Acta Obstetricia et Gynecologica Scandinavica 

About: Acta Obstetricia et Gynecologica Scandinavica is an academic journal published by Informa. The journal publishes majorly in the area(s): Pregnancy & Population. It has an ISSN identifier of 0001-6349. Over the lifetime, 12024 publications have been published receiving 266229 citations. The journal is also known as: AOGS,.

Menstrual blood loss--a population study. Variation at different ages and attempts to define normality.

Abstract: The previous literature on menstrual blood loss studies was reviewed. A new study was conducted to ascertain the variation of menstrual blood loss at various ages and to establish the upper normal limit of menstrual blood loss. The study involved 476 women of all ages in Goteborg Sweden. Amenorrheic women were excluded from the study. Measurement of hemoglobin concentration plasma iron concentration and hematocrit levels indicated wide variation among women. No statistically significant differences in menstrual blood loss were observed among age groups except that women 50 and older had the highest and women 15 and under the lowest mean loss levels. It was concluded that a loss of 60-80 ml is normal; losses above 80 ml should be considered pathological.

An integral theory of female urinary incontinence. Experimental and clinical considerations.

Abstract: In this Theory paper, the complex interplay of the specific structures involved in female urinary continence are analyzed. In addition the effects of age, hormones, and iatrogenically induced scar tissue on these structures, are discussed specifically with regard to understanding the proper basis for treatment of urinary incontinence. According to the Theory stress and urge symptoms may both derive, for different reasons from the same anatomical defect, a lax vagina. This laxity may be caused by defects within the vaginal wall itself, or its supporting structures i.e. ligaments, muscles, and their connective tissue insertions. The vagina has a dual function. It mediates (transmits) the various muscle movements involved in bladder neck opening and closure through three separate closure mechanisms. It also has a structural function, and prevents urgency by supporting the hypothesized stretch receptors at the proximal urethra and bladder neck. Altered collagen/elastin in the vaginal connective tissue and/or its ligamentous supports may cause laxity. This dissipates the muscle contraction, causing stress incontinence, and/or activation of an inappropriate micturition reflex, (“bladder instability”) by stimulation of bladder base stretch receptors. The latter is manifested by symptoms of frequency, urgency, nocturia with or without urine loss.

The Medical Birth Registry of Norway. Epidemiological research and surveillance throughout 30 years

Abstract: (2000). The Medical Birth Registry of Norway. Epidemiological research and surveillance throughout 30 years. Acta Obstetricia et Gynecologica Scandinavica: Vol. 79, No. 6, pp. 435-439.

State-of-the-art review.

Abstract: This September issue of AOGS is especially stimulating with a blend of articles from different sub-specialities using various methodologies: randomized controlled trials, experimental studies, cohort studies, questionnaire surveys and register-based follow-up studies. The guest editorial on how to reduce obesity starts with a first fresh reference to a Swedish register study that found a dose-response dependent correlation between increase in BMI/weight gain between first and second delivery, and subsequent stillbirth and infant mortality! Importantly, pregnancy and the time period between first and second pregnancy is both a window of opportunity and key to the outcome of the second pregnancy. We may still be challenged by wishful thinking – the observational studies make us conclude that an intervention is beneficial even though RCTs do not show the expected change. For a moment we may be disappointed, but then we reconsider and realize that the chosen outcome measures are not appropriate, but a result of the limitation of the short follow up of the RCTs. The theme of obesity is different from many other issues; obesity may change the intrauterine environment and the future health of the offspring for generations. Also, the September issue presents the first stateof-the-art review in AOGS. At the last editorial board meeting we discussed how to categorize reviews. For at least the last decade, epidemiologists have seen to that all reviews are systematic: when we receive a narrative review it has usually been condensed to a commentary in its own right. However, we needed a category that combines physiological, experimental and epidemiological perspectives written in a systematic fashion: not too far from a textbook chapter, but printed years before it would have been available in a textbook. We thought of “overview”, but chose “state-of-the-art”. Although some might consider this terminology preposterous, we think that when you read the publication on “Fetal movements” you will know what we mean. We present a high level review beyond the scope of a limited systematic literature search, including clinical experience and a large spread of references covering decades of relevant publications. Many articles in this issue are not obstetric. The first original research paper is a Danish population-based survey on gynecological cancer symptoms showing that in women who experienced one of five symptoms that might be associated with gynecologic cancer, only 20% mentioned it to their general practitioner and of these 40% were referred to or seen by a specialist. Among most women in Norway with leiomyosarcoma the diagnosis was not suspected prior to surgery, and since most women were menopausal the authors argue that morcellation could still be used in premenopausal women with fibromas. The authors present a balanced discussion of the use of a mechanical morcellator in laparoscopic hysterectomy, including the fear of spread of tumor cells in very few as opposed to the advantages of laparoscopic surgery. Mats Br€annstr€ om was the first to perform a successful uterus transplantation in the world. You may re-read his intriguing story of how he pursued the idea based on an urge to help a young woman, who had been hysterectomized (1). Now, Japanese researchers have performed experimental studies on technical issues: for how long can a uterus of the cynomolgus monkey “survive” warm ischaemia? (Answer: about four hours). A Swedish study on antenatal lifestyle intervention to reduce weight gain in pregnancy compared standard antenatal care with a composite of monitoring, personalized graph and specific education. The study shows that the intervention was actually associated with a reduced weight gain shortly after delivery. However, the difference disappeared within a year! Observational data within the trial showed that excessive weight gain shortly after delivery was associated with an even higher increase in body weight after one year. The short presentation of remaining articles in the following will illustrate the impressive coverage of this issue and may serve as appetizers: An Australian observational study of the effect of a hemostatic matrix used for hysterectomies was inconclusive, yet the authors still consider the matrix to be useful. See for yourself if you agree. Fertility manuscripts increasingly find their way to AOGS: A paper on Nordic ovarian tissue cryopreservation and transplantation report 20 years of experience. A total

Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies.

Abstract: Introduction The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has exposed vulnerable populations to an unprecedented global health crisis. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The objective of this study was to summarize the clinical manifestations and maternal and perinatal outcomes of COVID-19 during pregnancy. Material and methods We searched databases for all case reports and series from 12 February to 4 April 2020. Multiple terms and combinations were used including COVID-19, pregnancy, maternal mortality, maternal morbidity, complications, clinical manifestations, neonatal morbidity, intrauterine fetal death, neonatal mortality and SARS-CoV-2. Eligibility criteria included peer-reviewed publications written in English or Chinese and quantitative real-time polymerase chain reaction (PCR) or dual fluorescence PCR-confirmed SARS-CoV-2 infection. Unpublished reports, unspecified date and location of the study or suspicion of duplicate reporting, cases with suspected COVID-19 that were not confirmed by a laboratory test, and unreported maternal or perinatal outcomes were excluded. Data on clinical manifestations, maternal and perinatal outcomes including vertical transmission were extracted and analyzed. Results Eighteen articles reporting data from 108 pregnancies between 8 December 2019 and 1 April 2020 were included in the current study. Most reports described women presenting in the third trimester with fever (68%) and coughing (34%). Lymphocytopenia (59%) with elevated C-reactive protein (70%) was observed and 91% of the women were delivered by cesarean section. Three maternal intensive care unit admissions were noted but no maternal deaths. One neonatal death and one intrauterine death were also reported. Conclusions Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 and perinatal deaths were reported. Vertical transmission of the COVID-19 could not be ruled out. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted.