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Lilliecreutz, Caroline
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Publications (10 of 13) Show all publications
Baldvinsdottir, T., Blomberg, M. & Lilliecreutz, C. (2018). Improved clinical management but not patient outcome in women with postpartum haemorrhage-An observational study of practical obstetric team training. PLoS ONE, 13(9), Article ID e0203806.
Open this publication in new window or tab >>Improved clinical management but not patient outcome in women with postpartum haemorrhage-An observational study of practical obstetric team training
2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 9, article id e0203806Article in journal (Refereed) Published
Abstract [en]

Objective Postpartum haemorrhage (PPH) is the most common obstetric emergency. A well-established postpartum haemorrhage protocol in the labour ward is crucial for effective treatment. The aim of the study was to investigate if practical obstetric team training improves the patient outcome and clinical management of PPH. Setting The practical obstetric team training (PROBE) at Linkoping University Hospital, Sweden, with approximate 3000 deliveries annually, was studied between the years of 2004-2011. Each team consisted of one or two midwives, one obstetrician or one junior doctor and one nurse assistant. Emergency obstetrics cases were trained in a simulation setting. PROBE was scheduled during work hours at an interval of 1.5 years. Population Pre-PROBE women (N = 419 were defined as all women with vaginal birth between the years of 2004-2007 with an estimated blood loss of amp;gt;= 1000 ml within the first 24 hours of delivery. Post-PROBE women (N = 483) were defined as all women with vaginal birth between the years of 2008-2011 with an estimated blood loss of amp;gt;= 1000 ml within the first 24 hours of delivery. The two groups were compared regarding blood loss parameters and management variables using retrospective data from medical records. Results No difference was observed in estimated blood loss, haemoglobin level, blood transfusions or the incidence of postpartum haemorrhage between the two groups. Post-PROBE women had more often secured venous access (pamp;lt;0.001), monitoring of vital signs (pamp;lt;0.001) and received fluid resuscitation (pamp;lt;0.001) compared to pre-PROBE women. The use of uterine massage was also more common among the post-PROBE women compared with the pre-PROBE women (pamp;lt;0.001). Conclusion PROBE improved clinical management but not patient outcome in women with postpartum haemorrhage in the labour ward. These new findings may have clinical implications since they confirm that training was effective concerning the management of postpartum haemorrhage. However, there is still no clear evidence that simulation training improve patient outcome in women with PPH.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2018
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-152087 (URN)10.1371/journal.pone.0203806 (DOI)000446000200027 ()30256808 (PubMedID)
Available from: 2018-10-17 Created: 2018-10-17 Last updated: 2019-03-07
Lilliecreutz, C. & Cedergren, M. (2017). Dags att implementera nya rön om graviditetsdiabetes. Läkartidningen, 114
Open this publication in new window or tab >>Dags att implementera nya rön om graviditetsdiabetes
2017 (English)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114Article in journal, Editorial material (Other academic) Published
Abstract [en]

n/a

National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-146145 (URN)28485757 (PubMedID)
Available from: 2018-03-29 Created: 2018-03-29 Last updated: 2018-05-01
Lilliecreutz, C., Laren, J., Sydsjö, G. & Josefsson, A. (2016). Effect of maternal stress during pregnancy on the risk for preterm birth. BMC Pregnancy and Childbirth, 16(5)
Open this publication in new window or tab >>Effect of maternal stress during pregnancy on the risk for preterm birth
2016 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 16, no 5Article in journal (Refereed) Published
Abstract [en]

Background: Preterm birth defined as birth prior to 37 weeks of gestation is caused by different risk factors and implies an increased risk for disease and early death for the child. The aim of the study was to investigate the effect of maternal stress during pregnancy on the risk of preterm birth. Methods: A case-control study that included 340 women; 168 women who gave birth preterm and 172 women who gave birth at term. Data were manually extracted from standardized medical records. If the medical record contained a psychiatric diagnosis or a self-reported stressor e.g., depression or anxiety the woman was considered to have been exposed to stress during pregnancy. Adjusted odds ratio (AOR) was used to calculate the attributable risk (AR) of maternal stress during pregnancy on preterm birth, both for the women exposed to stress during pregnancy (AR1 = (AOR-1)/AOR) and for the whole study population (AR2 = AR1*case fraction). Results: Maternal stress during pregnancy was more common among women who gave birth preterm compared to women who gave birth at term (p <0.000, AOR 2.15 (CI = 1.18-3.92)). Among the women who experienced stress during pregnancy 54 % gave birth preterm with stress as an attributable risk factor. Among all of the women the percentage was 23 %. Conclusions: Stress seems to increase the risk of preterm birth. It is of great importance to identify and possibly alleviate the exposure to stress during pregnancy and by doing so try to decrease the preterm birth rate.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2016
Keywords
Premature birth; Stress; Pregnancy; Attributable risk
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-124632 (URN)10.1186/s12884-015-0775-x (DOI)000368071000001 ()26772181 (PubMedID)
Note

