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This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief and the Authors as the Authors failed to request and receive permission to use the data from Aarhus Hospital., (Copyright © 2017.)

Objectives: First trimester bleeding without miscarriage is a risk factor for complications later in the pregnancy, such as preterm delivery. Also, first trimester miscarriage has been linked to subsequent maternal ischemic heart disease. We investigated the link between maternal cardiovascular disease prior to and subsequent to first trimester bleeding without miscarriage., Study Design: We performed a registry-based retrospective cohort study of 796,915 women who gave birth to a singleton infant after 20 completed weeks in Denmark in 1978-2007. The exposures and endpoints were registry diagnoses of cardiovascular diseases preceding pregnancy, first trimester vaginal bleeding without miscarriage, and subsequent maternal cardiovascular disease. In the adjusted models, we considered preterm delivery, prelabor rupture of membranes, hypertensive pregnancy disorders, fetal growth restriction, placental abruption and stillbirth as possible confounders. We used logistic regression and Cox proportional hazard models to assess the associations., Results: Women with pre-pregnancy cardiovascular disease had a 2.2-fold (95% CI 1.3-4.1) increased risk of first trimester bleeding without miscarriage, and first trimester bleeding without miscarriage was associated with a 1.6-fold (1.4-1.8) increase in risk of subsequent maternal ischemic hearth disease after adjusting for other adverse pregnancy outcomes., Conclusion: First trimester bleeding without miscarriage is associated with pre-pregnancy as well as subsequent maternal cardiovascular morbidity., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Objective: To investigate the relation between breech at term and epilepsy in childhood, and identify risk factors for epilepsy in term breech infants., Study Design: Register-based study of all (n = 7514) singleton term infants without malformations, born between 1980 and 1994 and hospitalised with epilepsy until year 1996. For each case delivered in breech presentation (n = 290), the two subsequent deliveries of non-malformed, singleton infants delivered in breech presentation at term at the same hospital were selected as controls (n = 580)., Results: Breech presentation was a risk factor for epilepsy (OR: 1.2 [95% CI: 1.1, 1.3]). Breech infants with epilepsy were more often small for gestational age (9.7%) than breech infants without epilepsy (4.7%). Vaginal delivery was associated with low Apgar score, but mode of delivery and low Apgar score were not related to epilepsy., Conclusion: The increased risk of epilepsy in term breech infants is not related to intrapartum events, but to growth restriction in pregnancy.

Placenta percreta is still a life threatening condition due to the risk of excessive bleeding. Furthermore, it confers a considerable risk of the patient losing her uterus. An improved diagnosis including assessment of the depth of myometrial and serosal invasion is now available by color Doppler imaging, making the planning of elective caesarean section possible. We have designed a new operating technique, by which we successfully have achieved haemostasis of the areas containing the uterine arteries as well as the area between the bladder and the uterine cervix.

Objective: To assess the ability of the member states of the European Union to produce the indicators recommended by the PERISTAT project on perinatal health indicators and to provide an overview of fetal and infant health outcomes for these countries according to the information now available., Methods: We used data from the PERISTAT survey of data providers to compute PERISTAT indicators of fetal and infant health., Results: National data on fetal mortality are available for all countries, but vary in their definitions. To adjust for these differences in definition, PERISTAT recommends presenting rates by gestational age and birth weight. Not all countries can provide neonatal mortality data by gestational age, birth weight or plurality, as recommended by PERISTAT. Few countries in Europe can report infant mortality rates by birth weight and gestational age. The other recommended indicators are available to varying degrees., Conclusions: This overview, which shows that Europe can produce a variety of indicators for monitoring the health of its new-borns, indicates that some key dimensions of perinatal health cannot now be measured with routine health statistics and reveals important disparities in health outcomes throughout Europe. For most indicators, the highest values are between 50 and 100% higher than the lowest values. The reasons for these variations and their importance for the surveillance of perinatal health are discussed.

Objective: To identify health care issues important to reduce the perinatal mortality rate (PMR) in Ukraine., Study Design: Perinatal deaths in the Donetsk region (Ukraine) in 1997-1998 were compared with those in Denmark in 1996 by using the Nordic-Baltic classification for perinatal deaths. Clinical guidelines, use of technology and rates of interventions in the two regions were described., Results: A two-fold increase in PMR was found in Ukraine compared to Denmark, mainly explained by higher rates of antenatal deaths of growth restricted fetuses, intrapartum deaths, and neonatal deaths due to asphyxia. Vacuum extraction is rarely used in Ukraine. The clinical guidelines for care differ significantly between the two regions., Conclusion: Appropriate use of technology and implementation of evidence-based guidelines should be a matter of high priority in the Donetsk region, Ukraine.

Objective: To investigate the relation between low Apgar score in breech infants and handicap in childhood., Study Design: A case-control study. A questionnaire to mothers of 323 non-malformed, singleton infants delivered in breech presentation at term, 105 cases with Apgar score below 7 at 5 min and 218 controls., Results: Four cases (4.6%) and one control (0.5%) had cerebral palsy. In infants without cerebral palsy, speech/language problems were more frequent than controls (10.6 versus 3.2%) (P=0.02). There were no differences in rates of deficits in attention, motor control and perception (DAMP), epilepsy, cognitive developmental delay or learning disabilities. Absence of any handicap or disability was reported in 65 cases (75%) compared to 172 controls (92%) (OR: 3.9; 95% CI: 1.9-7.9)., Conclusion: Even though low Apgar score indicates an increased risk of neurological sequelae, most (75%) breech infants with low Apgar score are without a handicap/disability at follow-up.

The occurrence of prior cervical conization and the cervical microbial colonization was investigated in 38 women with idiopathic preterm labor, 35 women with preterm premature rupture of the membranes (PPROM) and 75 normal pregnant women at 26-34 weeks of gestation. Data were analyzed by Fisher's exact test (two-tailed). The frequency of prior cervical conization was significantly higher in PPROM patients compared to normal pregnant women (P < 0.001) and to patients in preterm labor (P < 0.01). Lactobacilli occurred with a lower frequency in patients with PPROM compared to patients in preterm labor (P < 0.05) and control patients (P = 0.0543)-and with a lower frequency in patients with prior cervical conization (P < 0.05). All other microorganisms occurred with the same frequencies in all groups. The absence of lactobacilli may indicate changes in the cervical flora, which could increase the risk of PPROM. Prior cervical conization may impair the antimicrobial defense-mechanisms in the cervix, which could facilitate ascending microbial colonization. This may lead to a release of prostaglandins and proteolytic enzymes and subsequently preterm labor and rupture of the membranes.

A case of preterm premature rupture of the membranes (PPROM) in the 31st week of gestation is reported. Initial cultures from the cervix and urine were without pathogenic microorganisms. After 8 days of prophylactic pivampicillin and metronidazol, culture from the cervix showed profuse growth of Group B Streptococci (GBS) and the patient developed symptoms of chorioamnionitis. Cesarean section was performed and the infant presented GBS-septicemia. In spite of continued treatment with pivampicillin, culture from the cervix on day 6 post partum still showed profuse growth of GBS. Prolonged prophylactic per oral administration of broad-spectrum antibiotics after PPROM may not always protect against infectious complications. Literature is reviewed, and it is discussed whether the applied regimen in some cases even may favour the occurrence of serious infections.