25 research outputs found

    Technology for melting amber chips to produce a solid block

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    This research is relevant, because the bulk of the mined amber comes in amber chips. Therefore, we have decided to review the current ways of melting amber chips to develop the most technologically efficient algorithm and to use it further for producing decorative items. The purpose of the work is to perfect the technology of obtaining whole-piece amber from amber chips and to explore the usability of the obtained material in decorative items and jewelry

    Anxiety reduction through obstetric consultation combined with ultrasound examination in women after cesarean section

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    Background: Women are at increased risk of developing anxiety or depression disorders after Cesarean section (CS). This study aims to evaluate whether an appointment with a senior obstetrician combined with an ultrasound examination reduces levels of anxiety in women after CS. Methods: A prospective observational study was conducted in Sweden. Women underwent an appointment with an obstetrician 6–9 months after their first CS. Before the appointment, women were asked to fill in the state and trait subscales of the Spielberger State-Trait Anxiety Inventory and the Beck's Depression Inventory. The women's experience of the childbirth was discussed and an ultrasound examination of the hysterotomy scar was performed. After the appointment, the participants filled in the state scale again. The women were divided into low trait anxiety (< 40) and high trait anxiety (≄ 40) groups for comparisons. Results: 147 women were included. Of those, 114 (78%) had lower trait score <40 (mean 29.2 ± 5.4) and 33 (22%) had higher trait score ≄ 40 (mean 47.4 ± 6.5). Mean difference of state score in the low trait anxiety group before and after the examination was 4.8 ± 5.6 (95% CI 7.20 to 11.97, p<0.0001) and in the high trait anxiety group, the mean difference was 9.2 ± 6.5 (95% CI 3.77 to 5.82, p<0.0001). Limitations: A clinical examination with a diagnosis of depression in these women was not made by a psychiatrist. Conclusions: A supportive obstetric consultation combined with an ultrasound examination of the uterine scar decreased anxiety levels in women after CS, particularly in patients with higher anxiet

    Assessment of Cesarean hysterotomy scar before pregnancy and at 11–14 weeks of gestation : a prospective cohort study

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    Objective: To compare the appearance and measurement of Cesarean hysterotomy scar before pregnancy and at 11–14 weeks in a subsequent pregnancy. Methods: This was a prospective cohort study of women aged 18–35 years who had one previous Cesarean delivery (CD) at ≄ 37 weeks. Women were examined with saline contrast sonohysterography 6–9 months after CD. A scar defect was defined as large if scar thickness was ≀ 2.5 mm. Women were followed up and those who became pregnant were examined by transvaginal ultrasound at 11–14 weeks. Scar thickness was measured and scars were classified subjectively as a scar with or without a large defect. A receiver–operating characteristics curve was constructed to determine the best cut-off value for scar thickness to define a large scar defect at the 11–14-week scan. Results: A total of 111 women with a previous CD were scanned in the non-pregnant state and at 11–14 weeks in a subsequent pregnancy. The best cut-off value for scar thickness to define a large scar defect at 11–14 weeks was 2.85 mm, which had 90% sensitivity (18/20), 97% specificity (88/91) and 95% accuracy (106/111). In the non-pregnant state, large scar defects were found in 18 (16%) women and all were confirmed at the 11–14-week scan. In addition, a large defect was found in three women at 11–14 weeks that was not identified in the non-pregnant state. Conclusion: The appearance of the Cesarean hysterotomy scar was similar in the non-pregnant state and at 11–14 weeks in a subsequent pregnancy

    Assessment of Cesarean hysterotomy scar before pregnancy and at 11-14 weeks of gestation: a prospective cohort study

