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  1. Book ; Thesis: Human chorionic gonadotropin beta genes and recurrent miscarriage

    Rull, Kristiina

    expression and variation study

    (Dissertationes medicinae Universitatis Tartuensis ; 153)

    2009  

    Author's details Kristiina Rull
    Series title Dissertationes medicinae Universitatis Tartuensis ; 153
    Collection
    Language Estonian ; English
    Size 151 S. : graph .Darst.
    Publishing country Estonia
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Tartu, Univ., Diss., 2009
    HBZ-ID HT016471970
    ISBN 978-9949-19-051-5 ; 9949-19-051-7
    Database Catalogue ZB MED Medicine, Health

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  2. Article ; Online: Periventricular hemorrhagic infarction in preterm neonates: Etiology and time of development.

    Ilves, N / Metsvaht, T / Laugesaar, R / Rull, K / Lintrop, M / Laan, M / Loorits, D / Kool, P / Ilves, P

    Journal of neonatal-perinatal medicine

    2024  Volume 17, Issue 1, Page(s) 111–121

    Abstract: Background: To find the obstetrical and delivery associated risk factors of antenatal and postnatal grade III intraventricular hemorrhage (IVH) or periventricular hemorrhagic infarction (PVHI) in preterm neonates.: Methods: A retrospective study of ... ...

    Abstract Background: To find the obstetrical and delivery associated risk factors of antenatal and postnatal grade III intraventricular hemorrhage (IVH) or periventricular hemorrhagic infarction (PVHI) in preterm neonates.
    Methods: A retrospective study of obstetric and delivery associated risk factors included neonates (<35 gestational weeks) with severe IVH/PVHI (n = 120) and a prospectively collected control group (n = 50). The children were divided into: (1) antenatal onset group (n = 27) with insult visible on cerebral ultrasonography within the first 12 hours of birth or periventricular cystic changes visible in PVHI within the first 3 days; (2) neonatal onset group (n = 70) with insult diagnosed after initial normal findings or I-II grade IVH, and (3) unknown time-onset group (n = 23) with insult visible at > 12 h of age.
    Results: The mothers of the antenatal onset group had significantly more bacterial infections before delivery compared to the neonatal onset group: 20/27 (74.1%) versus 23/69 (33.3%), (odds ratio (OR) 5.7 [95% confidence interval 2.1-16]; p = 0.0008) or compared to the control group (11/50 (22%); OR 11 [2.8-42]; p = 0.0005). Placental histology revealed chorioamnionitis more often in the antenatal compared to the neonatal onset group (14/21 (66.7%) versus 16/42 (38.1%), respectively; OR 3.7 [1.18-11]; p = 0.025). Neonates with neonatal development of severe IVH/PVHI had significantly more complications during delivery or intensive care.
    Conclusions: Bacterial infection during pregnancy is an important risk factor for development of antenatal onset severe IVH or PVHI. In neonates born to mothers with severe bacterial infection during pregnancy, cerebral ultrasonography is indicated for early detection of severe IVH or PVHI.
    MeSH term(s) Infant, Newborn ; Child ; Female ; Humans ; Pregnancy ; Retrospective Studies ; Gestational Age ; Placenta/pathology ; Cerebral Hemorrhage/diagnostic imaging ; Cerebral Hemorrhage/epidemiology ; Cerebral Hemorrhage/etiology ; Infant, Newborn, Diseases ; Infarction/complications ; Infarction/pathology ; Bacterial Infections ; Infant, Premature, Diseases/diagnostic imaging ; Infant, Premature, Diseases/epidemiology ; Infant, Premature, Diseases/etiology
    Language English
    Publishing date 2024-01-08
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2435387-5
    ISSN 1878-4429 ; 1934-5798
    ISSN (online) 1878-4429
    ISSN 1934-5798
    DOI 10.3233/NPM-230033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Validation of the short forms of the Pelvic Floor Distress Inventory and the Pelvic Floor Impact Questionnaire in Estonian.

    Mikeltadze, Iveta / Täär, Katrin / Kadastik, Ülle / Soplepmann, Pille / Rull, Kristiina

    International urogynecology journal

    2023  Volume 34, Issue 9, Page(s) 2235–2240

    Abstract: Introduction and hypothesis: Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) are reliable instruments for evaluating the quality of life in women with pelvic organ prolapse (POP). They have been translated ... ...

