Introduction: Pregnancies with the fetus in breech position at term are routinely managed by offering external cephalic version to increase the likelihood of vaginal birth in the cephalic position and reducing the risk of cesarean delivery. Although complications from external cephalic version are infrequent, placental abruption is a rare but serious risk, occurring in 0.08% of attempts. Methods: This case report details the experience of a woman with an uncomplicated singleton pregnancy with fetal breech presentation at gestational age 37 weeks and 2 days, coming for an outpatient external cephalic version. Preceding the external cephalic version, a fetal ultrasound and cardiotocography were both normal. Intravenous salbutamol was administered shortly before the procedure. Results: The external cephalic version was complicated by a three minute episode of fetal bradycardia, which resolved spontaneously without any maternal symptoms of abdominal pain or vaginal bleeding. Within 35 minutes post-procedure, an ultrasound revealed a de novo placental lake with a jet, potentially coming from a placental artery. The patient also started reporting increasing pain and upon palpation of the abdomen, increased uterine tone was noted. Emergency cesarean was performed resulting in the birth of a healthy girl with normal Apgar scores. Fetal hemoglobin was low at 8.3 mmol/L (reference 9.4 -14.4 mmol/L). Conclusion: This case accentuates the importance of caution in women with symptoms of placental abruption such as uterine contractions, increased tone, or vaginal bleeding, especially following a bradycardic event after external cephalic version. While such complications are rare, clinicians should consider a post-procedure fetal ultrasound before discharge in cases where bradycardia is observed. Funding None Trial registration Not relevant.
{"title":"External cephalic version complicated by bradycardia and placental abruption– a case report","authors":"PB Axelsson, Anne-Louise Lykke Nielsen, C. Vinter","doi":"10.56182/mp8dvk58","DOIUrl":"https://doi.org/10.56182/mp8dvk58","url":null,"abstract":"Introduction:\u0000Pregnancies with the fetus in breech position at term are routinely managed by offering external cephalic version to increase the likelihood of vaginal birth in the cephalic position and reducing the risk of cesarean delivery. Although complications from external cephalic version are infrequent, placental abruption is a rare but serious risk, occurring in 0.08% of attempts.\u0000Methods:\u0000This case report details the experience of a woman with an uncomplicated singleton pregnancy with fetal breech presentation at gestational age 37 weeks and 2 days, coming for an outpatient external cephalic version. Preceding the external cephalic version, a fetal ultrasound and cardiotocography were both normal. Intravenous salbutamol was administered shortly before the procedure.\u0000Results:\u0000The external cephalic version was complicated by a three minute episode of fetal bradycardia, which resolved spontaneously without any maternal symptoms of abdominal pain or vaginal bleeding. Within 35 minutes post-procedure, an ultrasound revealed a de novo placental lake with a jet, potentially coming from a placental artery. The patient also started reporting increasing pain and upon palpation of the abdomen, increased uterine tone was noted. Emergency cesarean was performed resulting in the birth of a healthy girl with normal Apgar scores. Fetal hemoglobin was low at 8.3 mmol/L (reference 9.4 -14.4 mmol/L).\u0000Conclusion:\u0000This case accentuates the importance of caution in women with symptoms of placental abruption such as uterine contractions, increased tone, or vaginal bleeding, especially following a bradycardic event after external cephalic version. While such complications are rare, clinicians should consider a post-procedure fetal ultrasound before discharge in cases where bradycardia is observed.\u0000Funding\u0000None\u0000Trial registration\u0000Not relevant.","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"35 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140224774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PB Axelsson, Tina Beermann, Heinke Hansen, M. M. Jeppesen, Anna Kristensen, Saskia Marxen, Rasmus Olesen, Camilla Palm, Emilie Sejer, Frederikke Skoven, Thea Thetmark, Kristina Renault
Vegetarian and vegan diets are becoming increasingly common among Danish women of reproductive age. We reviewed the available literature via PubMed and concluded that varied and well-balanced vegetarian and vegan diets are safe and sufficient during pregnancy and lactation, provided that dietary supplements for folate, vitamin B12, and vitamin D are taken regularly. Additionally, it is important to ensure adequate intake of calcium, protein, and iron. Protein requirements may be higher for vegetarians and especially for vegans, though evidence is limited regarding the recommendation for increased protein intake if the diet is exclusively plant-based. Routine blood tests are not recommended unless there has been insufficient supplementation leading up to or during pregnancy, or if symptoms suggest a deficiency. We found no evidence to support supplementation with docosahexaenoic acid (DHA). There is no indication of an increased risk of malformations for pregnant Danish women on a vegetarian or vegan diet compared to omnivores. The risk of delivering small for gestational age and low birthweight infants (<2500 grams) may be increased, but the evidence is conflicting and of poor quality. Vegetarian and vegan diets may offer benefits, such as a lower risk of excessive gestational weight gain and women consuming the lowest amounts of meat have a significantly lower risk of gestational diabetes. Vegans may face a lower risk of having large for gestational age infants. Vegetarian and vegan lifestyles are also compatible with breastfeeding, and provided women take the recommended supplements, there is no difference in the micronutrient content of the breast milk of vegetarian/vegan women compared to that of omnivores. Children of vegans and vegetarians with limited or no consumption of milk products or eggs are recommended to breastfeed or receive baby formula for at least the first two years of life.
