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  • 1.
    Bauer, Margit
    et al.
    Med Univ Graz, Dept Obstet & Gynecol, Graz, Austria..
    Mazza, Edoardo
    Swiss Fed Inst Technol, Dept Mech & Proc Engn, Zurich, Switzerland..
    Jabareen, Mahmood
    Swiss Fed Inst Technol, Dept Mech & Proc Engn, Zurich, Switzerland..
    Sultan, Leila
    Univ Zurich Hosp, Dept Obstet & Gynecol, CH-8091 Zurich, Switzerland..
    Bajka, Michael
    Univ Zurich Hosp, Dept Obstet & Gynecol, CH-8091 Zurich, Switzerland..
    Lang, Uwe
    Med Univ Graz, Dept Obstet & Gynecol, Graz, Austria..
    Zimmermann, Roland
    Univ Zurich Hosp, Dept Obstet & Gynecol, CH-8091 Zurich, Switzerland..
    Holzapfel, Gerhard A.
    KTH, School of Electrical Engineering (EES).
    In Vivo Biomechanical Testing of the Human Uterine Cervix in Pregnancy Using an Aspiration Device2009In: Reproductive Sciences, ISSN 1933-7191, E-ISSN 1933-7205, Vol. 16, no 3, p. 197A-197AArticle in journal (Other academic)
  • 2. Gyllencreutz, Erika
    et al.
    Lu, Ke
    KTH, School of Technology and Health (STH), Medical Engineering.
    Abtahi, Farhad
    KTH, School of Technology and Health (STH), Medical Engineering, Computer and Electronic Engineering.
    Lindecrantz, Kaj
    KTH, School of Technology and Health (STH), Medical Engineering, Computer and Electronic Engineering.
    Nordström, Lennart
    Lindqvist, Pelle
    Holzmann, Malin
    Characteristics of variable decelerations and prediction of fetal acidemia2017In: American Journal of Obstetrics and Gynecology, ISSN 0002-9378, E-ISSN 1097-6868, Vol. 216, no 1, p. S507-S507Article in journal (Other academic)
  • 3.
    Gyllencreutz, Erika
    et al.
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Ostersund Hosp, Dept Obstet & Gynecol, S-83183 Region Jamtland Harjedal, Ostersund, Sweden..
    Lu, Ke
    KTH, School of Technology and Health (STH).
    Lindecrantz, Kaj
    KTH, School of Technology and Health (STH). Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Lindqvist, Pelle G.
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.;Karolinska Univ Hosp, Pregnancy & Delivery Care, Stockholm, Sweden..
    Nordström, Lennart
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Karolinska Univ Hosp, Pregnancy & Delivery Care, Stockholm, Sweden..
    Holzmann, Malin
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Karolinska Univ Hosp, Pregnancy & Delivery Care, Stockholm, Sweden..
    Abtahi, Farhad
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden.;Karolinska Univ Hosp Huddinge, Dept Clin Physiol, Stockholm, Sweden..
    Validation of a computerized algorithm to quantify fetal heart rate deceleration area2018In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 97, no 9, p. 1137-1147Article in journal (Refereed)
    Abstract [en]

    IntroductionReliability in visual cardiotocography interpretation is unsatisfying, which has led to the development of computerized cardiotocography. Computerized analysis is well established for antenatal fetal surveillance but has yet not performed sufficiently during labor. We aimed to investigate the capacity of a new computerized algorithm compared with visual assessment in identifying intrapartum fetal heart rate baseline and decelerations. Material and methodsIn all, 312 intrapartum cardiotocography tracings with variable decelerations were analyzed by the computerized algorithm and visually examined by two observers, blinded to each other and the computer analysis. The width, depth and area of each deceleration was measured. Four cases (>100 variable decelerations) were subjected to in-depth detailed analysis. The outcome measures were bias in seconds (width), beats per minute (depth), and beats (area) between computer and observers using Bland-Altman analysis. Interobserver reliability was determined by calculating intraclass correlation and Spearman rank analysis. ResultsThe analysis (312 cases) showed excellent intraclass correlation (0.89-0.95) and very strong Spearman correlation (0.82-0.91). The detailed analysis of >100 decelerations in four cases revealed low bias between the computer and the two observers; width 1.4 and 1.4 seconds, depth 5.1 and 0.7 beats per minute, and area 0.1 and -1.7 beats. This was comparable to the bias between the two observers: 0.3 seconds (width), 4.4 beats per minute (depth) and 1.7 beats (area). The intraclass correlation was excellent (0.90-.98). ConclusionA novel computerized algorithm for intrapartum cardiotocography analysis is as accurate as gold standard visual assessment, with high correlation and low bias.