Funding Agencies|The Medical Research Council of Southeast Sweden

Available from: 2016-02-09 Created: 2016-02-08 Last updated: 2019-06-28
Tornblom-Paulander, S., Tingaker, B. K., Werner, A., Lilliecreutz, C., Conner, P., Wessel, H. & Ekman-Ordeberg, G. (2015). Novel topical formulation of lidocaine provides significant pain relief for intrauterine device insertion: pharmacokinetic evaluation and randomized placebo-controlled trial. Fertility and Sterility, 103(2), 422-427
Open this publication in new window or tab >>Novel topical formulation of lidocaine provides significant pain relief for intrauterine device insertion: pharmacokinetic evaluation and randomized placebo-controlled trial
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2015 (English)In: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 103, no 2, p. 422-427Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate the pharmacokinetics, safety, and analgesic efficacy of a novel topical formulation of lidocaine at insertion of an intrauterine device (IUD). Design: Randomized controlled trial; phase-I and phase-II studies. Setting: University and public hospitals. Patient(s): Women aged greater than= 18 years who wanted to receive an IUD. Four women were parous in phase I; all in phase II were nulliparous. Intervention(s): A single, 8.5-mL dose of lidocaine formulation (SHACT) was administered (to the portio, cervix, and uterus) with a specially designed applicator. Main Outcome Measure(s): The phase-I study (single-arm) was designed for pharmacokinetic assessment; the phase-II study (randomized) was intended for investigation of efficacy and safety. Result(s): From the phase-I study (15 participants), mean pharmacokinetic values were: maximum plasma concentration: 351 +/- 205 ng/mL; time taken to reach maximum concentration: 68 +/- 41 minutes; and area under the concentration-time curve from 0 to 180 minutes: 717 +/- 421 ng*h/mL. Pain relief was observed with lidocaine vs. placebo in the phase-II study (218 women, randomized). Mean visual analog scale score for maximum pain during the first 10 minutes after IUD insertion was 36% lower with lidocaine than with placebo (28.3 +/- 24.6 vs. 44.2 +/- 26.0). Pain intensity was also significantly lower in the lidocaine group at 30 minutes. On average, 3 of 4 patients will have less pain with lidocaine than with placebo. Adverse events were similar in the placebo and lidocaine groups. No serious adverse events were reported. Conclusion(s): Lidocaine provides pain relief lasting for 30-60 minutes for women undergoing IUD insertion, without any safety concerns. Further studies of this lidocaine formulation, for IUD insertion and other clinical applications, are planned. (C) 2015 by American Society for Reproductive Medicine.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Intrauterine device; lidocaine; pain; pharmacokinetics; topical anesthetic
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-114984 (URN)10.1016/j.fertnstert.2014.10.026 (DOI)000348966700022 ()25455873 (PubMedID)
Note

Funding Agencies|Pharmanest AB (Solna, Sweden)

Available from: 2015-03-10 Created: 2015-03-06 Last updated: 2017-12-04
Sydsjö, G., Möller, L., Lilliecreutz, C., Bladh, M., Andolf, E. & Josefsson, A. (2015). Psychiatric illness in women requesting caesarean section. British Journal of Obstetrics and Gynecology, 122(3), 351-358
Open this publication in new window or tab >>Psychiatric illness in women requesting caesarean section
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2015 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, no 3, p. 351-358Article in journal (Refereed) Published
Abstract [en]

