Research projects
The OPTION study is a randomised trial investigating whether labour induction at home is as effective as in hospital. Pregnant women who require labour induction and who are at low risk of complications are eligible to take part. The pregnant woman receives initial labour induction treatment at the hospital and, if all is well, she may be randomised to either go home or remain in hospital. Treatment continues in the same way at home as it does in hospital. Once contractions begin, all treatment continues at the hospital. The pregnant woman is asked to complete questionnaires. This does not involve any additional tests or visits.
The ACT study is a randomised trial investigating whether blood loss in the mother during a caesarean section can be reduced using a simple technique known as aortic compression. Women due to give birth by planned caesarean section are eligible to take part. Participants are randomised to receive aortic compression or not immediately after the baby is delivered, whilst the uterus is being sutured. Participation involves an additional blood test on days 2–3 after the birth, questionnaires and a follow-up visit 6–12 months later to check the uterine scar using a vaginal ultrasound scan.
The SUCCECS study is a so-called stepped-wedge randomised trial in which we are investigating whether delayed cord clamping is better for the baby than immediate cord clamping during emergency caesarean sections performed due to suspected oxygen deprivation.
The study is being conducted at 12 hospitals in Sweden. New parents are asked after the birth whether they would be willing to complete questionnaires about their baby’s well-being during the early days.
Pre-eclampsia (PE) is a blood pressure disorder that can develop into a serious condition affecting around 5–10 per cent of all pregnant women. Treatment with dietary nitrate can reduce oxidative stress and increase the production of the vasodilator nitric oxide (NO), which in turn may help prevent cardiovascular disease in PE. A multidisciplinary project is investigating the effects of daily NO intake in the form of beetroot juice on cardiovascular function, including blood pressure, in pregnant women with PE.
Pre-eclampsia (PE) that develops early in pregnancy is particularly serious, especially if labour needs to be induced before 34 weeks’ gestation.
The Pre-eclampsia Intervention 4 (PI4) study is a randomised, placebo-controlled trial in which women who develop PE between weeks 22 and 34 are randomised to receive metformin or a placebo. Metformin has vasoprotective effects in other contexts and is thought to be able to slow the progression of the condition and prolong the pregnancy.
We want to assess what sex life is like after the birth of a first child. Women who gave birth around a year ago are invited to complete questionnaires to help us determine how to measure sexual function after childbirth, as well as what sex life is like following a caesarean section and a vaginal birth, with or without tearing or an episiotomy. We are also investigating how damage to the levator muscles can affect sexual relations.
SOFT is a research study investigating whether local anesthesia during the pushing stage of vaginal delivery can reduce the risk of perineal tears, a common complication. The project consists of an ongoing prospective observational study with data from over 500 deliveries, as well as an interview study with midwives and pregnant women, which together will form the basis for a planned randomized controlled trial in 2027 comparing mepivacaine with a placebo. The study has received ethical approval and is funded by the Allmänna BB Memorial Fund and the Trygg-Hansa Research Fund, with the goal of improving knowledge about tear prevention and strengthening the scientific basis of childbirth care.
A randomised, multicentre study that investigated whether prophylactic oblique episiotomy during vacuum-assisted delivery in first-time mothers protects against sphincter injury. The incidence of sphincter injuries was halved. A follow-up study is now underway, in which we are looking at how the women are faring in the longer term.
Other research projects and collaborations
We also conduct research into how to make complicated deliveries and caesarean sections safer; for example, when labour is prolonged and how to identify those at risk of major haemorrhage.
Selected publications
Obstetric anal sphincter injury after episiotomy in vacuum extraction: an epidemiological study using an emulated randomised trial approach.
Ankarcrona V, Zhao H, Jacobsson B, Brismar Wendel S
BJOG 2021 Sep;128(10):1663-1671
Delivery outcome after trial of labor in nulliparous women 40 years or older-A nationwide population-based study.
Ankarcrona V, Altman D, Wikström AK, Jacobsson B, Brismar Wendel S
Acta Obstet Gynecol Scand 2019 Sep;98(9):1195-1203
Operator experience affects the risk of obstetric anal sphincter injury in vacuum extraction deliveries.
Bergendahl S, Lindberg P, Brismar Wendel S
Acta Obstet Gynecol Scand 2019 Jun;98(6):787-794
Lateral episiotomy versus no episiotomy to reduce obstetric anal sphincter injury in vacuum-assisted delivery in nulliparous women: study protocol on a randomised controlled trial.
Bergendahl S, Ankarcrona V, Leijonhufvud Å, Hesselman S, Karlström S, Kopp Kallner H, Brismar Wendel S
BMJ Open 2019 Mar;9(3):e025050
Red blood cells from patients with pre-eclampsia induce endothelial dysfunction.
McCann Haworth SM, Zhuge Z, Nihlén C, Von Rosen MF, Weitzberg E, Lundberg JO, Krmar RT, Nasiell J, Carlström M
J Hypertens 2021 Aug;39(8):1628-1641
Increased incidence of obstetric and perinatal complications in pregnancies achieved using donor oocytes and single embryo transfer in young and healthy women. A prospective hospital-based matched cohort study.
Rodriguez-Wallberg KA, Berger AS, Fagerberg A, Olofsson JI, Scherman-Pukk C, Lindqvist PG, Nasiell J
Gynecol Endocrinol 2019 Apr;35(4):314-319