  • 4.
    Herling, L.
    et al.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Obstet & Gynecol, Ctr Fetal Med, Stockholm, Sweden..
    Johnson, Jonas
    KTH, School of Technology and Health (STH), Medical Engineering. Karolinska Univ Hosp, Dept Obstet & Gynecol, Ctr Fetal Med, Stockholm, Sweden.
    Ferm-Widlund, K.
    Karolinska Univ Hosp, Dept Obstet & Gynecol, Ctr Fetal Med, Stockholm, Sweden..
    Bergholm, Fredrik
    KTH, School of Technology and Health (STH), Medical Engineering.
    Lindgren, P.
    Karolinska Univ Hosp, Dept Obstet & Gynecol, Ctr Fetal Med, Stockholm, Sweden..
    Sonesson, S. -E
    Acharya, G.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Obstet & Gynecol, Ctr Fetal Med, Stockholm, Sweden.;UiT Arctic Univ Norway, Dept Clin Med, Womens Hlth & Perinatol Res Grp, Tromso, Norway..
    Westgren, M.
    Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Obstet & Gynecol, Ctr Fetal Med, Stockholm, Sweden..
    Automated analysis of fetal cardiac function using color tissue Doppler imaging2018In: Ultrasound in Obstetrics and Gynecology, ISSN 0960-7692, E-ISSN 1469-0705, Vol. 52, no 5, p. 599-608Article in journal (Refereed)
    Abstract [en]

    Objective To evaluate the feasibility of automated analysis of fetal myocardial velocity recordings obtained by color tissue Doppler imaging (cTDI). Methods This was a prospective cross-sectional observational study of 107 singleton pregnancies >= 41 weeks of gestation. Myocardial velocity recordings were obtained by cTDI in a long-axis four-chamber view of the fetal heart. Regions of interest were placed in the septum and the right (RV) and left (LV) ventricular walls at the level of the atrioventricular plane. Peak myocardial velocities and mechanical cardiac time intervals were measured both manually and by an automated algorithm and agreement between the two methods was evaluated. Results In total, 321 myocardial velocity traces were analyzed using each method. It was possible to analyze all velocity traces obtained from the LV, RV and septal walls with the automated algorithm, and myocardial velocities and cardiac mechanical time intervals could be measured in 96% of all traces. The same results were obtained when the algorithm was run repeatedly. The myocardial velocities measured using the automated method correlated significantly with those measured manually. The agreement between methods was not consistent and some cTDI parameters had considerable bias and poor precision. Conclusions Automated analysis of myocardial velocity recordings obtained by cTDI was feasible, suggesting that this technique could simplify and facilitate the use of cTDI in the evaluation of fetal cardiac function, both in research and in clinical practice.

  • 5. Juth, Niklas
    et al.
    Tannsjö, Torbjörn
    Hansson, Sven-Ove
    KTH, School of Architecture and the Built Environment (ABE), Philosophy and History of Technology, Philosophy.
    Lynöe, Niels
    Honour-related threats and human rights: A qualitative study of Swedish healthcare providers' attitudes towards young women requesting a virginity certificate or hymen reconstruction2013In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 18, no 6, p. 451-459Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate the preferred actions of healthcare staff, as well as their reasoning and attitudes about young females' requests for a virginity certificate or hymen restoration. Method A qualitative study, consisting of semi-structured interviews of healthcare providers from different parts of Sweden and from different medical specialties and professions, who had experience of women who asked for a virginity certificate or a hymen repair. Results Using content analysis, ten themes emerged regarding healthcare personnel's attitudes and reasoning about young female patients and their requests for demonstration of virginity. The themes logically were categorised as values, beliefs, and cultural affiliation. Conclusions Responders had a more pragmatic and permissive view than the restrictive, official Swedish policy opposing hymenoplasties within the public healthcare system. There were degrees of willingness to accommodate such requests, due, for example, to different moral beliefs and medical concerns. Responders expressed frustration over the difficulty of following up patients, a situation likely due to the restrictive policy. The patient-centred approach adopted by a Dutch team of health professionals would probably better enable quality assurance.

