down syndrome and neural tube defects, but most positive test results (6.6% of all) are false positives. This study examined the influence of positive test results on women's experiences of pregnancy.Methods:The study population was all 67 pregnant women who received a positive result on serum screening in two Finnish towns from September 1993 to March 1994. For each case woman a control woman, matched for age, parity, education, and previous miscarriages, was selected. Of those invited, 45 case women and 46 control women (79%) responded to semistructured interviews.Results:Of the 45 case women, 2 underwent termination of pregnancy after the diagnosis of an abnormality and 1 had a miscarriage. Of the remaining 42, 7 decided not to undergo further diagnostic tests, for 2 women the second serum test was normal, and 33 had amniocentesis or chorionic villus sampling. The positive screening result and wait for the final results negatively affected the emotional well-being of most of these 33 women, and 6 were still worried after receiving final reassuring results. Of the 46 control women, 17 felt some worry or fear regarding abnormality in their fetus.Conclusion:The significant negative psychosocial effects of serum screening should be taken into account by caregivers when deciding whether and how to institutionalize these tests as part of antenatal care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1523-536X.1996.tb00837.x
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  • 9
    Electronic Resource
    Electronic Resource
    Treatment of Pretem Birth with Ritodrine (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Birth 20 (1993), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1523-536X.1993.tb00180.x
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  • 10
    Electronic Resource
    Electronic Resource
    Views of Finnish doctors on fetal screening (2000)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 107 (2000), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To investigate the views of Finnish doctors concerning fetal screening.Design Anonymous, questionnaire survey conducted in 1996–1997.Population A representative sample of gynaecologists, paediatricians and general practitioners in Finland. Both leading doctors and ordinary practitioners were included.Results Most doctors said that serum screening for Down's syndrome and ultrasound screening for structural abnormalities should be available for all pregnant women. In response to more direct questions, doctors acknowledged many drawbacks to Down's serum screening, notably the worry due to false positives. Only a few were against abortion, and a fifth said fetal screening is partly based on a eugenic ideology. There were some differences between the different doctor groups, but the overall impression was of similarity rather than divergence, both between the different specialist groups, and by the position of the doctor (leading vs ordinary).Conclusions Finnish doctors support current fetal screening, but many acknowledged resulting ethical, psychological, and social problems.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2000.tb13309.x
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