[Traumatic uterine rupture in gemelli pregnant woman causing emergency hysterectomy].

This is a case report of a 30-year-old gemelli pregnant woman in gestation week 15 and 6 days, who was admitted to a local hospital after being involved in a high impact motor vehicle accident. Traumatic uterine rupture was suspected and the patient was immediately operated with exploratory laparotomy. Emergency hysterectomy was performed, hence the pregnancy was terminated. This case is a rare obstetric trauma situation, and prompt diagnosis is life-saving.

Persistent organic pollutants and haematological markers in Greenlandic pregnant women: the ACCEPT sub-study.

The Arctic populations have high blood concentrations of persistent organic pollutants (POPs). Exposure to POPs was related to adverse health effects e.g. immune, neurological and reproductive systems. This study investigates associations between serum POP levels and haematological markers in Greenlandic pregnant women. This cross-sectional study included 189 women enrolled in 2010-2011 at the Greenlandic West coast by the inclusion criteria ≥18 years of age and had lived for 50% or more of their life in Greenland. The associations between the sum of the POP variables polychlorinated biphenyls (sumPCBs), organochlorine pesticides (sumOCPs), perfluoroalkylated substances (sumPFASs) and 24 haematological markers were analysed using linear regression adjusted for age, pre-pregnancy BMI, parity, gestation week, plasma-cotinine and alcohol intake. It showed a significantly inverse association between several haematological markers (eosinophil, lymphocyte, neutrophil and white blood cells) and sumPCBs, sumOCPs and sumPFASs. In addition, the monocyte, mean corpuscular haemoglobin concentration, plateletcrit and platelet count markers were significantly inversely associated with sumPFASs, but the haematocrit and mean erythrocyte corpuscular volume were positively associated with sumPFASs. In conclusion, exposure to POPs influenced several haematological markers, especially cell count parameters, suggesting immunosuppressive potential of POPs in Greenlandic pregnant women. The data need further investigations.

Lifestyle, reproductive factors and food intake in Greenlandic pregnant women: the ACCEPT - sub-study.

BACKGROUND: In the past decades, Greenland has changed from a hunter society to a more western lifestyle, causing less intake of traditional food, such as marine mammals, fish and seabirds. These changes in the living conditions and food habits might impact the maternal health in Greenland. OBJECTIVES: To describe lifestyle, reproductive factors and food intake in Greenlandic pregnant women, and to assess possible age and geographical differences. DESIGN: Cross-sectional study of 189 Greenlandic pregnant women. Inclusion criteria were ≥18 years and lived >50% of their life in Greenland. Data were collected in 2010-2011, and information was obtained from lifestyle and food frequency questionnaires. Two age groups for comparison were given for the pregnant women (<27 years vs. ≥27 years) with regard to the median age. Region groups for comparison were West, Disko Bay, South, North and East. RESULTS: Population characteristics showed that 43.3% had pre-pregnancy body mass index (BMI) >25.0 kg/m(2), 46.3% were current smokers in the beginning of their pregnancy and few participants consumed alcohol during pregnancy. Women <27 years were more in doubt regarding planned breastfeeding period and consumed more dried fish and fast food. A trend for higher alcohol intake during pregnancy was found for women ≥27 years. The regional differences showed that women living >50% in North, South and West had a higher alcohol intake during pregnancy. Women in North had the fewest breastfeeding plans. Women in Disko Bay had the lowest intake of terrestrial species. No significant geographical differences were found for intake of marine mammals or seabirds. CONCLUSIONS: The present study found relatively high BMI level and high smoking frequency in Greenlandic pregnant women. Age and region differences were found for alcohol consumption, breastfeeding plans and food intake profile. Further research is needed to implement relevant maternal health intervention programs in Greenland.

Sexual and reproductive health in Greenland: evaluation of implementing sexual peer-to-peer education in Greenland (the SexInuk project).

BACKGROUND: For decades, the rates of sexually transmitted infections (STIs), such as gonorrhoea, chlamydia and syphilis, have increased in Greenland, especially within the young age groups (15-29 years). From 2006 to 2013, the number of abortions has been consistent with approximately 800-900 abortions per year in Greenland, which is nearly as high as the total number of births during the same period. Previous studies in Greenland have reported that knowledge about sexual health is important, both as prevention and as facilitator to stop the increasing rates of STIs. A peer-to-peer education programme about sexual health requires adaption to cultural values and acceptance among the population and government in order to be sustainable. OBJECTIVE: Formative evaluation of a voluntary project (SexInuk), in relation to peer-to-peer education with focus on sexual health. Two workshops were conducted in Nuuk, Greenland, to recruit Greenlandic students. DESIGN: Qualitative design with focus group interviews (FGIs) to collect qualitative feedback on feasibility and implementation of the project. Supplemented with a brief questionnaire regarding personal information (gender, age, education) and questions about the educational elements in the SexInuk project. Eight Greenlandic students, who had completed one or two workshops, were enrolled. RESULTS: The FGIs showed an overall consensus regarding the need for improving sexual health education in Greenland. The participants requested more voluntary educators, to secure sustainability. The articulation of taboo topics in the Greenlandic society appeared very important. The participants suggested more awareness by promoting the project. CONCLUSIONS: Cultural values and language directions were important elements in the FGIs. To our knowledge, voluntary work regarding peer-to-peer education and sexual health has not been structurally evaluated in Greenland before. To achieve sustainability, the project needs educators and financial support. Further research is needed to investigate how peer-to-peer education can improve sexual and reproductive health in Greenland.

Food intake and serum persistent organic pollutants in the Greenlandic pregnant women: The ACCEPT sub-study.

The Greenlandic Inuit have high blood concentrations of environmental persistent organic pollutants (POPs). High POP concentrations have been associated with age, smoking and consumption of marine mammals. Studies have indicated that exposure to POPs during pregnancy may adversely affect fetal and child development. To assess geographical differences in diet, lifestyle and environmental contaminant exposure among pregnant women in Greenland, blood samples and questionnaire data were collected from 207 pregnant women in five Greenlandic regions (North, Disco Bay, West, South and East). Blood samples were analyzed for 11 organochlorine pesticides (OCPs), 14 polychlorinated biphenyls (PCBs), 5 polybrominated diphenyl ethers (PBDEs), 15 perfluoroalkylated substances (PFASs) and 63 metals. A trend of higher intake of marine mammals in the East and North regions was reflected by a higher n-3/n-6 fatty acid ratio. Participants in the East region tended also to have higher intake of terrestrial species. A significant higher seabird intake was seen for pregnant women in the West region. Significant regional differences were found for blood concentrations of PCBs, OCPs, PFASs and mercury, with higher levels in the North and East regions. PFASs were significantly associated with PCBs and OCPs in most of the regions. In the North region, PFASs were associated with both selenium and mercury. No significant regional difference was observed for PBDEs. The regional differences of blood levels of POPs and mercury were related to differences in intake of the traditional food. Compared to earlier reports, decreased levels of legacy POPs, Hg and Pb and perfluorooctane sulfonate and perfluorooctanoic acid were observed, but the levels of PFAS congeners perfluorohexane sulfonate and perfluorononanoic acid were sustained. The detection of POPs and heavy metals in maternal blood indicates fetal exposure to these compounds possibly influencing fetal development.