  • 6.
    Lu, Ke
    et al.
    KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Health Informatics. Royal Inst Technol, Stockholm, Sweden..
    Holzmann, M.
    Karolinska Inst, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Obstet & Gynecol, Stockholm, Sweden..
    Abtahi, F.
    Karolinska Inst, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Clin Physiol, Stockholm, Sweden..
    Lindecrantz, Kaj
    KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Health Informatics. Karolinska Univ Hosp, Dept Clintec, Stockholm, Sweden..
    Lindqvist, P.
    Karolinska Inst, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Clintec, Stockholm, Sweden..
    Nordström, L.
    Karolinska Inst, Stockholm, Sweden..
    Fetal heart rate short term variation (STV) during labour in relation to early stages of hypoxia: An observational study2018In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 125, p. 55-55Article in journal (Other academic)
  • 7.
    Lu, Ke
    et al.
    KTH, School of Technology and Health (STH).
    Holzmann, Malin
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Karolinska Univ Hosp, Patient Area Pregnancy & Delivery Care, Stockholm, Sweden..
    Abtahi, Fahrad
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden.;Karolinska Univ Hosp Huddinge, Dept Clin Physiol, Stockholm, Sweden..
    Lindecrantz, Kaj
    KTH, School of Technology and Health (STH). Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Lindqvist, Pelle G.
    Karolinska Univ Hosp, Patient Area Pregnancy & Delivery Care, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Nordström, Lennart
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Karolinska Univ Hosp, Patient Area Pregnancy & Delivery Care, Stockholm, Sweden..
    Fetal heart rate short term variation during labor in relation to scalp blood lactate concentration2018In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 97, no 10, p. 1274-1280Article in journal (Refereed)
    Abstract [en]

    IntroductionFetal heart rate short term variation (STV) decreases with severe chronic hypoxia in the antenatal period. However, only limited research has been done on STV during labor. We have tested a novel algorithm for a valid baseline estimation and calculated STV. To explore the value of STV during labor, we compared STV with fetal scalp blood (FBS) lactate concentration, an early marker in the hypoxic process. Material and methodsSoftware was developed which estimates baseline frequency using a novel algorithm and thereby calculates STV according to Dawes and Redman in up to four 30-minute blocks prior to each FBS. Cardiotocography traces from 1070 women in labor who had had FBS performed on 2134 occasions were analyzed. ResultsIn acidemic cases (lactate >4.8mmol/L; Lactate Pro), median STV 30minutes prior to FBS was 7.10milliseconds compared with 6.09milliseconds in the preacidemic (4.2-4.8mmol/L) and 5.23milliseconds in the normal (<4.2mmol/L) groups (P<.05). There was a positive correlation between lactate and STV (rho=0.16-0.24; P<.05). Median lactate concentration in cases with STV <3.0milliseconds (n=160) was 2.3mmol/L. When 2 FBS were performed within 60minutes the change rate of lactate correlated to STV (rho=0.33; P<.001). Cases with increasing lactate concentration had a median STV of 5.29milliseconds vs 4.41milliseconds in those with decreasing lactate (P<.001). ConclusionsIn the early stages of intrapartum hypoxia, STV increases, contrary to findings regarding chronic hypoxia in the antenatal period. The increase in the adrenergic surge is a likely explanation.