Objective To compare psychiatric in-and outpatient care during the 5 years before first delivery in primiparae delivered by caesarean section on maternal request with all other primiparae women who had given birth during the same time period. Design Prospective, population-based register study. Setting Sweden. Sample Women giving birth for the first time between 2002 and 2004 (n = 64 834). Methods Women giving birth by caesarean section on maternal request (n = 1009) were compared with all other women giving birth (n = 63 825). The exposure of interest was any psychiatric diagnosis according to the International Statistical Classification of Diseases and Related Health Problems (ninth revision, ICD-9, 290-319; tenth revision, ICD-10, F00-F99) in The Swedish national patient register during the 5 years before first delivery. Main outcome measures Psychiatric diagnoses and delivery data. Results The burden of psychiatric illnesses was significantly higher in women giving birth by caesarean section on maternal request (10 versus 3.5%, P less than 0.001). The most common diagnoses were ` Neurotic disorders, stress-related disorders and somatoform disorders (5.9%, aOR 3.1, 95% CI 1.1-2.9), and ` Mood disorders (3.4%, aOR 2.4, 95% CI 1.7-3.6). The adjusted odds ratio for caesarean section on maternal request was 2.5 (95% CI 2.0-3.2) for any psychiatric disorder. Women giving birth by caesarean section on maternal request were older, used tobacco more often, had a lower educational level, higher body mass index, were more often married, unemployed, and their parents were more often born outside of Scandinavia (P less than 0.05). Conclusions Women giving birth by caesarean section on maternal request more often have a severe psychiatric disease burden. This finding points to the need for psychological support for these women as well as the need to screen and treat psychiatric illness in pregnant women.

Place, publisher, year, edition, pages
Wiley: 12 months, 2015
Keywords
Caesarean section; maternal request; mental health; psychiatric diagnoses
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-115326 (URN)10.1111/1471-0528.12714 (DOI)000348866600015 ()24628766 (PubMedID)
Note

Funding Agencies|County Council of Ostergotland, Sweden

Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2019-06-28
Möller, L., Josefsson, A., Bladh, M., Lilliecreutz, C. & Sydsjö, G. (2015). Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register-based study. British Journal of Obstetrics and Gynecology, 122(3), 329-334
Open this publication in new window or tab >>Reproduction and mode of delivery in women with vaginismus or localised provoked vestibulodynia: a Swedish register-based study
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2015 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 122, no 3, p. 329-334Article in journal (Refereed) Published
Abstract [en]

Objective To compare sociodemographics, parity and mode of delivery between women diagnosed with vaginismus or localised provoked vestibulodynia (LPV) to women without a diagnosis before first pregnancy. Design Retrospective, population-based register study. Setting Sweden. Sample All women born in Sweden 1973-83 who gave birth for the first time or remained nulliparous during the years 2001-09. Methods Nationally linked registries were used to identify the study population. Women diagnosed with vaginismus or LPV were compared to all other women. Odds ratios for parity and mode of delivery were calculated using multinominal regression analysis and logistic regression. Main outcome measures Parity and mode of delivery. Results Women with vaginismus/LPV were more likely to be unmarried (P = 0.001), unemployed (P = 0.012), have a higher educational level (P less than 0.001), a lower body mass index (P less than 0.001) and use nicotine during pregnancy (P = 0.008). They were less likely to give birth (adjusted odds ratio [OR] 0.61, 95% confidence interval [95% CI] 0.56-0.67). Women with vaginismus/LPV more often delivered by caesarean section (P less than 0.001) especially for maternal request (adjusted OR 3.48, 95% CI 2.45-4.39). In women having vaginal delivery, those with vaginismus/LPV were more likely to suffer a perineal laceration (adjusted OR 1.87, 95% CI 1.56-2.25). Conclusions Women with vaginismus/LPV are less likely to give birth and those that do are more likely to deliver by caesarean section and have a caesarean section based upon maternal request. Those women delivering vaginally are more likely to suffer perineal laceration. These findings point to the importance of not only addressing sexual function in women with vaginismus/LPV but reproductive function as well.

Place, publisher, year, edition, pages
Wiley: 12 months, 2015
Keywords
Caesarean section; localised provoked vestibulodynia; reproduction; vaginismus
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-115325 (URN)10.1111/1471-0528.12946 (DOI)000348866600011 ()24990073 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden

Available from: 2015-03-13 Created: 2015-03-13 Last updated: 2019-06-28
Sydsjö, G., Bladh, M., Lilliecreutz, C., Persson, A.-M., Vyoni, H. & Josefsson, A. (2014). Obstetric outcomes for nulliparous women who received routine individualized treatment for severe fear of childbirth - a retrospective case control study. BMC Pregnancy and Childbirth, 14(126)
Open this publication in new window or tab >>Obstetric outcomes for nulliparous women who received routine individualized treatment for severe fear of childbirth - a retrospective case control study
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2014 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 14, no 126Article in journal (Refereed) Published
Abstract [en]

