[Spontaneous pneumomediastinum during labour].

This is a case report of a 35-year-old women who had spontaneous pneumomediastinum (SPM) during the second stage of labour. Although this condition during labor is very rare, it is described in the literature as Hamman's syndrome. The symptoms are dyspnoea, chest pain and subcutaneous emphysema which leads to much more severe differential diagnoses that should be eliminated quickly. There has not yet been found any dispositions to the condition. Duration of the second stage of labour is a theoretic factor of relevance, which naturally puts nulliparas at a higher risk.

Ultrasound in Prenatal Diagnostics and Its Impact on the Epidemiology of Spina Bifida in a National Cohort from Denmark with a Comparison to Sweden.

OBJECTIVES: The aim of this study was to assess the incidence, the prenatal detection rate by ultrasound, and the pregnancy outcome of spina bifida (SB) in Denmark (DK) in 2008-2015 and to compare results to national data from Sweden. METHODS: Data were retrieved from the Danish Fetal Medicine Database, which includes International Classification of Diseases- (ICD-) 10 codes for pre- or postnatally diagnoses and pregnancy outcome. Missing data were obtained from the National Patient Register. Livebirth data with myelomeningocele (MMC) in Sweden were obtained from different databases. RESULTS: There were 234 cases with SB in DK in 2008-2015. The incidence of SB was 4.9 : 10,000; 89% were detected with ultrasound prior to week 22; 90% of these pregnancies were terminated (ToP); 91% were isolated malformations of which 11% showed abnormal karyotype. The incidence of newborns with MMC was 1.3 : 10,000 in Sweden. CONCLUSIONS: Ultrasound screening has a major impact on the epidemiology of SB. The prenatal detection rate of SB was high, and most SB cases were isolated and had a normal karyotype. Among women with a prenatal fetal diagnosis of SB, 90% chose to have ToP. The incidence of newborns with SB was higher in Sweden than in DK.

Characteristics of first-trimester screening of non-responders in a high-uptake population.

INTRODUCTION: Our aim was to compare demographic, social and reproductive health-related medical factors between women who did and women who did not undergo combined first-trimester screening (cFTS) and to examine their reasons for declining a screening offer, especially whether non-participation was an informed choice. METHODS: This was a nationwide survey conducted in Denmark in 2014. A structured questionnaire with 33 questions relating to demographical data and medical history was mailed to 1,495 randomly selected women who gave birth in 2012. Half of the women were selected among the population without cFTS, the other half from those with cFTS. A cohort of 20 women tested the questionnaire for consistency. The results are based on the responders (58%). RESULTS: The response rate was 88% among the women with cFTS and 19% among the women without. Not having a cFTS performed was associated with the following factors: country of origin other than Denmark (p < 0.01), less education (p < 0.01) and unemployment (p < 0.01). These women more often had a religious belief (p < 0.01), and had undergone fewer induced abortions (p = 0.01). They felt less informed about the cFTS (p < 0.01) and thought it was a more difficult decision (p < 0.01) than the women who had undergone cFTS. The main reason for declining cFTS was a wish to keep the child regardless of any cFTS results (82%). CONCLUSIONS: Women without cFTS differ from those who undergo cFTS. Not undergoing cFTS seemed most often to be the result of a conscious choice based on ethical considerations, rather than being the result of a lack of information. However, a low response rate decreases the strength of our conclusions. FUNDING: none. TRIAL REGISTRATION: not relevant.