Publications (13) View all
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Article: Feasibility and clinical effects of laparoscopic abdominal cerclage: an observational study.
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ABSTRACT: Objective: To evaluate the effect of laparoscopic abdominal cerclage performed as an interval procedure in non-pregnant women at high risk of second trimester spontaneous abortion and early preterm birth. Design: Observational study. Sample: Fifty-two consecutive patients at high risk of preterm birth. Setting: Department of Obstetrics and Gynecology, Aarhus University Hospital. Methods: Patients were registered prospectively. Indications for surgery included classical cervical insufficiency, preterm premature rupture of membranes (PPROM) or two conizations/cervical amputation. Outcome of subsequent pregnancies was registered. Main outcome measure: Gestational age in subsequent pregnancies. Results: No operative or postoperative complications were observed. A total of 45 pregnancies were registered during the observation period. Among 36 pregnancies lasting beyond 16th week of gestation, 30 women (83.3%) gave birth by cesarean section after 36 weeks of gestation and the overall mean gestational age was 37.4 weeks compared to a mean gestational age of 25.2 weeks of the pregnancies prior to the cerclage. The cesarean sections were uncomplicated in all but one patient, where a re-laparotomy was needed six hours later due to atonic postpartum hemorrhage.without evident bleeding through the cervix. Conclusion: Laparoscopic abdominal cerclage is a feasible and safe procedure. Obstetrical outcomes are encouraging, but prospective studies are needed to define the effectiveness of the laparoscopic cerclage compared to the traditional transvaginal approach.Acta Obstetricia Et Gynecologica Scandinavica 09/2012; · 1.77 Impact Factor -
Article: Diagnosis and treatment of rectovaginal endometriosis: an overview.
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ABSTRACT: Rectovaginal endometriosis can be a cause of severe pain, dyspareunia and intestinal problems. A thorough examination is needed and should include diagnostic imaging, such as transvaginal or transrectal ultrasound or magnetic resonance imaging. Medical therapies, such as oral contraceptives, progestins and levonorgestrel-releasing intrauterine devices, all seem to reduce pain and should always be considered. Surgical treatment is challenging and implies a risk of severe complications. It is preferable to treat endometriotic lesions with superficial infiltration into the rectal wall by local laparoscopic excision, while segmental rectal resection is needed in the case of severe intestinal infiltration. This review describes available diagnostic tools, the possibilities for medical treatment and the alternative surgical approaches.Acta Obstetricia Et Gynecologica Scandinavica 01/2012; 91(6):648-57. · 1.77 Impact Factor -
Article: Transvaginal ultrasonography of rectosigmoid endometriosis: interobserver variation of lesion size.
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ABSTRACT: This study evaluates the interobserver variation of transvaginal ultrasonographic measurements of the size of deep infiltrating endometriosis lesions in the rectosigmoid wall performed by an experienced and a less experienced sonographer. Fifteen outpatient women were seen for a gynecologic examination and 24 women were seen with rectosigmoid endometriosis. Transvaginal ultrasonography was performed independently by two observers with a focus on the presence and size of rectosigmoid endometriosis. The senior observer had several years of experience, whereas the junior observer was a medical student with no prior experience in transvaginal ultrasonography. The findings of the two observers were identical concerning the identification of rectosigmoid endometriosis. The probability of differences in size within 30% of the mean was 0.81, 0.63 and 0.61 for length, width and depth, respectively. Our data suggest that fair skills in this technique can be acquired by inexperienced examiners within a short period of time.Acta Obstetricia Et Gynecologica Scandinavica 11/2011; 91(2):264-8. · 1.77 Impact Factor -
Article: Three-dimensional ultrasound of deep infiltrating endometriosis involving the rectosigmoid colon.
Acta Obstetricia Et Gynecologica Scandinavica 01/2011; 90(1):122-5. · 1.77 Impact Factor -
Article: Association of Interleukin‐10 Promoter Polymorphism and Endometriosis
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ABSTRACT: Citation Riiskjaer M, Nielsen K, Steffensen R, Erikstrup C, Forman A, Kruse C. Association of Interleukin-10 Promoter Polymorphism and Endometriosis. Am J Reprod Immunol 2011; 65: 13–19Problem Inflammatory processes are believed to play an important role in the pathogenesis of endometriosis. Interleukin-10 (IL-10) is an important immunoregulatory cytokine. The biological actions are mainly inhibitory including inactivation of macrophages and inhibition of pro-inflammatory cytokines. Twin and family studies have shown that between 50 and 75% of the observed variability of IL-10 secretion was explained by genetic factors. Several single nucleotide polymorphisms (SNPs) in the promoter region of IL-10 have been described, but the most investigated are located at positions −1082, −819 and −592 of the transcriptional start site.Method of Study Three SNPs in the promoter region of IL-10 (−1082)G>A, (−819)C>T and (−592)C>A were examined in 100 Danish patients with endometriosis and 358 healthy Danish blood donors, and haplotype associations were tested.Results We observed no strong single IL-10 marker effects and no single haplotype showed significant association. However, the ACC/ACC genotype showed a significant association because this genotype was significantly higher among patients with endometriosis than in healthy controls [OR = 3.55 (CI = 1.42–18.92); P = 0.006].Conclusion Our results suggest that the IL-10 ACC/ACC genotype, which is known to be a ‘low-producer’ of IL-10, is associated with endometriosis.American Journal Of Reproductive Immunology 07/2010; 65(1):13 - 19. · 2.17 Impact Factor