Background: To study pregnancy and delivery outcomes in nulliparous women with severe FOC (fear of childbirth), all of whom had received routine treatment for their FOC and to make comparisons with a healthy reference group of nulliparous women. To study the possible relationship between the number of FOC-treatment sessions and the delivery method. Methods: All nulliparous women with a diagnose FOC who received routine treatment for FOC (n = 181) and a reference group of nulliparous women without FOC (n = 431) at a university and a county hospital in the south east region of Sweden were analysed. Data from antenatal and delivery medical records were used to study outcome. Results: The majority of women with severe FOC had a vaginal delivery. The incidence of elective CS was greater in the index group than in the reference group (p less than 0.001). The total number of women with a planned CS in the index group was 35 (19.4%) and in the control group 14 (3.2%). Thus, on average five women per year received an elective CS during the study years due to severe FOC. The women in the index group who wished to have a CS were similar to the other women in the index group with reference to age, BMI, chronic disease but had been in in-patient care more often during their pregnancy than those who did not ask for CS (p = 0.009). Conclusion: In this study of women treated for severe FOC, the majority gave birth vaginally and no relationship was found between number of treatment sessions and mode of childbirth.

Place, publisher, year, edition, pages
BioMed Central, 2014
Keywords
FOC; Primary fear of childbirth; Pregnancy outcome
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-106855 (URN)10.1186/1471-2393-14-126 (DOI)000334943900002 ()
Available from: 2014-05-28 Created: 2014-05-23 Last updated: 2019-06-28
Lilliecreutz, C., Sydsjö, G. & Josefsson, A. (2011). Obstetric and perinatal outcomes among women with blood- and injection phobia during pregnancy. Journal of Affective Disorders, 129(1-3), 289-295
Open this publication in new window or tab >>Obstetric and perinatal outcomes among women with blood- and injection phobia during pregnancy
2011 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 129, no 1-3, p. 289-295Article in journal (Refereed) Published
Abstract [en]

Backgroun: Little is known about how anxiety disorders affect pregnancy outcomes. Therefore we investigated the impact of one anxiety disorder, blood- and injection phobia, on obstetric and neonatal outcomes.

Method: From a population-based prospectively collected cohort we compared an index group of 110 women with blood- and injection phobia with a control group of 220 women. Standardized medical records were used to collect data. Obstetric and neonatal outcomes e.g. elective cesarean, prematurity, and small for gestational age were used as the main outcome measures.

Result: Women with blood- and injection phobia stated more often a fear of childbirth (p < 0.001) and were more frequently delivered by elective cesarean section (p = 0.032). The incidence of premature delivery (p = 0.028), neonatal morbidity (p = 0.001) and the risk of having a baby born small for gestational age (p = 0.009) was higher among women with blood- and injection phobia.

Limitation: The medical records, from which all information is drawn, despite standardization, sometimes may lack some information. However, this dilemma exists in both groups.

Conclusions: Women with an anxiety disorder such as blood- and injection phobia are at increased risk for adverse obstetric outcomes, premature delivery and for having a baby born with higher neonatal morbidity. It therefore seems important to identify and treat women with anxiety disorders without delay early during pregnancy in an effort to minimize risks of complications for the woman herself and the child.

Place, publisher, year, edition, pages
Elsevier, 2011
Keywords
Anxiety, blood-and injection phobia, premature, small for gestational age, cesarean
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-59743 (URN)10.1016/j.jad.2010.08.013 (DOI)000288293400038 ()20825998 (PubMedID)
Note
Original Publication: Caroline Lilliecreutz, Gunilla Sydsjö and Ann Josefsson, Obstetric and perinatal outcomes among women with blood- and injection phobia during pregnancy, 2011, Journal of Affective Disorders, (129), 1-3, 289-295. http://dx.doi.org/10.1016/j.jad.2010.08.013 Copyright: Elsevier Science B.V., Amsterdam. http://www.elsevier.com/ Available from: 2010-09-24 Created: 2010-09-24 Last updated: 2019-06-28Bibliographically approved
Lilliecreutz, C., Theodorsson, E., Sydsjö, G. & Josefsson, A. (2011). Salivary cortisol in pregnant women suffering from blood-and injection phobia. Archives of Women's Mental Health, 14(5), 405-411
Open this publication in new window or tab >>Salivary cortisol in pregnant women suffering from blood-and injection phobia
2011 (English)In: Archives of Women's Mental Health, ISSN 1434-1816, E-ISSN 1435-1102, Vol. 14, no 5, p. 405-411Article in journal (Refereed) Published
Abstract [en]