    Abstract Introduction and hypothesis: Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) are reliable instruments for evaluating the quality of life in women with pelvic organ prolapse (POP). They have been translated and validated in many languages. The study was aimed at validating the Estonian translations of the PFDI-20 and PFIQ-7 tools.
    Methods: The questionnaires were translated into Estonian using a multistep translation method. A total of 132 women were enrolled: patients with diagnosed POP (n=57) were allocated to test-retest reliability analyses, and those with no POP signs (n=88) completed the questionnaire only once. The total scores of questionnaires and their subscales of both patient and reference groups were compared. Item response rate, floor and ceiling effects, corrected item-total correlations, internal consistency, and convergent and discriminant validity were analyzed. The study was approved by the Ethics Committee of Human Research of the University Clinic of Tartu, Estonia, and informed consent was obtained from each participant.
    Results: The translated questionnaires demonstrated good internal consistency (Cronbach's α values 0.77-0.93). The item response rate was 99%. Intra-class correlations (ICC) were strong for PFDI-20 and PFIQ-7 and their subscales ranged from 0.86 to 0.96. Construct validity of the tools demonstrated by manyfold higher scores among patients with POP compared with women without POP (p<0.0001).
    Conclusions: The Estonian versions of the PFDI-20 and PFIQ-7 tools are reliable and valid instruments for assessing the quality of life in women with POP.
    MeSH term(s) Humans ; Female ; Pelvic Floor Disorders/diagnosis ; Psychometrics ; Estonia ; Pelvic Floor ; Reproducibility of Results ; Quality of Life ; Language ; Surveys and Questionnaires ; Pelvic Organ Prolapse/diagnosis
    Language English
    Publishing date 2023-04-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 1050631-7
    ISSN 1433-3023 ; 0937-3462
    ISSN (online) 1433-3023
    ISSN 0937-3462
    DOI 10.1007/s00192-023-05532-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: The prevalence of congenital anomalies: nationwide study in 2020 in Estonia.

    Süüden, Eva-Liina / Muru, Kai / Põder, Kelli / Rull, Kristiina

    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

    2023  Volume 36, Issue 2, Page(s) 2259050

    Abstract: Objective: To assess the prevalence of congenital anomalies (CAs), chromosomal abnormalities and monogenic diseases among births and terminated pregnancies due to fetal anomalies (TOPFA) in 2020 in Estonia. Up to 2020 no data on prevalence of CAs in ... ...

    Abstract Objective: To assess the prevalence of congenital anomalies (CAs), chromosomal abnormalities and monogenic diseases among births and terminated pregnancies due to fetal anomalies (TOPFA) in 2020 in Estonia. Up to 2020 no data on prevalence of CAs in Estonia is reported.
    Methods: For retrospective observational study data of all births and terminations of pregnancies after 12th gestational week from (i) the Estonian Medical Birth Registry, (ii) Abortion Registy, (iii) Health Insurance Fund and (iv) hospital records were linked. To calculate the total, live birth, stillbirth and TOPFA prevalence of CAs with 95% confidence intervals (CI), guidelines issued by EUROCAT, European network for the epidemiological surveillance of CAs, https://eu-rd-platform.jrc.ec.europa.eu/eurocat_en were followed.
    Results: In 2020 the total prevalence of CAs, chromosomal abnormalities and monogenic diseases in Estonia was 378.6 per 10,000 births (95% CI 346.0, 413.5). The most prevalent CAs were heart defects, 163.7 cases per 10,000 births (95%CI 142.5, 187.2). The prevalence of chromosomal abnormalities and genetic diseases was 92.6 per 10,000 births (95%CI 76.8, 110.6), 80% of cases were among TOPFAs. No newborns with major aneuploidies (Trisomy 21, 18, 13, polyploidy) were reported in 2020. Live birth prevalence of CAs, including chromosomal abnormalities and genetic diseases was 258.4 per 10,000 live births (95%CI 231.5, 287.5) and stillbirth prevalence of CAs 0.8 per 10,000 births.
    Conclusions: The prevalence of CAs and genetic disorders in Estonia is one of the highest compared to prevalence reported by other European regions. It indicates to high population coverage with prenatal diagnostics in Estonia. Low number of major aneuploidies among live births may reflect good detection rate of major chromosomal abnormalities and cultural preferences.
    MeSH term(s) Female ; Pregnancy ; Humans ; Estonia/epidemiology ; Stillbirth/epidemiology ; Prevalence ; Chromosome Aberrations ; Aneuploidy
    Language English
    Publishing date 2023-09-24
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2077261-0
    ISSN 1476-4954 ; 1057-0802 ; 1476-7058
    ISSN (online) 1476-4954
    ISSN 1057-0802 ; 1476-7058
    DOI 10.1080/14767058.2023.2259050
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Screening of Gestational Diabetes and Its Risk Factors: Pregnancy Outcome of Women with Gestational Diabetes Risk Factors According to Glycose Tolerance Test Results.

