Pelle Lindqvist
Karolinska Institutet, CLINTEC, Faculty Member
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Venous thromboembolism (VTE) is a major cause of mortality during Western women's fertile life. Although half of thromboembolic events occur during times of low-risk situations, almost all our knowledge is... more
Venous thromboembolism (VTE) is a major cause of mortality during Western women's fertile life. Although half of thromboembolic events occur during times of low-risk situations, almost all our knowledge is focused on medical thromboprophylaxis during high-risk situations. Thus, since we only use medical thromboprophylaxis at high-risk periods, lifestyle advice could be an attractive complement both during high- and low-risk situations. The knowledge of how lifestyle factors affect VTE risk has grown in recent years, and women at high risk are often highly motivated to make changes in order to reduce their risk. This review is focused on modifiable risk factors for VTE and advice that may be given to women at increased risk of VTE.
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Cardiotocography (CTG) has high sensitivity, but less specificity in detection of fetal hypoxia. There is need for adjunctive methods easy to apply during labor. Low fetal heart rate short term variation (STV) is predictive for hypoxia... more
Cardiotocography (CTG) has high sensitivity, but less specificity in detection of fetal hypoxia. There is need for adjunctive methods easy to apply during labor. Low fetal heart rate short term variation (STV) is predictive for hypoxia during the antenatal period. The objectives of our study were to methodologically evaluate monitoring of STV during labor and to compare two different monitors (Sonicaid™ and EDAN™) for antenatal use. A prospective observational study at the obstetric department, Karolinska University hospital, Stockholm (between September 2011 and April 2015). In 100 women of ≥ 36 weeks gestation, STV values were calculated during active labor. In a subset of 20 women we compared STV values between internal and external signal acquisition. Additionally we compared antenatal monitoring with two different monitors in another 20 women. Median STV in 100 fetuses monitored with scalp electrode during labor (EDAN™) was 7.1 msec (range 1.3-25.9) with no difference between e...
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To investigate seasonality in onset and incidence of central retinal vein occlusion (CRVO) in Stockholm, Sweden. A retrospective consecutive population-based case series of patients presenting to the emergency department with CRVO from... more
To investigate seasonality in onset and incidence of central retinal vein occlusion (CRVO) in Stockholm, Sweden. A retrospective consecutive population-based case series of patients presenting to the emergency department with CRVO from January 2008 through December 2013 at the St Erik Eye Hospital. Date, age at occurrence and sex were recorded in the study cohort. A total of 854 patients presented with CRVO during the study period. Peak CRVO onset occurred during the winter/spring period and was significantly higher than during the summer/autumn period. The number of patients presenting by season were: 166 (28.8%, 95% confidence interval, CI, 25.3-32.6%) in winter, 172 (29.9%, 95% CI 26.3-33.7%) in spring, 131 (22.7%, 95% CI 19.5-26.3%) in summer, and 107 (18.9%, 95% CI 15.6-22.0%) in autumn (p < 0.0002). There were more males, accounting for 53.9% of subjects (460/856; p = 0.029). Mean annual incidence of CRVO was 2/10,000 for persons aged over 40 years, increasing from 0.25/10,...
Research Interests: Adolescent, Ophthalmic Epidemiology, Sweden, Humans, Female, and 14 moreMale, Follow-up studies, Incidence, Risk factors, Clinical Sciences, Aged, Middle Aged, Optometry and Ophthalmology, Adult, Public health systems and services research, Retrospective Studies, Risk Factors, Seasons, and Retinal Vein Occlusion
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Research Interests: Risk assessment, Sweden, Pregnancy, Humans, Female, and 17 moreAnticoagulants, Risk factors, Clinical Sciences, Adult, Time Factors, Retrospective Studies, Thrombosis, Chi Square Distribution, Risk Factors, Risk Assessment, Parity, Gestational Age, Blood Loss, Postpartum Hemorrhage, Premature Birth, Control Group, and Case Control Studies
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The Nordic medical birth registers have long been used for valuable clinical research. Their collection of data for more than four decades offers unusual possibilities for research across generations. At the same time, serum and blotting... more
The Nordic medical birth registers have long been used for valuable clinical research. Their collection of data for more than four decades offers unusual possibilities for research across generations. At the same time, serum and blotting paper blood samples have been stored from most neonates. Two large cohorts (approximately 100 000 births) in Denmark and Norway have been described by questionnaires, interviews and collection of biological samples (blood, urine and milk teeth), as well as a systematic prospective follow-up of the offspring. National patient registers provide information on preceding, underlying and present health problems of the parents and their offspring. Researchers may, with permission from the national authorities, obtain access to individualized or anonymized data from the registers and tissue-banks. These data allow for multivariate analyses but their usefulness depends on knowledge of the specific registers and biological sample banks and on proper validation of the registers.