{"title":"DSOG Guideline Bulletin: Vegetarian and vegan diets during pregnancy","authors":"PB Axelsson, Tina Beermann, Heinke Hansen, M. M. Jeppesen, Anna Kristensen, Saskia Marxen, Rasmus Olesen, Camilla Palm, Emilie Sejer, Frederikke Skoven, Thea Thetmark, Kristina Renault","doi":"10.56182/ccd2xa40","DOIUrl":"https://doi.org/10.56182/ccd2xa40","url":null,"abstract":"Vegetarian and vegan diets are becoming increasingly common among Danish women of reproductive age. We reviewed the available literature via PubMed and concluded that varied and well-balanced vegetarian and vegan diets are safe and sufficient during pregnancy and lactation, provided that dietary supplements for folate, vitamin B12, and vitamin D are taken regularly. Additionally, it is important to ensure adequate intake of calcium, protein, and iron. Protein requirements may be higher for vegetarians and especially for vegans, though evidence is limited regarding the recommendation for increased protein intake if the diet is exclusively plant-based. Routine blood tests are not recommended unless there has been insufficient supplementation leading up to or during pregnancy, or if symptoms suggest a deficiency. We found no evidence to support supplementation with docosahexaenoic acid (DHA). There is no indication of an increased risk of malformations for pregnant Danish women on a vegetarian or vegan diet compared to omnivores. The risk of delivering small for gestational age and low birthweight infants (<2500 grams) may be increased, but the evidence is conflicting and of poor quality. Vegetarian and vegan diets may offer benefits, such as a lower risk of excessive gestational weight gain and women consuming the lowest amounts of meat have a significantly lower risk of gestational diabetes. Vegans may face a lower risk of having large for gestational age infants. Vegetarian and vegan lifestyles are also compatible with breastfeeding, and provided women take the recommended supplements, there is no difference in the micronutrient content of the breast milk of vegetarian/vegan women compared to that of omnivores. Children of vegans and vegetarians with limited or no consumption of milk products or eggs are recommended to breastfeed or receive baby formula for at least the first two years of life.","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"46 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140231474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jane Ravn, A. Gulbech, Lise Dokkedahl Christensen, Sven Hoedt Karstensen, Pernille Ravn, Phillip KL Keudel, F. Lauszus
Introduction: Sharing nude photos and exchanging intimacy favors transcends the threshold from hidden and private content into public consciousness. Ever-present is the differentiation between an image shared by consent and those not consented to and distributed as part of harassment, revenge and abuse. Similarly, the continuum of exchanging intimacy moves across normative boundaries some see as unproblematic and occur in many sexual and romantic encounters, while others can be experienced as problematic. The purpose of this quantitative study is in a low-risk setting to investigate basic characteristics in the spread of the phenomenon of sugar-dating and nude photo sharing among adolescents. Methods: An anonymous questionnaire was sent to all 9th grade classes at schools in a single Danish municipality for three consecutive years from 2020 to 2022 with pupils and teachers not notified in advance. The survey included questions on gender identity, sugar-dating, sharing nude photos, and, from 2022, consent and setting up boundaries to sex. Results: Of 729 pupils 541 (74%) answered the questionnaire. More pupils with sexual debut sent nude photos of themselves via tablet/phones/computers, received nude photos and had passed them on than those without sexual debut, while no gender difference was found. More than four times as many pupils had received nude photos than pupils who had sent nudes of themselves. Ten percent stated they had exchanged intimacy for favors like presents or entry to parties; the intimacy act was spelled out as oral sex, hand job or sexual intercourse (vaginal penetration). Sugar-dating and knowledge hereof were associated with sexual debut but was not exclusively performed by debutants. Of those who gave sexual favors, 40% were non-debutant pupils. Conclusion: The survey found a 10 % prevalence of sugar-dating and 53 % receiving nude photos amongst 9th graders. The implication of the phenomena on behavior has obvious perspectives on adolescents’ mental and physical health.
