Maternal and neonatal complications of shoulder dystocia with a focus on obstetric maneuvers: A case-control study of 1103 deliveries.

Introduction: Shoulder dystocia is a severe obstetric emergency that can cause substantial neonatal and maternal complications. This study aims to assess the performed obstetric maneuvers and their frequency, success, and association with maternal and neonatal complication rates.

Material And Methods: The study population was collected among all deliveries in the Hospital District of Helsinki and Uusimaa between 2006 and 2015 (n = 181 352) by searching for ICD-10 codes for shoulder dystocia, brachial plexus injury and clavicle fracture.

How do different childbirth experience scales predict childbirth-related posttraumatic stress symptoms and disorder?

Purpose: Post-traumatic stress disorder (PTSD) after childbirth causes severe and lasting effects. Screening of childbirth experience may expedite early PTSD recognition. Systematic reviews have not provided consensus on how and when to measure childbirth experience and the clinical implications of such measurements.

Pitfalls in the diagnostics of shoulder dystocia: an analysis based on the scrutiny of 2274 deliveries.

Purpose: Shoulder dystocia is an obstetric emergency with severe complications. Our objective was to evaluate the major pitfalls in the diagnostics of shoulder dystocia, diagnostic descriptions documented in medical records, use of obstetric maneuvers, and their correlations to Erb's and Klumpke's palsy and the use of ICD-10 code 066.0.

Cross-sectional study of the proportion of antibiotic use during childbirth in full-term deliveries in Finland.

Purpose: In developed countries, data on the frequency of antibiotics given to mothers during childbirth are limited beyond the overall effect of all various prophylactic indications. Also, data on the impact of such antibiotics to the well-being of term babies are scarce. We aimed to characterize the frequency of antibiotic use during childbirth of term pregnancy.

Quantitative insights into effects of intrapartum antibiotics and birth mode on infant gut microbiota in relation to well-being during the first year of life.

Birth mode and maternal intrapartum (IP) antibiotics affect infants' gut microbiota development, but their relative contribution to absolute bacterial abundances and infant health has not been studied. We compared the effects of Cesarean section (CS) delivery and IP antibiotics on infant gut microbiota development and well-being over the first year. We focused on 92 healthy infants born between gestational weeks 37-42 vaginally without antibiotics (N = 26), with IP penicillin (N = 13) or cephalosporin (N = 7) or by CS with IP cephalosporin (N = 33) or other antibiotics (N = 13).

The prevalence and consequences of abdominal rectus muscle diastasis among Finnish women: an epidemiological cohort study.

Purpose: Post-pregnancy abdominal rectus diastasis (ARD) has raised attention in the field of surgery in recent years, but there is no consensus about when to consider surgery. Our aim was to find out what is the normal inter-rectus distance in fertile aged, female population in Finland and to examine whether there is a linea alba width that would predispose to diastasis-related problems after pregnancy.

Methods: For this prospective cohort study, women participating early pregnancy ultrasound in Helsinki University Hospital Department of Obstetrics and Gynecology during 1.

Fear of childbirth after medical vs surgical abortion. Population-based register study from Finland.

Introduction: To evaluate the effect of method of induced abortion and other abortion-associated variables on the incidence of fear of childbirth in subsequent pregnancy.

Material And Methods: This population-based register study cohort includes all nulliparous women with their first pregnancy ending in an induced abortion in 2000-2015 and subsequent pregnancy with live singleton delivery between 2000 and 2017 (n = 21 479). Data were derived from three national registers maintained by the Finnish Institute for Health and Welfare.

Rising trends in the incidence of shoulder dystocia and development of a novel shoulder dystocia risk score tool: a nationwide population-based study of 800 484 Finnish deliveries.

Introduction: Shoulder dystocia has remained an unpredictable and feared emergency in obstetrics. Some risk factors have been identified but nevertheless there is a lack of risk evaluation tools in clinical practice. The aim of this study was to evaluate the incidence and risk factors of shoulder dystocia in the Finnish population and to develop a shoulder dystocia risk score tool.

Maternal Fecal Microbiota Transplantation in Cesarean-Born Infants Rapidly Restores Normal Gut Microbial Development: A Proof-of-Concept Study.

Infants born by vaginal delivery are colonized with maternal fecal microbes. Cesarean section (CS) birth disturbs mother-to-neonate transmission. In this study (NCT03568734), we evaluated whether disturbed intestinal microbiota development could be restored in term CS-born infants by postnatal, orally delivered fecal microbiota transplantation (FMT).

Changes in emotions and personal goals in primiparous pregnant women during group intervention for fear of childbirth.

The changes in emotions, subjective fear of childbirth, and personal goals were examined during a group intervention to treat fear of childbirth (FOC). The objective was to gain a more detailed understanding of the changes occurring during the group intervention of FOC. The changes in emotions, subjective FOC, and personal goals were studied in primiparous pregnant women with severe FOC participating in a group intervention (n = 105).

Partners of nulliparous women with severe fear of childbirth: A longitudinal study of psychological well-being.