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    Objective To compare the appearance and measurement of Cesarean hysterotomy scar before pregnancy and at 11–14 weeks in a subsequent pregnancy. Methods This was a prospective cohort study of women aged 18–35 years who had one previous Cesarean delivery (CD) at ≄ 37 weeks. Women were examined with saline contrast sonohysterography 6–9 months after CD. A scar defect was defined as large if scar thickness was ≀ 2.5 mm. Women were followed up and those who became pregnant were examined by transvaginal ultrasound at 11–14 weeks. Scar thickness was measured and scars were classified subjectively as a scar with or without a large defect. A receiver–operating characteristics curve was constructed to determine the best cut‐off value for scar thickness to define a large scar defect at the 11–14‐week scan. Results A total of 111 women with a previous CD were scanned in the non‐pregnant state and at 11–14 weeks in a subsequent pregnancy. The best cut‐off value for scar thickness to define a large scar defect at 11–14 weeks was 2.85 mm, which had 90% sensitivity (18/20), 97% specificity (88/91) and 95% accuracy (106/111). In the non‐pregnant state, large scar defects were found in 18 (16%) women and all were confirmed at the 11–14‐week scan. In addition, a large defect was found in three women at 11–14 weeks that was not identified in the non‐pregnant state. Conclusion The appearance of the Cesarean hysterotomy scar was similar in the non‐pregnant state and at 11–14 weeks in a subsequent pregnancy

    Validation of prediction model for successful vaginal birth after Cesarean delivery based on sonographic assessment of hysterotomy scar

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    Objective: To validate a prediction model for successful vaginal birth after Cesarean delivery (VBAC) based on sonographic assessment of the hysterotomy scar, in a Swedish population. Methods: Data were collected from a prospective cohort study. We recruited non-pregnant women aged 18–35 years who had undergone one previous low-transverse Cesarean delivery at ≄ 37 gestational weeks and had had no other uterine surgery. Participants who subsequently became pregnant underwent transvaginal ultrasound examination of the Cesarean hysterotomy scar at 11 + 0 to 13 + 6 and at 19 + 0 to 21 + 6 gestational weeks. Thickness of the myometrium at the thinnest part of the scar area was measured. After delivery, information on pregnancy outcome was retrieved from hospital records. Individual probabilities of successful VBAC were calculated using a previously published model. Predicted individual probabilities were divided into deciles. For each decile, observed VBAC rates were calculated. To assess the accuracy of the prediction model, receiver–operating characteristics curves were constructed and the areas under the curves (AUC) were calculated. Results: Complete sonographic data were available for 120 women. Eighty (67%) women underwent trial of labor after Cesarean delivery (TOLAC) with VBAC occurring in 70 (88%) cases. The scar was visible in all 80 women at the first-trimester scan and in 54 (68%) women at the second-trimester scan. AUC was 0.44 (95% CI, 0.28–0.60) among all women who underwent TOLAC and 0.51 (95% CI, 0.32–0.71) among those with the scar visible sonographically at both ultrasound examinations. Conclusion: The prediction model demonstrated poor accuracy for prediction of successful VBAC in our Swedish population

    Hysterotomy level at Cesarean section and occurrence of large scar defects : a randomized single-blind trial

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    Objective: To study the association between the level of Cesarean hysterotomy and the presence of large uterine scar defects 6–9 months after delivery. Methods: This was a two-center, randomized, single-blind trial of a surgical procedure with masked assessment of the principal outcome under study. Women without a history of Cesarean section (CS) who underwent emergency CS at cervical dilatation ≄ 5 cm were randomized to high or low incision. Hysterotomy was performed 2 cm above and 2 cm below the plica vesicouterina in the high and low incision groups, respectively. Women were examined using saline contrast sonohysterography to assess the appearance of the hysterotomy scar 6–9 months after delivery. The main outcome was presence of a large scar defect, defined as the remaining myometrial thickness over the defect being ≀ 2.5 mm. Secondary outcomes were perinatal outcome, operative complications within 8 weeks after delivery and long-term outcome in a subsequent pregnancy. Results: Of 122 patients enrolled in the trial, 114 were assessed by ultrasound examination, of whom 55 were randomized to high and 59 to low CS incision. Large scar defects were seen in four (7%) women in the high-incision group and in 24 (41%) in the low-incision group (P < 0.001; odds ratio, 8.7 (95% CI, 2.8–27.4)). There were no differences in operative complications and perinatal outcomes between the two groups. The median follow-up time was 4 years and 7 months, during which 56 (49%) women had a subsequent pregnancy. No significant differences were observed in the rate of complications in subsequent pregnancy and delivery between women who had low and those who had high incision at the index CS. Conclusion: Low Cesarean hysterotomy level in women in advanced labor is associated with higher incidence of large scar defects detected by transvaginal ultrasound examination 6–9 months after delivery
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