{"title":"Exchanging intimacy for favors and nude photos among ninth graders","authors":"Jane Ravn, A. Gulbech, Lise Dokkedahl Christensen, Sven Hoedt Karstensen, Pernille Ravn, Phillip KL Keudel, F. Lauszus","doi":"10.56182/djog.v2i1.35","DOIUrl":"https://doi.org/10.56182/djog.v2i1.35","url":null,"abstract":"Introduction: Sharing nude photos and exchanging intimacy favors transcends the threshold from hidden and private content into public consciousness. Ever-present is the differentiation between an image shared by consent and those not consented to and distributed as part of harassment, revenge and abuse. Similarly, the continuum of exchanging intimacy moves across normative boundaries some see as unproblematic and occur in many sexual and romantic encounters, while others can be experienced as problematic. The purpose of this quantitative study is in a low-risk setting to investigate basic characteristics in the spread of the phenomenon of sugar-dating and nude photo sharing among adolescents. Methods: An anonymous questionnaire was sent to all 9th grade classes at schools in a single Danish municipality for three consecutive years from 2020 to 2022 with pupils and teachers not notified in advance. The survey included questions on gender identity, sugar-dating, sharing nude photos, and, from 2022, consent and setting up boundaries to sex. Results: Of 729 pupils 541 (74%) answered the questionnaire. More pupils with sexual debut sent nude photos of themselves via tablet/phones/computers, received nude photos and had passed them on than those without sexual debut, while no gender difference was found. More than four times as many pupils had received nude photos than pupils who had sent nudes of themselves. Ten percent stated they had exchanged intimacy for favors like presents or entry to parties; the intimacy act was spelled out as oral sex, hand job or sexual intercourse (vaginal penetration). Sugar-dating and knowledge hereof were associated with sexual debut but was not exclusively performed by debutants. Of those who gave sexual favors, 40% were non-debutant pupils. Conclusion: The survey found a 10 % prevalence of sugar-dating and 53 % receiving nude photos amongst 9th graders. The implication of the phenomena on behavior has obvious perspectives on adolescents’ mental and physical health.","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139234522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sine Jacobsen, F. Lauszus, Cathrine Krogh Jeppesen, Heidi Christensen, Axel Forman
Introduction: Genitourinary syndrome of menopause (GSM) is common after natural menopause as well as in women with induced menopause due to endocrine therapy and/or oophorectomy following breast cancer. Vaginal laser therapy is a nonhormonal treatment option that appears to alleviate GSM symptoms in natural menopause; however, women with induced menopause may respond differently. The aim of this study was thus to evaluate the efficacy and safety of laser treatment on GSM in postmenopausal women and breast cancer survivors. Methods: A total of 34 women were enrolled in the study, each completing three treatments at monthly intervals. After each treatment, sexual function was assessed with PISQ-12, urinary incontinence and overactive bladder symptoms were measured using ICIQ-UI SF and ICIQ-OAB, and the improvement of urinary incontinence was measured using PGI-I and PGI-S. Results: At the time of follow-up, one year after the start of treatment the total PISQ-12 score had significantly increased in both groups compared to baseline (33 to 35.5, difference 2.5, 95% CI: 0.9-4.3). As assessed by ICIQ-UI SF scores, vaginal laser therapy also improved urinary incontinence from 5.3 at baseline to 3.4 at one-year follow-up (difference 1.9, 95% CI:0.4-3.1) for the total group. Improved urgency score from 3.1 at baseline to 2.5 at one-year follow-up (difference 0.7, 95% CI:0.02-1.5) and less leakage after urgency 3.1 at baseline to 2.8 at one-year follow-up (difference 0.8, 95% CI:0.05-1.5) were also reported. No complications were observed. Conclusion: Vaginal laser therapy appears to be safe and may reduce GSM symptoms in postmenopausal women and breast cancer survivors. Separate randomized controlled studies are needed.