    Hanson, Ele / Ringmets, Inge / Kirss, Anne / Laan, Maris / Rull, Kristiina

    Journal of clinical medicine

    2022  Volume 11, Issue 17

    Abstract: ... ...

    Abstract Background
    Language English
    Publishing date 2022-08-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11174953
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Value of soluble fms-like tyrosine kinase-1/placental growth factor test in third trimester of pregnancy for predicting preeclampsia in asymptomatic women.

    Hanson, Ele / Rull, Kristiina / Ratnik, Kaspar / Vaas, Pille / Teesalu, Pille / Laan, Maris

    Journal of perinatal medicine

    2022  Volume 50, Issue 7, Page(s) 939–946

    Abstract: Objectives: To estimate the value of screening maternal serum soluble fms-like tyrosine kinase/placental growth factor (sFlt-1/PlGF) ratio in asymptomatic women during 3rd trimester to predict preeclampsia (PE) development.: Methods: The investigated ...

    Abstract Objectives: To estimate the value of screening maternal serum soluble fms-like tyrosine kinase/placental growth factor (sFlt-1/PlGF) ratio in asymptomatic women during 3rd trimester to predict preeclampsia (PE) development.
    Methods: The investigated group comprised of 178 pregnant women. During this gestation, 24 cases had developed PE and 12 isolated gestational hypertension (GH); whereas 142 remained normotensive. Blood samples were collected between 180 and 259 gestational days (g.d.) when the participants were asymptomatic. Serums were analyzed using the BRAHMS sFlt-1 Kryptor/BRAHMS PlGF plus Kryptor PE ratio test (Thermo Fisher Scientific, Henningdorf, Germany). High-risk pregnancies for the PE development were defined as sFlt-1/PlGF>38.
    Results: The detection rate (DR) for manifestation of PE≤30 days after sampling was 83.3% and overall DR during pregnancy 58.3%. Ten of 15 women having false positive prediction of PE suffered from GH, preterm birth and/or delivery of a small-for-gestational-age-newborn. False positive rate was significantly higher at 239-253 g.d. compared to sampling at 210-224 g.d. and 225-238 g.d. (21.9% vs. 7.8% and 5.3%; p < 0.05).
    Conclusions: The sFlt-1/PlGF test during 180-259 g.d. detected approximately half of subsequent PE cases. An optimal time to use the test for screening purposes was estimated 225-238 g.d. (DR 66.7%). False positive test results were more common to cases with other adverse pregnancy outcomes and samples drawn at higher gestational age.
    MeSH term(s) Biomarkers ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Newborn ; Placenta Growth Factor ; Pre-Eclampsia/diagnosis ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Third ; Premature Birth ; Vascular Endothelial Growth Factor Receptor-1
    Chemical Substances Biomarkers ; Placenta Growth Factor (144589-93-5) ; Vascular Endothelial Growth Factor Receptor-1 (EC 2.7.10.1)
    Language English
    Publishing date 2022-05-13
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 123512-6
    ISSN 1619-3997 ; 0300-5577 ; 0936-174X
    ISSN (online) 1619-3997
    ISSN 0300-5577 ; 0936-174X
    DOI 10.1515/jpm-2022-0127
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Open versus laparoscopic appendectomy for acute appendicitis in pregnancy: a population-based study.

    Lipping, Edgar / Saar, Sten / Rull, Kristiina / Tark, Airi / Tiiman, Mari / Jaanimäe, Liis / Lepner, Urmas / Talving, Peep

    Surgical endoscopy

    2023  Volume 37, Issue 8, Page(s) 6025–6031

    Abstract: Background: Laparoscopic appendectomy (LA) is the standard treatment for acute appendicitis (AA) in general population. However, the safety of LA during pregnancy has remained a matter of debate. The purpose of this study was to compare surgical and ... ...