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Research Interests: Sweden, Pregnancy, Humans, Placenta, Female, and 4 moreRisk factors, Risk Factors, Umbilical Cord, and Fetal death
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Historically, lethal exsanguinations and severe infections have been two major causes of maternal death. Gene mutations that lower the risk of profuse hemorrhage or severe infections would give a survival advantage. A single mutation of... more
Historically, lethal exsanguinations and severe infections have been two major causes of maternal death. Gene mutations that lower the risk of profuse hemorrhage or severe infections would give a survival advantage. A single mutation of coagulation factor V, known as FV Leiden (FVL), can be such a beneficial mutation. FVL is common among Caucasians and today confers an increased risk of thromboembolism. However, the high prevalence of FVL (up to 15%) in the general population suggests that it has given an evolutionary advantage. In this review, we discuss possible mechanisms of the evolutionary survival advantage associated with FVL. In women, FVL confers lower risk of blood loss and profuse hemorrhage in association with delivery and improves the hemoglobin status. In addition, FVL carriers possibly have a survival advantage during sepsis. In conclusion, the high prevalence of FVL may be the result of one or more evolutionary selection advantages.
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Research Interests: Obesity, Statistical Analysis, Risk assessment, Sweden, Prospective studies, and 18 morePregnancy, Complication, Humans, Models, Female, Estimation, Thromboembolism, Risk factors, Logistic Regression Analysis, Prevalence, Risk Factor, Adult, Public health systems and services research, Odds ratio, Risk Factors, Risk Assessment, Gestation, and Cohort Studies
Research Interests: Prospective studies, Pregnancy, Humans, Female, Male, and 16 moreSmall for Gestational Age, Haemostasis and Thrombosis, Risk factors, Clinical Sciences, Newborn Infant, Adult, Pregnancy Complication, Risk Factors, Venous thromboembolism, Blood Loss, Fetal death, Pregnancy Outcome, Intrauterine Growth Restriction, Control Group, Case Control Studies, and Pre Eclampsia
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Long-term results after obstetric anal sphincter injury (OASI) are poor. We aimed to improve the long-term outcome after OASI by lessening symptoms of anal incontinence. In a prospective study at Malmö University Hospital, twenty-six... more
Long-term results after obstetric anal sphincter injury (OASI) are poor. We aimed to improve the long-term outcome after OASI by lessening symptoms of anal incontinence. In a prospective study at Malmö University Hospital, twenty-six women with at least grade 3B OASI were classified and sutured in a systematic way, including separate suturing of the internal and external sphincter muscles with monofilament absorbable sutures. The principal outcome assessed by answers given to six questions, was a difference in anal incontinence score, between the study group and two control groups (women with prior OASI [n = 180] and primiparous women delivered vaginally without a diagnose of OASI [n = 100]). An anal incontinence score of zero (i.e., no symptoms) was found in 74% of the study group, 47% of the OASI control group, and 66% of the vaginal control group (p = 0.02 and 0.5, as compared to the study group). A modified suturing technique was followed by significant improved one-year symptom...
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Research Interests: Risk assessment, Sweden, Pregnancy, Humans, Female, and 17 moreAnticoagulants, Risk factors, Clinical Sciences, Adult, Time Factors, Retrospective Studies, Thrombosis, Chi Square Distribution, Risk Factors, Risk Assessment, Parity, Gestational Age, Blood Loss, Postpartum Hemorrhage, Premature Birth, Control Group, and Case Control Studies
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Research Interests: Prospective studies, Pregnancy, Humans, Female, Male, and 16 moreSmall for Gestational Age, Haemostasis and Thrombosis, Risk factors, Clinical Sciences, Newborn Infant, Adult, Pregnancy Complication, Risk Factors, Venous thromboembolism, Blood Loss, Fetal death, Pregnancy Outcome, Intrauterine Growth Restriction, Control Group, Case Control Studies, and Pre Eclampsia
Research Interests: Sweden, Pregnancy, Humans, Fertility and Sterility, Female, and 16 moreIn Vitro Fertilization, Male, Young Adult, Incidence, Anticoagulants, Risk factors, Registries, Clinical Sciences, Newborn Infant, Adult, Public health systems and services research, Fertilization in Vitro, Risk Factors, Venous thromboembolism, Pregnancy Outcome, and Cohort Studies
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Research Interests: Sweden, Pregnancy, Humans, Female, Incidence, and 3 moreAdult, Aortic Dissection, and Aortic Aneurysm
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Historically, lethal exsanguinations and severe infections have been two major causes of maternal death. Gene mutations that lower the risk of profuse hemorrhage or severe infections would give a survival advantage. A single mutation of... more
Historically, lethal exsanguinations and severe infections have been two major causes of maternal death. Gene mutations that lower the risk of profuse hemorrhage or severe infections would give a survival advantage. A single mutation of coagulation factor V, known as FV Leiden (FVL), can be such a beneficial mutation. FVL is common among Caucasians and today confers an increased risk of thromboembolism. However, the high prevalence of FVL (up to 15%) in the general population suggests that it has given an evolutionary advantage. In this review, we discuss possible mechanisms of the evolutionary survival advantage associated with FVL. In women, FVL confers lower risk of blood loss and profuse hemorrhage in association with delivery and improves the hemoglobin status. In addition, FVL carriers possibly have a survival advantage during sepsis. In conclusion, the high prevalence of FVL may be the result of one or more evolutionary selection advantages.