{"title":"Vaginal laser therapy for urogenital symptoms in postmenopausal women and breast cancer survivors","authors":"Sine Jacobsen, F. Lauszus, Cathrine Krogh Jeppesen, Heidi Christensen, Axel Forman","doi":"10.56182/djog.v2i1.26","DOIUrl":"https://doi.org/10.56182/djog.v2i1.26","url":null,"abstract":"Introduction: Genitourinary syndrome of menopause (GSM) is common after natural menopause as well as in women with induced menopause due to endocrine therapy and/or oophorectomy following breast cancer. Vaginal laser therapy is a nonhormonal treatment option that appears to alleviate GSM symptoms in natural menopause; however, women with induced menopause may respond differently. The aim of this study was thus to evaluate the efficacy and safety of laser treatment on GSM in postmenopausal women and breast cancer survivors. Methods: A total of 34 women were enrolled in the study, each completing three treatments at monthly intervals. After each treatment, sexual function was assessed with PISQ-12, urinary incontinence and overactive bladder symptoms were measured using ICIQ-UI SF and ICIQ-OAB, and the improvement of urinary incontinence was measured using PGI-I and PGI-S. Results: At the time of follow-up, one year after the start of treatment the total PISQ-12 score had significantly increased in both groups compared to baseline (33 to 35.5, difference 2.5, 95% CI: 0.9-4.3). As assessed by ICIQ-UI SF scores, vaginal laser therapy also improved urinary incontinence from 5.3 at baseline to 3.4 at one-year follow-up (difference 1.9, 95% CI:0.4-3.1) for the total group. Improved urgency score from 3.1 at baseline to 2.5 at one-year follow-up (difference 0.7, 95% CI:0.02-1.5) and less leakage after urgency 3.1 at baseline to 2.8 at one-year follow-up (difference 0.8, 95% CI:0.05-1.5) were also reported. No complications were observed. Conclusion: Vaginal laser therapy appears to be safe and may reduce GSM symptoms in postmenopausal women and breast cancer survivors. Separate randomized controlled studies are needed.","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139271810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There are more than 160 journals within our specialty indexed in Medline/PubMed. So is there really a need for a new gynecological and obstetrics journal? We believe so. Several factors may hinder researchers from publishing their studies, especially younger or non-established researchers. To our knowledge, the publishers behind all of the above journals are for-profit and as such, are limited by either not being open access journals or those that are open access, follow the pay-to-publish model. The fees for publishing are often so high that independent researchers cannot pay out of their own pocket and it can be difficult to obtain funding for article processing charges. Novelty is a criterion most journals ask their peer-reviewers to assess when reviewing submitted manuscripts. This means that reproduction studies and negative findings are more difficult to publish, even though they are the very backbone of the scientific method. Researchers may be hesitant to publish such studies for a hefty fee when they know they are rarely cited, which is why publication bias is a common finding in meta-analyses. Case reports, protocols, and descriptive studies often have difficulty in finding a suitable journal. Currently, only randomized studies are required to have a protocol registered prior to inclusion of patients. However, it is a good practice for observational studies to do so as well, as there is an inherent penchant for researchers to adjust their aims when they have access to the data. Case reports are often the type of articles less experienced colleagues first try their hands at and can be their stepping-stone into the research world. Finally, even though the Danish Journal of Obstetrics and Gynaecology is an international journal exclusively publishing articles in English, we believe that having a journal that is mainly read by clinicians from Denmark may help the publishing of Danish guideline résumés and articles specific to a Danish clinical setting. Having such articles regarding changes in clinical practice published for posterity will make it easier for future clinicians to evaluate and account for the effects of such changes. The ability to cite guideline résumés through CrossRef is also encouraging for those participating in producing them and makes it easier to our non-Danish speaking colleagues in the rest of the world to read what the clinical practice is in Denmark. [abbreviated]
{"title":"Editorial - first issue","authors":"","doi":"10.56182/djog.v1i1.31","DOIUrl":"https://doi.org/10.56182/djog.v1i1.31","url":null,"abstract":"There are more than 160 journals within our specialty indexed in Medline/PubMed. So is there really a need for a new gynecological and obstetrics journal? \u0000We believe so. Several factors may hinder researchers from publishing their studies, especially younger or non-established researchers. To our knowledge, the publishers behind all of the above journals are for-profit and as such, are limited by either not being open access journals or those that are open access, follow the pay-to-publish model. The fees for publishing are often so high that independent researchers cannot pay out of their own pocket and it can be difficult to obtain funding for article processing charges. \u0000Novelty is a criterion most journals ask their peer-reviewers to assess when reviewing submitted manuscripts. This means that reproduction studies and negative findings are more difficult to publish, even though they are the very backbone of the scientific method. Researchers may be hesitant to publish such studies for a hefty fee when they know they are rarely cited, which is why publication bias is a common finding in meta-analyses. \u0000Case reports, protocols, and descriptive studies often have difficulty in finding a suitable journal. Currently, only randomized studies are required to have a protocol registered prior to inclusion of patients. However, it