Purpose: Stress and/or anxiety during pregnancy affect maternal and fetal wellbeing and can cause premature delivery and postnatal pathology in the child. Women suffering from phobias related to blood and injections are prone to high levels of stress including anxiety and sometimes panic attacks during pregnancy. Cortisol is amongst the mediators through which the neurohormonal expressions of maternal psychological factors may be transduced to the fetus. The aim was to investigate if pregnant women suffering from blood- and injection phobia have raised cortisol levels or are characterized by unusual diurnal salivary cortisol profiles compared to healthy controls.

Methods: The sample consisted of 110 pregnant women with blood- and injection phobia and 110 pregnant healthy controls. Both groups provided morning and evening saliva samples in week 25 and 36 for the assay of cortisol. In gestational week 25 when blood was drawn for the mandatory blood testing extra blood was taken to analyze corticotrophin releasing  factor (CRF), adrenocorticotropic hormone (ACTH) and cortisol in serum.

Results: The expected diurnal decline in salivary cortisol was observed as well as increased cortisol levels during pregnancy. Pregnant women suffering from blood- and injection phobia had higher output of cortisol compared to women without the phobia (F=6.25 df=1 p=0.014) but no marked difference in the diurnal cortisol rhythm was found between the groups.

Conclusion: Our findings indicate that untreated blood- and injection phobia during pregnancy increases cortisol concentrations. Blood- and injection phobia is treatable and cognitive behavioral therapy can be used.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2011
Keywords
Cortisol, anxiety, stress, pregnancy, blood- and injection phobia
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-59744 (URN)10.1007/s00737-011-0234-2 (DOI)000297847800005 ()
Available from: 2010-09-24 Created: 2010-09-24 Last updated: 2019-06-28
Lilliecreutz, C., Josefsson, A. & Sydsjö, G. (2010). An open trial with cognitive behavioral therapy for blood- and injection phobia in pregnant women-a group intervention program. ARCHIVES OF WOMENS MENTAL HEALTH, 13(3), 259-265
Open this publication in new window or tab >>An open trial with cognitive behavioral therapy for blood- and injection phobia in pregnant women-a group intervention program
2010 (English)In: ARCHIVES OF WOMENS MENTAL HEALTH, ISSN 1434-1816, Vol. 13, no 3, p. 259-265Article in journal (Refereed) Published
Abstract [en]

Around 7% of pregnant women suffer from blood- and injection phobia. The aim was to investigate if cognitive behavior group therapy (CBT) is effective in treating pregnant womens blood- and injection phobia. Thirty pregnant women with blood- and injection phobia according to DSM-IV took part in an open treatment intervention. A two-session cognitive behavior group therapy was conducted. As controls, 46 pregnant women with untreated blood- and injection phobia and 70 healthy pregnant women were used. Repeated measures ANOVA were performed. The scores for the CBT treatment group on the "Injection Phobia Scale-Anxiety" were reduced both after each treatment session and postpartum (p andlt; 0.001). Anxiety and depressive symptoms were also reduced (p andlt; 0.001). Cognitive-behavior group therapy for pregnant women with blood- and injection phobia is effective and stable up to at least 3 months postpartum. It seems also to reduce anxiety and depressive symptoms during pregnancy.

Place, publisher, year, edition, pages
Springer Science Business Media, 2010
Keywords
Anxiety, Blood- and injection phobia, Cognitive behavior group therapy, Depression, Pregnancy
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-56809 (URN)10.1007/s00737-009-0126-x (DOI)000277935600010 ()
Note
The original publication is available at www.springerlink.com: Caroline Lilliecreutz, Ann Josefsson and Gunilla Sydsjö, An open trial with cognitive behavioral therapy for blood- and injection phobia in pregnant women-a group intervention program, 2010, ARCHIVES OF WOMENS MENTAL HEALTH, (13), 3, 259-265. http://dx.doi.org/10.1007/s00737-009-0126-x Copyright: Springer Science Business Media http://www.springerlink.com/ Available from: 2010-06-04 Created: 2010-06-04 Last updated: 2019-06-28
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