Harald Almström
Karolinska Institutet
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Featured researches published by Harald Almström.
The Lancet | 1992
Harald Almström; Gunvor Ekman; Ove Axelsson; Ulf Ulmsten; Sven Cnattingius; Alf Maesel; Karel Marsal; K. Årström
Intrauterine growth retardation is associated with an increased risk of fetal asphyxia as well as greater perinatal morbidity and mortality. Ultrasound fetometry enables detection of fetuses that are small for gestational age. Doppler velocimetry of the umbilical artery has good predictive ability for fetal distress, but it is not yet clear whether it could replace cardiotocography in antenatal surveillance of small-for-gestational-age fetuses. We have done a randomised comparison of the two methods. At four obstetric departments in Sweden, women with fetuses found to be small on ultrasound examination at 31 completed weeks of pregnancy or later were randomly assigned to antenatal surveillance with either doppler velocimetry (doppler; 214) or cardiotocography (CTG; 212). Pregnancies in the doppler group were managed according to a protocol based on blood-flow classes deriving from the semiquantitative evaluation of umbilical-artery velocity waveforms; unless the pregnancy was complicated by any other disorder, no antenatal cardiotocography was done. By comparison with the CTG group, the doppler group had fewer monitoring occasions (mean 4.1 [SD 3.1] vs 8.2 [6.2], p < 0.01), antenatal hospital admissions (68 [31.3%] vs 97 [45.8%], p < 0.01), inductions of labour (22 [10.3%] vs 46 [21.7%], p < 0.01), emergency caesarean sections for fetal distress (11 [5.1] vs 30 [14.2%], p < 0.01), and admissions to neonatal intensive care (76 [35.5%] vs 92 [43.4%], p = 0.10). The groups did not differ in gestational age at birth, birthweight, Apgar scores, or total number of caesarean deliveries. Umbilical-artery doppler velocimetry of small-for-gestational-age fetuses allows antenatal monitoring and obstetric interventions to be aimed more precisely than does cardiotocography.
British Journal of Obstetrics and Gynaecology | 2006
Sissel Saltvedt; Harald Almström; Marius Kublickas; Lil Valentin; Charlotta Grunewald
Objective To compare the antenatal detection rate of malformations in chromosomally normal fetuses between a strategy of offering one routine ultrasound examination at 12 gestational weeks (gws) and a strategy of offering one routine examination at 18 gws.
Ultrasound in Obstetrics & Gynecology | 2005
Povilas Sladkevicius; Sissel Saltvedt; Harald Almström; Marius Kublickas; Charlotta Grunewald; Lil Valentin
To determine the accuracy of established ultrasound dating formulae when used at 12–14 weeks of gestation.
British Journal of Obstetrics and Gynaecology | 2006
Maria-Dorothea Westin; Sissel Saltvedt; G Bergman; Marius Kublickas; Harald Almström; Charlotta Grunewald; Lil Valentin
Objective To compare the rate of prenatal diagnosis of heart malformations between two policies of screening for heart malformations.
Ultrasound in Obstetrics & Gynecology | 2006
Maria-Dorothea Westin; Sissel Saltvedt; G Bergman; Harald Almström; Charlotta Grunewald; Lil Valentin
To determine the performance of nuchal translucency thickness (NT) measurement as a screening method for congenital heart defects (CHD) among fetuses with normal karyotype.
Ultrasound in Obstetrics & Gynecology | 2005
Sissel Saltvedt; Harald Almström; Marius Kublickas; Lil Valentin; R Bottinga; Th Bui; Maria Cederholm; P Conner; B Dannberg; Peter Malcus; A. Marsk; Charlotta Grunewald
Nuchal translucency (NT) screening increases antenatal detection of Down syndrome (DS) compared to maternal age‐based screening. We wanted to determine if a change in policy for prenatal diagnosis would result in fewer babies born with DS.
Ultrasound in Obstetrics & Gynecology | 2007
Maria-Dorothea Westin; Sissel Saltvedt; Harald Almström; Charlotta Grunewald; Lil Valentin
In this study we aimed to estimate the magnitude of a possible increase in risk of adverse outcome in fetuses with normal karyotype and increased nuchal translucency (NT), and to determine how well NT measurements can distinguish between fetuses with normal and adverse outcome.
Acta Obstetricia et Gynecologica Scandinavica | 1999
Sissel Saltvedt; Harald Almström
BACKGROUND Recent studies have debated the safety of early amniocentesis, one of which reported a significant increase in spontaneous fetal losses following amniocentesis performed at 10-13 weeks of gestation. The aim of this study was to determine the fetal loss rate following amniocentesis performed at different stages in the second trimester. METHODS One thousand six hundred and fifty-one consecutive amniocenteses undertaken in a low risk population between 13 weeks+0 days and 20 weeks+6 days were evaluated. In 87% of the women the reason for testing was maternal age (mean 37.1 years). Data concerning patients, procedure details and pregnancy outcome were recorded. RESULTS Spontaneous abortion before 28 weeks of gestation occurred in 1.1%, one third of which were within two weeks and the remaining within seven weeks after the procedure. The fetal loss rate was higher when the amniocentesis was performed earlier in pregnancy, at 13 weeks+0 days exceeding 3%. Abnormal color of the amniotic fluid and leakage of amniotic fluid were strong predictors of fetal loss. Transplacental needle insertion did not increase the risk of pregnancy loss. CONCLUSION Amniocentesis performed very early in the second trimester is followed by an increased fetal loss rate that cannot be explained solely by a higher risk of spontaneous abortion at this time of gestation.
Acta Obstetricia et Gynecologica Scandinavica | 1995
Harald Almström; Lena Granström; Gunver Ekman
Objective. In view of the increased risk of obstetric and perinatal complications in post‐term pregnancy, and the lack of consensus regarding clinical routines for fetal surveillance and labor induction, the aim of this prospective controlled study was to compare obstetric and perinatal outcome after serial monitoring until 43 weeks of gestation with that after labor induction at 42 gestational weeks.
Acta Oncologica | 1995
Folke Flam; Harald Almström; Ann-Cathrin Hellström; Birgitta Moberger
Twenty-seven women with endometrial cancer were studied with Doppler ultrasound coupled with a vaginal probe. Pulsatility index of the flow velocity of the uterine artery was recorded and compared to that of a control group. The subjects and the controls did not differ in blood flow measurements. There was no correlation between severity of disease and flow velocimetry values. Eleven of the patients underwent brachytherapy prior to surgery. Administration of brachytherapy resulted in a decrease of the peripheral resistance. The results of this study indicate that Doppler velocimetry of the uterine artery is not a valuable tool in discriminating between malignant and benign endometrium.