is a good practice for observational studies to do so as well, as there is an inherent penchant for researchers to adjust their aims when they have access to the data. Case reports are often the type of articles less experienced colleagues first try their hands at and can be their stepping-stone into the research world. \u0000Finally, even though the Danish Journal of Obstetrics and Gynaecology is an international journal exclusively publishing articles in English, we believe that having a journal that is mainly read by clinicians from Denmark may help the publishing of Danish guideline résumés and articles specific to a Danish clinical setting. Having such articles regarding changes in clinical practice published for posterity will make it easier for future clinicians to evaluate and account for the effects of such changes. The ability to cite guideline résumés through CrossRef is also encouraging for those participating in producing them and makes it easier to our non-Danish speaking colleagues in the rest of the world to read what the clinical practice is in Denmark. [abbreviated]","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128780949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The founding of DSOG On a dark evening on October 5th, 1898, the ”Forening for Gynækologi og Obstetrik i København, Association for Gynaecology and Obstetrics in Copenhagen”, was founded at a meeting in the Fødselsstiftelsen [Institution for Delivery] in Amaliegade in Copenhagen. The association was the first association for a medical specialty in Denmark, preceding all other medical specialties. Birth assistance has evidently been practiced since the very beginning of mankind, although only much more recently as an obstetric discipline by doctors and midwives. The specialty of gynaecology was in 1898 relatively new, and the boundary between surgery and gynaecology was still being discussed. In 1960 the name of the association was changed to Danish Society of Obstetrics and Gynaecology (DSOG) and for the sake of consistency, this name will mostly be used in this narration. At the founding meeting in 1998 eighteen middle-aged or elderly men attended. New members needed to be invited - one could not just register as you do today. Two founding fathers will be emphasized. [abbreviated]
{"title":"The Danish Society of Obstetrics and Gynaecology (DSOG) and its history","authors":"P. Hornnes","doi":"10.56182/djog.v1i1.30","DOIUrl":"https://doi.org/10.56182/djog.v1i1.30","url":null,"abstract":"The founding of DSOG \u0000On a dark evening on October 5th, 1898, the ”Forening for Gynækologi og Obstetrik i København, Association for Gynaecology and Obstetrics in Copenhagen”, was founded at a meeting in the Fødselsstiftelsen [Institution for Delivery] in Amaliegade in Copenhagen. The association was the first association for a medical specialty in Denmark, preceding all other medical specialties. Birth assistance has evidently been practiced since the very beginning of mankind, although only much more recently as an obstetric discipline by doctors and midwives. The specialty of gynaecology was in 1898 relatively new, and the boundary between surgery and gynaecology was still being discussed. In 1960 the name of the association was changed to Danish Society of Obstetrics and Gynaecology (DSOG) and for the sake of consistency, this name will mostly be used in this narration. At the founding meeting in 1998 eighteen middle-aged or elderly men attended. New members needed to be invited - one could not just register as you do today. Two founding fathers will be emphasized. [abbreviated]","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121833433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
U. Knudsen, N. Uldbjerg, K. Gemzell‐Danielsson, J. Trovik, O. Heikinheimo, T. Steingrimsdottir, R. O. Svarrer
The purpose of this publication is to describe the success, which you find at Obstetrics and Gynecology - online textbook for medical students - sundhed.dk, an easily accessible, up to date Obstetrics and Gynecology teaching for medical students including international students in the Nordic countries. In 2018, NFOG (the Nordic Federation of Societies of Obstetrics and Gynecology) decided to finance the production of an electronic textbook for medical students by 1,000,000 Danish kr.: Text, illustrations, learning principles to be aligned with the curricula for obstetrics and gynecology in Nordic medical schools (and the needs of GPs and junior doctors outside our specialty, but not trainees in obstetrics and gynecology or midwives). Author fee: none. Availability On the internet, for computer, tablet and smartphone. No paper version published. Based on modern pedagogic principles not addressed in traditional printed books. Free access to the platform (open source). Each chapter written by a set of subspecialist authors from three or more Nordic countries. The editorial committee Included members from each Nordic country (the authors of this publication). Distributed relevant topics among 32 obstetrical and 28 gynecological chapters. Appointed a maximum number of words for each chapter. Enrolled about 187 authors. Electronic platform for publication dk, even though some book companies offer platform with more features. However, sundhed.dk guarantees reliability and offers this service for free. Videos and illustrations We engaged two gynecologists, Jørgen Præst for video editing and Lotte Clevin who is also a professional illustrator. The use of good colleagues ensured the relevance of the products. Formalities We hired a law firm to elaborate collaboration agreements. That was necessary with these international stakeholders. Language revision An obstetrician/gynecologist (Reynir Tómas Geirsson, former AOGS Chief Editor) delivered text editing. Multiple-choice questions A medical student (Thomas Jensen) established a platform for MCQ. Authors, professors, associate professors, and medical students are encouraged to add new MCQ to this collection. We publish them as soon as the authors have approved the suggestion.