    Abstract Background: Laparoscopic appendectomy (LA) is the standard treatment for acute appendicitis (AA) in general population. However, the safety of LA during pregnancy has remained a matter of debate. The purpose of this study was to compare surgical and obstetrical outcomes in pregnant women who underwent LA vs. open appendectomy (OA) for AA. We hypothesized that LA results in improved surgical and obstetric outcomes during pregnancy.
    Methods: Using a nationwide claim-based database in Estonia, a retrospective review of all cases of pregnant women undergoing OA or LA for AA from 2010 to 2020 was performed. Patient characteristics, surgical and obstetrical outcomes were analyzed. Primary outcomes were preterm delivery, fetal loss and perinatal mortality. Secondary outcomes included operative time, hospital length of stay (HLOS) and 30-day postoperative complications.
    Results: Overall, 102 patients were included of whom 68 (67%) underwent OA and 34 patients (33%) LA, respectively. Patients in LA cohort had a significantly shorter length of pregnancy in terms of gestational weeks when compared to OA cohort (12 weeks versus 17 weeks, p = 0.002). Most of the patients in their 3
    Conclusions: Laparoscopic appendectomy for acute appendicitis was associated with a significantly shorter operative time and a shorter hospital length of stay while open and laparoscopic appendectomy cohorts experienced comparable obstetrical outcomes. Our findings support the laparoscopic approach for acute appendicitis in pregnancy.
    MeSH term(s) Infant, Newborn ; Humans ; Pregnancy ; Female ; Laparoscopy/methods ; Appendicitis/surgery ; Appendicitis/etiology ; Appendectomy/methods ; Treatment Outcome ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Length of Stay ; Retrospective Studies ; Acute Disease
    Language English
    Publishing date 2023-04-26
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-023-10075-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Single-Tube Multimarker Assay for Estimating the Risk to Develop Preeclampsia.

    Ratnik, Kaspar / Rull, Kristiina / Hanson, Ele / Kisand, Kalle / Laan, Maris

    The journal of applied laboratory medicine

    2020  Volume 5, Issue 6, Page(s) 1156–1171

    Abstract: Background: Preeclampsia (PE) affects 2%-8% of all pregnancies worldwide. The predictive value of the currently used maternal serum fms-like tyrosine kinase-1/ placental growth factor (sFlt-1/PlGF) test is < 40% for PE onset within 4 weeks. We aimed to ... ...

    Abstract Background: Preeclampsia (PE) affects 2%-8% of all pregnancies worldwide. The predictive value of the currently used maternal serum fms-like tyrosine kinase-1/ placental growth factor (sFlt-1/PlGF) test is < 40% for PE onset within 4 weeks. We aimed to develop an innovative multiplex assay to improve PE prediction.
    Methods: The 6PLEX assay combining the measurements of ADAM12, sENG, leptin, PlGF, sFlt-1, and PTX3 was developed for the Luminex® xMAP platform. Assay performance was evaluated using 61 serum samples drawn from 53 pregnant women between 180 and 275 gestational days: diagnosed PE cases, n = 4; cases with PE onset within 4-62 days after sampling, n = 25; controls, n = 32. The B·R·A·H·M·S Kryptor sFlt-1/PlGF test (Thermo Fisher Scientific, Hennigsdorf, Germany) was applied as an external reference. Alternative PE prediction formulae combining 6PLEX measurements with clinical parameters were developed.
    Results: There was a high correlation in sFlt-1/PlGF estimated for individual sera between the 6PLEX and B·R·A·H·M·S Kryptor immunoassays (Spearman's r = 0.93, P < 0.0001). The predictive power of the 6PLEX combined with gestational age and maternal weight at sampling reached AUC 0.99 (95% CI 0.97-1.00) with sensitivity 100.0% and specificity 96.9%. In all models, sFlt-1/PlGF derived from the B·R·A·H·M·S immunoassays exhibited the lowest AUC value (<0.87) and sensitivity (<80%) with broad confidence intervals (13%-92%). The estimated prognostic yield of the 6PLEX compared to the B·R·A·H·M·S assay was significantly higher (96.5% vs 73.7%; P = 0.0005).
    Conclusions: The developed single-tube multimarker assay for PE risk estimation in combination with clinical symptoms reached high prognostic yield (96.5%) and exhibited superior performance compared to the sFlt-1/PlGF test.
    MeSH term(s) Biological Assay ; Biomarkers/blood ; Female ; Gestational Age ; Humans ; Placenta Growth Factor/blood ; Pre-Eclampsia/diagnosis ; Pregnancy ; Vascular Endothelial Growth Factor Receptor-1/blood
    Chemical Substances Biomarkers ; Placenta Growth Factor (144589-93-5) ; FLT1 protein, human (EC 2.7.10.1) ; Vascular Endothelial Growth Factor Receptor-1 (EC 2.7.10.1)
    Language English
    Publishing date 2020-05-12
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2576-9456
    ISSN 2576-9456
    DOI 10.1093/jalm/jfaa054
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: C-allele of rs4769613 Near

    Kikas, Triin / Inno, Rain / Ratnik, Kaspar / Rull, Kristiina / Laan, Maris

    Hypertension (Dallas, Tex. : 1979)

    2020  Volume 76, Issue 3, Page(s) 884–891

    Abstract: The variant rs4769613 T/C within the enhancer element ... ...

    Abstract The variant rs4769613 T/C within the enhancer element near
    MeSH term(s) Adult ; Biomarkers/blood ; Case-Control Studies ; Female ; Gene Expression Profiling/methods ; Genome-Wide Association Study ; Gestational Age ; Humans ; Placenta/metabolism ; Pre-Eclampsia/diagnosis ; Pre-Eclampsia/genetics ; Pre-Eclampsia/metabolism ; Predictive Value of Tests ; Pregnancy ; Pregnancy, High-Risk/blood ; Pregnancy, High-Risk/metabolism ; Prognosis ; Risk Assessment ; Risk Factors ; Vascular Endothelial Growth Factor Receptor-1/blood ; Vascular Endothelial Growth Factor Receptor-1/genetics
    Chemical Substances Biomarkers ; FLT1 protein, human (EC 2.7.10.1) ; Vascular Endothelial Growth Factor Receptor-1 (EC 2.7.10.1)
    Language English
    Publishing date 2020-08-03
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 423736-5
    ISSN 1524-4563 ; 0194-911X ; 0362-4323
    ISSN (online) 1524-4563
    ISSN 0194-911X ; 0362-4323
    DOI 10.1161/HYPERTENSIONAHA.120.15346
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Recurrent Pregnancy Loss and Concealed Long-QT Syndrome.

    Kasak, Laura / Rull, Kristiina / Yang, Tao / Roden, Dan M / Laan, Maris

    Journal of the American Heart Association

    2021  Volume 10, Issue 17, Page(s) e021236

    Abstract: Background Recurrent pregnancy loss affects 1% to 2% of couples attempting childbirth. A large fraction of all cases remains idiopathic, which warrants research into monogenic causes of this distressing disorder. Methods and Results We investigated a ... ...

    Abstract Background Recurrent pregnancy loss affects 1% to 2% of couples attempting childbirth. A large fraction of all cases remains idiopathic, which warrants research into monogenic causes of this distressing disorder. Methods and Results We investigated a nonconsanguineous Estonian family who had experienced 5 live births, intersected by 3 early pregnancy losses, and 6 fetal deaths, 3 of which occurred during the second trimester. No fetal malformations were described at the autopsies performed in 3 of 6 cases of fetal death. Parental and fetal chromosomal abnormalities (including submicroscopic) and maternal risk factors were excluded. Material for genetic testing was available from 4 miscarried cases (gestational weeks 11, 14, 17, and 18). Exome sequencing in 3 pregnancy losses and the mother identified no rare variants explicitly shared by the miscarried conceptuses. However, the mother and 2 pregnancy losses carried a heterozygous nonsynonymous variant, resulting in p.Val173Asp (
    MeSH term(s) Abortion, Habitual/diagnosis ; Abortion, Habitual/genetics ; Animals ; Cricetinae ; Cricetulus ; Estonia ; Female ; Humans ; KCNQ1 Potassium Channel/genetics ; Long QT Syndrome/diagnosis ; Long QT Syndrome/genetics ; Pregnancy
    Chemical Substances KCNQ1 Potassium Channel ; KCNQ1 protein, human
    Language English
    Publishing date 2021-08-16
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.121.021236
    Database MEDical Literature Analysis and Retrieval System OnLINE

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