  • 8. Pettersson, K.
    et al.
    Ajne, J.
    Yousaf, K.
    Sturm, Dennis
    KTH, School of Technology and Health (STH).
    Westgren, M.
    Ajne, G.
    Traction force during vacuum extraction: a prospective observational study2015In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, no 13, p. 1809-1816Article in journal (Refereed)
    Abstract [en]

    ObjectiveTo investigate the traction force employed during vacuum extractions. DesignObservational cross-sectional study. SettingObstetric Department, Karolinska University Hospital, Sweden, and the Swedish National Congress of Obstetrics and Gynaecology, 2013. PopulationTwo hundred women with vacuum extraction at term and 130 obstetricians participating in a simulated setting. MethodsIn a normal clinical setting, we used a specially adapted device to measure and record the force used to undertake vacuum extraction. In a subsequent part of the study, the force employed for vacuum extraction by a group of obstetricians in a fictive setting was estimated and objectively measured. Main outcome measuresApplied force during vacuum extraction in relation to the estimated level of difficulty in the delivery; perinatal diagnoses of asphyxia or head trauma; estimated force compared with objectively measured force employed in the fictive setting. ResultsThe median (minimum-maximum) peak forces for minimum, average and excessive vacuum extraction in the clinical setting were 176N (5-360N), 225N (115-436N), and 241N (164-452N), respectively. In 34% of cases a force in excess of 216N was employed. There was no correlation between the umbilical arterial pH at delivery and the traction force employed during extraction. Four cases of mild hypoxic ischaemic encephalopathy were observed, three of which were associated with a delivery whereby excessive traction force was employed during the vacuum extraction. In the fictive setting, the actual exerted force was twice the quantitative estimation. The measured forces in the clinical setting were four times higher than that estimated in the fictive setting. ConclusionsHigher than expected levels of traction force were used for vacuum extraction delivery. As obstetricians tend to underestimate the force applied during vacuum extraction, objective measurement with instantaneous feedback may be valuable in raising awareness.

  • 9.
    Salafia, C.
    et al.
    Placental Analyt LLC, Larchmont, NY 10538 USA.;New York State Inst Basic Res Dev Disabil, Staten Isl, NY 10314 USA..
    Yampolsky, M.
    Univ Toronto, Toronto, ON, Canada..
    Volk, Denis
    KTH, School of Engineering Sciences (SCI), Mathematics (Dept.).
    Stodgell, C. J.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;Univ Rochester, Sch Med & Dent, Rochester, NY USA..
    Katzman, P. J.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;Univ Rochester, Sch Med & Dent, Rochester, NY USA..
    Culhane, J.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA..
    Landrigan, P.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;Mt Sinai Sch Med, New York, NY USA..
    Szabo, S.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;Med Coll Wisconsin, Milwaukee, WI 53226 USA..
    Thieux, N.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;S Dakota State Univ, Brookings, SD 57007 USA..
    Swanson, J.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;Univ Calif Irvine, Irvine, CA USA..
    Dole, N.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;Univ N Carolina, Chapel Hill, NC USA..
    Varner, M. W.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;Univ Utah, Salt Lake City, UT USA..
    Moye, J.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;NIH, Natl Childrens Study, Bethesda, MD 20892 USA..
    Miller, R.
    Natl Childrens Study Placenta Consortium, Bethesda, MD USA.;Univ Rochester, Sch Med & Dent, Rochester, NY USA..
    Mapping placental topology from 3D scans, the graphic display of variation in arborisation across gestation (vol 34, pg A73, 2013)2014In: Placenta, ISSN 0143-4004, E-ISSN 1532-3102, Vol. 35, no 1, p. 75-75Article in journal (Refereed)
  • 10. Wågström, Elle
    et al.
    Johnson, Jonas
    KTH, School of Technology and Health (STH), Medical Engineering.
    Ferm-Widlund, Kjerstin
    Elmstedt, Nina
    KTH, School of Technology and Health (STH), Medical Engineering.
    Liuba, Karina
    Lind, Britta
    KTH, School of Technology and Health (STH), Medical Engineering.
    Brodin, Lars-Åke
    KTH, School of Technology and Health (STH), Medical Engineering.
    Westgren, Magnus
    The Cardiac State Diagram as a novel approach for evaluation of phases of the cardiac cycle in asfyxiated fetal lambs2012In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 91, p. 144-144Article in journal (Other academic)
1 - 10 of 10
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