{"title":"Electronic textbook Obstetrics and Gynecology for medical students","authors":"U. Knudsen, N. Uldbjerg, K. Gemzell‐Danielsson, J. Trovik, O. Heikinheimo, T. Steingrimsdottir, R. O. Svarrer","doi":"10.56182/djog.v1i1.32","DOIUrl":"https://doi.org/10.56182/djog.v1i1.32","url":null,"abstract":"The purpose of this publication is to describe the success, which you find at Obstetrics and Gynecology - online textbook for medical students - sundhed.dk, an easily accessible, up to date Obstetrics and Gynecology teaching for medical students including international students in the Nordic countries. \u0000In 2018, NFOG (the Nordic Federation of Societies of Obstetrics and Gynecology) decided to finance the production of an electronic textbook for medical students by 1,000,000 Danish kr.: \u0000 \u0000Text, illustrations, learning principles to be aligned with the curricula for obstetrics and gynecology in Nordic medical schools (and the needs of GPs and junior doctors outside our specialty, but not trainees in obstetrics and gynecology or midwives). \u0000Author fee: none. \u0000 \u0000Availability \u0000 \u0000On the internet, for computer, tablet and smartphone. No paper version published. \u0000Based on modern pedagogic principles not addressed in traditional printed books. \u0000Free access to the platform (open source). \u0000Each chapter written by a set of subspecialist authors from three or more Nordic countries. \u0000 \u0000The editorial committee \u0000 \u0000Included members from each Nordic country (the authors of this publication). \u0000Distributed relevant topics among 32 obstetrical and 28 gynecological chapters. \u0000Appointed a maximum number of words for each chapter. \u0000Enrolled about 187 authors. \u0000 \u0000Electronic platform for publication \u0000 \u0000dk, even though some book companies offer platform with more features. However, sundhed.dk guarantees reliability and offers this service for free. \u0000 \u0000Videos and illustrations \u0000 \u0000We engaged two gynecologists, Jørgen Præst for video editing and Lotte Clevin who is also a professional illustrator. The use of good colleagues ensured the relevance of the products. \u0000 \u0000Formalities \u0000 \u0000We hired a law firm to elaborate collaboration agreements. That was necessary with these international stakeholders. \u0000 \u0000Language revision \u0000 \u0000An obstetrician/gynecologist (Reynir Tómas Geirsson, former AOGS Chief Editor) delivered text editing. \u0000 \u0000Multiple-choice questions \u0000 \u0000 \u0000 \u0000A medical student (Thomas Jensen) established a platform for MCQ. Authors, professors, associate professors, and medical students are encouraged to add new MCQ to this collection. We publish them as soon as the authors have approved the suggestion. \u0000 \u0000 \u0000","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116085715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Pedunculated fibroids are a subtype of submucousal fibroids, that can prolapse into the cervical canal and vagina while remaining attached to the uterine cavity by a pedicle. This condition is known as fibroma in statu nascendi and its exact prevalence is unknown. As the most frequently presented symptoms are abnormal vaginal bleeding/discharge and lower abdominal pain, a complete release of the pedicle leading to spontaneous expulsion of an isolated fibroid is a rarity. Methods: A case report describing a complete, spontaneous release of a pedunculated fibroid measuring 8x5 cm. Results: A 63-year-old woman with no gynecological history was referred by her general practitioner after spontaneous expulsion of a large vaginal mass, which measured 8x5 cm. She had no vaginal bleeding since menopause and she had experienced a few days of whitish discharge and a sensation of something filling the vagina before the mass was expelled. Gynecological examination revealed a normal-appearing vagina and transvaginal ultrasound showed a thin endometrial echo. Histopathological diagnosis confirmed the suspicion of fibroma in statu nascendi. Conclusion: Prolapsed submucousal fibroids are a well-known condition, that frequently presents as abnormal vaginal bleeding/discharge and lower abdominal pain. Total, spontaneous detachment of the fibroid is rare. The diagnosis is typically evident; however, differential diagnoses, such as endometrial polyps and sarcomas, must be considered and clarified via histopathological evaluation.
