Marit Lieng

• Aas-Eng, Mee Kristine; Dauser, Bernhard; Lieng, Marit; Diep, Lien My; Leonardi, M.; Condous, G. & Hudelist, Gernot (2020). Transvaginal sonography accurately measures lesion-to-anal-verge distance in women with deep endometriosis of the rectosigmoid. Ultrasound in Obstetrics and Gynecology.  ISSN 0960-7692.  56(5), s 766- 772 . doi: 10.1002/uog.21995 Full text in Research Archive.
• Aas-Eng, Mee Kristine; Montanari, Eliana; Lieng, Marit; Keckstein, Joerg & Hudelist, Gernot (2020). Transvaginal tonographic imaging and associated techniques for diagnosis of ovarian, deep endometriosis, and adenomyosis: A comprehensive review. Seminars in Reproductive Medicine.  ISSN 1526-8004.  38, s 216- 226 . doi: 10.1055/s-0040-1718740
• Goderstad, Jeanne Mette; Fosse, Erik; Sandvik, Leiv & Lieng, Marit (2020). Development and validation of a curriculum for laparoscopic supracervical hysterectomy. Facts, views & vision in ObGyn..  ISSN 2032-0418.  12(2), s 83- 90
• Johanson, Maja Lieng; Dögl, Malin Andrea Elisabeth & Lieng, Marit (2020). Hysterektomi i Norge 2008–18. Tidsskrift for Den norske legeforening.  ISSN 0029-2001.  (14) . doi: 10.4045/tidsskr.20.0167 Show summary

  Background: Hysterectomy is a common gynaecological procedure. No Norwegian guidelines for the choice of hysterectomy surgical method exist, but international guidelines recommend minimally invasive surgery. The objective of this study was to investigate the kinds of surgical methods that were used for hysterectomies in the period 2008-18. Furthermore, we wished to identify the scope of robot-assisted hysterectomies and to find out whether salpingectomies are undertaken on a benign indication in Norway. Material and method: The study is based on data from the Norwegian Patient Registry. Relevant variables for all gynaecological hysterectomies in Norway in the period 2008-18 were collected at the individual level. Results: During the study period, 53 178 hysterectomies were registered in the Norwegian Patient Registry. The proportion of hysterectomies that were performed with minimally invasive techniques increased from 41 % to 73 % during the study period. Robot-assisted hysterectomies accounted for 15 % of the total in 2018. The number of concomitant salpingectomies also increased during the period, and were performed in more than half of all hysterectomies undertaken on a benign indication. Interpretation: Norwegian gynaecologists largely follow international guidelines and recommendations regarding minimally invasive hysterectomy and salpingectomy. Although the total proportion of minimally invasive hysterectomies is now relatively high, there are considerable variations between the different health trusts.

• Ravlo, Merethe; Lieng, Marit; Bukholm, Ida Rashida Khan; Moen, Mette Haase & Vanky, Eszter (2020). Claims for compensation from women with cervical cancer in Norway-A retrospective, descriptive study of a 12-year period. Acta Obstetricia et Gynecologica Scandinavica.  ISSN 0001-6349.  99(11), s 1546- 1553 . doi: 10.1111/aogs.13930 Show summary