Background: Little is known about the psychological status of partners of women with severe fear of childbirth (FOC). In this longitudinal study from Helsinki University Central Hospital, we investigated FOC, depression, and posttraumatic stress in the partners of women with severe FOC, and possible effects of group psychoeducation and mode of birth.

Methods: During pregnancy, 250 partners of nulliparous women with severe FOC participated, 93 in the intervention group and 157 in the control group.

Life satisfaction, general well-being and costs of treatment for severe fear of childbirth in nulliparous women by psychoeducative group or conventional care attendance.

Objective: Fear of childbirth is a common reason for seeking cesarean section. It is important to consider outcomes and costs associated with alternative treatment and delivery mode. We compared well-being and costs of group psychoeducation and conventional care for fear of childbirth.

Complement activation and regulation in preeclamptic placenta.

Preeclampsia (PE) is a common disorder of pregnancy originating in the placenta. We examined whether excessive activation or poor regulation of the complement system at the maternal-fetal interface could contribute to the development of PE. Location and occurrence of complement components and regulators in placentae were analyzed.

Birth experience of women conceiving with assisted reproduction: a prospective multicenter study.

Objective: To determine how infertility and subsequent assisted reproductive treatment (ART) affect a woman's childbirth experience.

Design: Prospective multicenter case-control study.

Setting: We recruited women pregnant with a singleton fetus after either ART (n = 324) or spontaneous conception (n = 304) from five infertility clinics and one university maternity clinic in Finland.

[Fear of childbirth].

Fear of childbirth casts a shadow in 10% of the pregnancies. It can cause fear, mental illnesses and previous experiences of violence or bad experiences in giving birth. It is treated at the phobia clinic with the support of a midwife and an obstetrician.

Obstetric outcome after intervention for severe fear of childbirth in nulliparous women - randomised trial.

Objective: To compare the numbers of vaginal deliveries and delivery satisfaction among women with fear of childbirth randomised to either psychoeducation or conventional surveillance during pregnancy.

Design: Randomised controlled trial.

Setting: Maternity unit of Helsinki University Central Hospital.

Promoting positive motherhood among nulliparous pregnant women with an intense fear of childbirth: RCT intervention.

This RCT intervention among nulliparous pregnant women with an intense fear of childbirth sought to promote preparedness for childbirth and to enhance positive parenting. Pregnant women (n = 8,611) filled in a 'fear of childbirth' questionnaire. Nulliparous women with severe fear of childbirth (n = 355) were randomized into intervention (n = 131; 41 refused) and control (n = 224) groups.

Mental health problems common in women with fear of childbirth.

Objective: To investigate whether women with fear of childbirth have more mental health problems than women of childbearing age in general.

Design: Register-based retrospective study.

Setting: The maternity clinic of Helsinki University Central Hospital.

Elevated levels of decidual insulin-like growth factor binding protein-1 in cervical fluid in early and mid-pregnancy are associated with an increased risk of spontaneous preterm delivery.

Objective: To study whether elevated levels of decidual insulin-like growth factor binding protein-1 (IGFBP-1) in the cervical fluid of unselected asymptomatic women in early or mid-pregnancy are associated with spontaneous preterm delivery (PTD).

Design: Prospective population-based cohort study.

Setting: Maternity Clinics, University Central Hospital, Helsinki, Finland.

Cervical length measurement and cervical phosphorylated insulin-like growth factor binding protein-1 testing in prediction of preterm birth in patients reporting uterine contractions.

Objectives: To evaluate the performance of cervical phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) testing and cervical length measurement separately and in combination with physician's clinical judgment in prediction of preterm birth among patients with self-reported uterine contractions and intact membranes.

Design: We enrolled a total of 246 women between 22 and 34 weeks of gestation.

Methods: The initial evaluation included cervical length measurement using transvaginal ultrasonography.

Fear of childbirth according to parity, gestational age, and obstetric history.

Objective: To examine fear of childbirth according to parity, gestational age, and obstetric history.

Design: A questionnaire study.

Population And Setting: 1400 unselected pregnant women in outpatient maternity clinics of a university central hospital.

Long-term survival after postpartum liver rupture and necrosis requiring liver transplantation in a twin pregnancy.

A 32-year-old G6P5 (hepatitis B carrier, of African origin) with a spontaneous twin pregnancy gave birth at the 37th gestational week. Four hours later she collapsed. Upon an emergency laparotomy, right liver lobe rupture and later massive liver necrosis were diagnosed.

Longitudinal study on the predictors of parental stress in mothers and fathers of toddlers.

Aim: Longitudinal study on the predictors of parental stress in mothers and fathers of toddlers.

Background: To study whether anxiety, depression, or marital problems increase the parenting stress in parents of toddlers.

Methods: At early pregnancy, 2 - 3 months, and 2 - 3 years after delivery, 214 low-risk couples filled in questionnaires on their marital relationship, social support, child's temperament, and self-evaluated competence in routine care-taking.