{"title":"Spontaneous expulsion of a large vaginal mass – a case of complete ejection of a detached fibroma in statu nascendi.","authors":"Karina Fogh Trelborg, Anne-Mette Bay Bjørn","doi":"10.56182/djog.v1i1.20","DOIUrl":"https://doi.org/10.56182/djog.v1i1.20","url":null,"abstract":"Objective: Pedunculated fibroids are a subtype of submucousal fibroids, that can prolapse into the cervical canal and vagina while remaining attached to the uterine cavity by a pedicle. This condition is known as fibroma in statu nascendi and its exact prevalence is unknown. As the most frequently presented symptoms are abnormal vaginal bleeding/discharge and lower abdominal pain, a complete release of the pedicle leading to spontaneous expulsion of an isolated fibroid is a rarity.\u0000Methods: A case report describing a complete, spontaneous release of a pedunculated fibroid measuring 8x5 cm.\u0000Results: A 63-year-old woman with no gynecological history was referred by her general practitioner after spontaneous expulsion of a large vaginal mass, which measured 8x5 cm. She had no vaginal bleeding since menopause and she had experienced a few days of whitish discharge and a sensation of something filling the vagina before the mass was expelled. Gynecological examination revealed a normal-appearing vagina and transvaginal ultrasound showed a thin endometrial echo. Histopathological diagnosis confirmed the suspicion of fibroma in statu nascendi.\u0000Conclusion: Prolapsed submucousal fibroids are a well-known condition, that frequently presents as abnormal vaginal bleeding/discharge and lower abdominal pain. Total, spontaneous detachment of the fibroid is rare. The diagnosis is typically evident; however, differential diagnoses, such as endometrial polyps and sarcomas, must be considered and clarified via histopathological evaluation.","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134525420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Axelsson, A. Winther, T. Clausen, E. Løkkegaard
Introduction: The last Danish survey in 1995 on the antibiotic prophylactic practices in cesarean section found that there was no consensus between delivery wards. Since then national guidelines have been established. We therefore wanted to see if clinical practice regarding antibiotic prophylaxis had become more uniform. Methods: In February of 2019 the delivery wards in Denmark (n=21) were contacted to answer an online questionnaire regarding type and dose of antibiotic prophylaxis used, timing of the administration, and differences between elective and emergency cesarean section. Results: All twenty-one wards applied a single dose of 1500 mg Cefuroxime, a 3rd generation cephalosporin. Three wards (14%) administered antibiotic prophylaxis after cord clamping and eighteen (86%) prior to clamping, with nine (43%) wards having changed practice during the last 10 years. Three wards recalled the precise year for the change, six wards gave an approximate range of years, and five wards did not remember. The exact timing of the antibiotic varied from 0-60 minutes prior to incision, with sixteen (76%) wards reporting giving antibiotics usually 0-30 minutes prior to and of those, eleven (52%) immediately prior. All wards had the same prophylactic antibiotics principles for emergency and elective cesarean sections. Conclusion: Most wards adhere to national guideline recommendations, but recollection was imperfect as to when changes in practices were implemented. We suggest that current and previous guidelines from hospitals in Denmark be stored in a national database, or more preferably that a national cesarean birth registry be established, accounting for the frequent local changes and interpersonal differences in clinical practice.
{"title":"Antibiotic prophylaxis practices in cesarean section with focus on timing – a Danish national survey","authors":"P. Axelsson, A. Winther, T. Clausen, E. Løkkegaard","doi":"10.56182/djog.v1i1.8","DOIUrl":"https://doi.org/10.56182/djog.v1i1.8","url":null,"abstract":"Introduction: The last Danish survey in 1995 on the antibiotic prophylactic practices in cesarean section found that there was no consensus between delivery wards. Since then national guidelines have been established. We therefore wanted to see if clinical practice regarding antibiotic prophylaxis had become more uniform.\u0000 \u0000Methods: In February of 2019 the delivery wards in Denmark (n=21) were contacted to answer an online questionnaire regarding type and dose of antibiotic prophylaxis used, timing of the administration, and differences between elective and emergency cesarean section.\u0000Results: All twenty-one wards applied a single dose of 1500 mg Cefuroxime, a 3rd generation cephalosporin. Three wards (14%) administered antibiotic prophylaxis after cord clamping and eighteen (86%) prior to clamping, with nine (43%) wards having changed practice during the last 10 years. Three wards recalled the precise year for the change, six wards gave an approximate range of years, and five wards did not remember. The exact timing of the antibiotic varied from 0-60 minutes prior to incision, with sixteen (76%) wards reporting giving antibiotics usually 0-30 minutes prior to and of those, eleven (52%) immediately prior. All wards had the same prophylactic antibiotics principles for emergency and elective cesarean sections.\u0000Conclusion: Most wards adhere to national guideline recommendations, but recollection was imperfect as to when changes in practices were implemented. We suggest that current and previous guidelines from hospitals in Denmark be stored in a national database, or more preferably that a national cesarean birth registry be established, accounting for the frequent local changes and interpersonal differences in clinical practice.","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131274024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To assess the adherence to recommended guidelines on measurement of blood pressure in obstetric clinical practice and to determine the difference in blood pressure values between observed clinical measurements and measurements strictly following recommended guidelines. Methods: We assessed blood pressure of 60 women admitted to the maternity ward for a hypertensive disorder of pregnancy in pregnancy or postpartum. Blood pressure was measured by hospital staff according to usual clinical practice, and study personnel performed the measurement in accordance with international guidelines. Groups were compared using paired sample t-test and the Mantel-Haenszel test. Results: None of the clinical measurements fulfilled all recommended guidelines. Study systolic and diastolic readings were lower than those obtained in the usual clinical setting (systolic BP -7.0 mmHg (95% confidence interval: -9.2 to -4.8), p<0.001; diastolic BP -2.0 mmHg (95% confidence interval: -3.7 to -0.4), p=0.02). The risk of being categorized as hypertensive (≥140/90mmHg) decreased by 22% (95% confidence interval: 0.05-0.40, p=0.01) and 22/58 (38%) women shifted to a 10 mmHg category lower in systolic blood pressure along with 15/58 (26%) in diastolic blood pressure when measurements were performed by study personnel following recommended guidelines. Conclusion: Following recommended blood pressure measurement guidelines significantly lowers blood pressure readings and the risk of being categorized as hypertensive. TWEETABLE ABSTRACT: Following recommended guidelines significantly decreases blood pressure readings and reduces the risk of being categorized as hypertensive in an obstetrical population.
{"title":"Comparison of clinical blood pressure measurements to measurements according to guidelines in women admitted to the maternity ward for hypertension.","authors":"F. Lihme, Karoline Hedetoft, L. Persson, J. Lykke","doi":"10.56182/djog.v1i1.24","DOIUrl":"https://doi.org/10.56182/djog.v1i1.24","url":null,"abstract":"Objective: To assess the adherence to recommended guidelines on measurement of blood pressure in obstetric clinical practice and to determine the difference in blood pressure values between observed clinical measurements and measurements strictly following recommended guidelines.\u0000 \u0000Methods: We assessed blood pressure of 60 women admitted to the maternity ward for a hypertensive disorder of pregnancy in pregnancy or postpartum. Blood pressure was measured by hospital staff according to usual clinical practice, and study personnel performed the measurement in accordance with international guidelines. Groups were compared using paired sample t-test and the Mantel-Haenszel test.\u0000Results: None of the clinical measurements fulfilled all recommended guidelines. Study systolic and diastolic readings were lower than those obtained in the usual clinical setting (systolic BP -7.0 mmHg (95% confidence interval: -9.2 to -4.8), p<0.001; diastolic BP -2.0 mmHg (95% confidence interval: -3.7 to -0.4), p=0.02). The risk of being categorized as hypertensive (≥140/90mmHg) decreased by 22% (95% confidence interval: 0.05-0.40, p=0.01) and 22/58 (38%) women shifted to a 10 mmHg category lower in systolic blood pressure along with 15/58 (26%) in diastolic blood pressure when measurements were performed by study personnel following recommended guidelines.\u0000Conclusion: Following recommended blood pressure measurement guidelines significantly lowers blood pressure readings and the risk of being categorized as hypertensive.\u0000 \u0000TWEETABLE ABSTRACT: \u0000Following recommended guidelines significantly decreases blood pressure readings and reduces the risk of being categorized as hypertensive in an obstetrical population.","PeriodicalId":301577,"journal":{"name":"Danish Journal of Obstetrics and Gynaecology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116527358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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