  Introduction: In Norway, all patient-reported claims for compensation are evaluated by The Norwegian System of Patient Injury Compensation (NPE). The number of claims from women with cervical cancer is rising, and the approval rate is high. Our aim was to study claims for compensation from women with cervical cancer to identify the type of failures, when, during the time-course of treatment, the medical failures occurred, and the consequences of the failures. Material and methods: A retrospective, descriptive study of claims for compensation to NPE from cervical cancer patients during a 12-year period, from 2007 through 2018. We used anonymized medical expert statements and summaries of NPE cases. Results: In all, 161 women claimed compensation for alleged medical failure related to cervical cancer. Compensation was approved for 100 (62%) women. Mean age at the time of alleged failure was 37.5 years (SD ±9.9). The main reasons why women sought medical attention were routine cervical screening (56%), or vaginal bleeding or discharge (30%). In approved cases, incorrect evaluation of cytology and histology was the cause of most failures (72%). Mean delay of cervical cancer diagnosis for approved cases was 28 months (SD ±22). Treatment not in accordance with guidelines was the cause of failure in 2% of the cases, and failure during follow up was the cause of failure in 12%. Consequences of the failures were as follows: worsening of cancer prognosis (89%), treatment-induced adverse effects, such as loss of fertility (43%) and/or loss of ovarian function in premenopausal women (50%), and permanent injury after chemo-radiation (27%). Seven women (7%) died, most probably as a consequence of the failure. Conclusions: The main cause of medical failure in women with cervical cancer was incorrect pathological diagnosis. The main consequences of failures were worsening of cancer prognosis and treatment-induced adverse effects. Increased focus on the quality of pathological examinations, and better routines in all parts of the cervical examinations might improve patient safety for women in risk of cervical cancer.

• Goderstad, Jeanne Mette; Sandvik, Leiv; Fosse, Erik & Lieng, Marit (2019). Development and validation of a general and easy assessable scoring system for laparoscopic skills using a virtual reality simulator.. European Journal of Obstetrics, Gynecology, and Reproductive Biology.  ISSN 0301-2115.  4, s 1- 5 . doi: 10.1016/j.eurox.2019.100092 Full text in Research Archive.
• Mortensen, Berit; Diep, Lien My; Lukasse, Mirjam; Lieng, Marit; Dwekat, Ibtesam; Elias, Dalia & Fosse, Erik (2019). Women's satisfaction with midwife-led continuity of care: An observational study in Palestine. BMJ Open.  ISSN 2044-6055.  9(11), s 1- 9 . doi: 10.1136/bmjopen-2019-030324 Full text in Research Archive. Show summary

  Abstract Objectives A midwife-led continuity model of care had been implemented in the Palestinian governmental health system to improve maternal services in several rural areas. This study investigated if the model influenced women’s satisfaction with care, during antenatal, intrapartum and postnatal period. Design An observational case-control design was used to compare the midwife-led continuity model of care with regular maternity care. Participants and setting Women with singleton pregnancies, who had registered for antenatal care at a rural governmental clinic in the West Bank, were between 1 to 6 months after birth invited to answer a questionnaire rating satisfaction with care in 7-point Likert scales. Primary outcome The mean sum-score of satisfaction with care through the continuum of antenatal, intrapartum and postnatal period, where mean sum-scores range from 1 (lowest) to 7 (highest). Secondary outcome Exclusive breastfeeding. Results Two hundred women answered the questionnaire, 100 who received the midwife-led model and 100 who received regular care. The median time point of interview were 16 weeks postpartum in both groups. The midwife-led model was associated with a statistically significant higher satisfaction with care during antenatal, intrapartum and postnatal period, with a mean sum-score of 5.2 versus 4.8 in the group receiving regular care. The adjusted mean difference between the groups’ sum-score of satisfaction with care was 0.6 (95% CI 0.35 to 0.85), p<0.0001. A statistically significant higher proportion of women who received the midwife-led continuity model of care were still exclusively breastfeeding at the time point of interview, 67% versus 46% in the group receiving regular care, an adjusted OR of 2.56 (1.35 to 4.88) p=0.004. Conclusions There is an association between receiving midwife-led continuity of care and increased satisfaction with care through the continuum of pregnancy, intrapartum and postpartum period, and an increased duration of exclusive breastfeeding.

• Mortensen, Berit; Lieng, Marit; Diep, Lien My; Lukasse, Mirjam; Atieh, Kefaya & Fosse, Erik (2019). Improving Maternal and Neonatal Health by a Midwife-led Continuity Model of Care ? An Observational Study in One Governmental Hospital in Palestine. EClinicalMedicine.  ISSN 2589-5370.  10, s 84- 91 . doi: 10.1016/j.eclinm.2019.04.003 Full text in Research Archive. Show summary

  Background:From 2013 a midwife-led continuity model of care was implemented in the Nablus region in occu-pied Palestine, involving a governmental hospital and ten rural villages. This study analysed the relation betweenthe midwife-led model and maternal and neonatal health outcomes.Method:A register-based, retrospective cohort design was used, involving 2201 singleton births betweenJanuary 2016 and June 2017 at Nablus governmental hospital. Data from rural women, with singleton preg-nancies and mixed risk status, who either lived in villages that offered the midwife-led continuity modeland had registered at the governmental clinic, or who lived in villages without the midwife-led modeland received regular care, were compared. Primary outcome was unplanned caesarean section. Secondaryoutcomes were other modes of birth, postpartum anaemia, preterm birth, birthweight, and admission toneonatal intensive care unit.Findings:Statistically significant less women receiving the midwife-led model had unplanned caesareansections, 12·8% vs 15·9%, adjusted risk ratio (aRR) 0·80 (95% CI 0·64–0·99) and postpartum anaemia,19·8%vs 28·6%, aRR 0·72 (0·60–0·85). There was also a statistically significant lower rate of preterm births withinthe exposed group, 13·1% vs 16·8, aRR 0·79 (0·63–0·98), admission to neonatal intensive care unit, 7·0% vs9·9%, aRR 0·71 (0·52–0·98) and newborn with birth weight 1500 g and less, 0·1% vs 1·1%, aRR 0·13(0·02–0·97).Interpretation:Receiving the midwife-led continuity model of care in Palestine was associated with severalimproved maternal and neonatal health outcomes. Thefindings support further implementation of the model.Implementation research, including randomised studies, would be useful to further investigate the effect andfeasibility of the model in a low resource setting.Funding:This study was partly funded by the Research Council of Norway through the Global Health andVaccination Program (GLOBVAC), project number 243706. The implementation received public funding throughNorwegian Aid Committee (NORWAC)

• Ravlo, Merethe; Lieng, Marit; Bukholm, Ida Rashida Khan; Moen, Mette Haase & Vanky, Eszter (2019). Approved claims for compensation from gynecological patients in Norway?What characterizes the cases? A 14-year nationwide study. Acta Obstetricia et Gynecologica Scandinavica.  ISSN 0001-6349.  98(8), s 1070- 1076 . doi: 10.1111/aogs.13605 Full text in Research Archive.
• Tellum, Tina; MATIC, GORDANA; Dormagen, Johann Baptist; Nygård, Ståle; Viktil, Ellen; Qvigstad, Erik & Lieng, Marit (2019). Diagnosing adenomyosis with MRI: a prospective study revisiting the junctional zone thickness cutoff of 12 mm as a diagnostic marker. European Radiology.  ISSN 0938-7994.  29(12), s 6971- 6981 . doi: 10.1007/s00330-019-06308-3
• Tellum, Tina; Nygård, Ståle & Lieng, Marit (2019). Non-invasive diagnosis of adenomyosis: a structured review and meta-analysis of diagnostic accuracy. Journal of minimally invasive gynecology.  ISSN 1553-4650.  27(2), s 408- 418 . doi: 10.1016/j.jmig.2019.11.001
• Tellum, Tina; Qvigstad, Erik; Skovholt, Else K. & Lieng, Marit (2019). In vivo adenomyosis tissue sampling using a transvaginal ultrasound-guided core biopsy technique for research purposes: Safety, feasibility, and effectiveness. Journal of minimally invasive gynecology.  ISSN 1553-4650.  26(7), s 1357- 1362 . doi: 10.1016/j.jmig.2019.02.002
• Mortensen, Berit; Lukasse, Mirjam; Diep, Lien My; Lieng, Marit; Abu-Awad, Amal; Suleiman, Munjid & Fosse, Erik (2018). Can a midwife-led continuity model improve maternal services in a low-resource setting? A non-randomised cluster intervention study in Palestine. BMJ Open.  ISSN 2044-6055.  8(3) . doi: 10.1136/bmjopen-2017-019568 Full text in Research Archive. Show summary

  Objectives: To improve maternal health services in rural areas, the Palestinian Ministry of Health launched a midwife-led continuity model in the West Bank in 2013. Midwives were deployed weekly from governmental hospitals to provide antenatal and postnatal care in rural clinics. We studied the intervention’s impact on use and quality indicators of maternal services after 2 years’ experience. Design: A non-randomised intervention design was chosen. The study was based on registry data only available at cluster level, 2 years before (2011and2012) and 2 years after (2014and2015) the intervention. Setting All 53 primary healthcare clinics in Nablus and Jericho regions were stratified for inclusion. Primary and secondary outcomes Primary outcome was number of antenatal visits. Important secondary outcomes were number of referrals to specialist care and number of postnatal home visits. Differences in changes within the two groups before and after the intervention were compared by using mixed effect models. Results: 14 intervention clinics and 25 control clinics were included. Number of antenatal visits increased by 1.16 per woman in the intervention clinics, while declined by 0.39 in the control clinics, giving a statistically significant difference in change of 1.55 visits (95% CI 0.90 to 2.21). A statistically significant difference in number of referrals was observed between the groups, giving a ratio of rate ratios of 3.65 (2.78–4.78) as number of referrals increased by a rate ratio of 3.87 in the intervention group, while in the control the rate ratio was only 1.06. Home visits increased substantially in the intervention group but decreased in the control group, giving a ratio of RR 97.65 (45.20 - 210.96) Conclusion: The Palestinian midwife-led continuity model improved use and some quality indicators of maternal services. More research should be done to investigate if the model influenced individual health outcomes and satisfaction with care.

• Tellum, Tina; Nygård, Ståle; Skovholt, Else K.; Qvigstad, Erik & Lieng, Marit (2018). Development of a clinical prediction model for diagnosing adenomyosis. Fertility and Sterility.  ISSN 0015-0282.  110(5), s 957- 964.e3 . doi: 10.1016/j.fertnstert.2018.06.009
• Zimmo, Mohammed; Laine, Katariina; Hassan, Sahar J. A.; Böttcher, Bettina; Fosse, Erik; Ali, Hadil; Zimmo, Kaled; Falk, Ragnhild Sørum; Lieng, Marit & Vikanes, Åse (2018). Caesarean section in Palestine using the Robson Ten Group Classification System: A population-based birth cohort study. BMJ Open.  ISSN 2044-6055.  8:e022875(10), s 1- 8 . doi: 10.1136/bmjopen-2018-022875 Full text in Research Archive.
• Zimmo, Mohammed; Laine, Katariina; Hassan, Sahar; Fosse, Erik; Lieng, Marit; Ali, Hadil; Zimmo, Kaled; Anti, Marit; Bottcher, Bettina; Falk, Ragnhild Sørum & Vikanes, Åse Vigdis (2018). Differences in rates and odds for emergency caesarean section in six Palestinian hospitals: A population-based birth cohort study. BMJ Open.  ISSN 2044-6055.  8(3) . doi: 10.1136/bmjopen-2017-019509 Full text in Research Archive.
• Aas-Eng, Mee Kristine; Langebrekke, Anton; Lieng, Marit & Qvigstad, Erik (2017). Management of Broad Ligament Defects and Herniation of Colon. Journal of minimally invasive gynecology.  ISSN 1553-4650.  24(5), s 713- 714 . doi: 10.1016/j.jmig.2016.12.002
• Goderstad, Jeanne Mette; Sandvik, Leiv; Fosse, Erik & Lieng, Marit (2016). Assessment of surgical competence: Development and validation of rating scales used for laparoscopic supracervical hysterectomy. Journal of Surgical Education.  ISSN 1931-7204.  73(4), s 600- 608 . doi: 10.1016/j.jsurg.2016.01.001
• Skorstad, Mette; Kent, Andrew & Lieng, Marit (2016). Preoperative evaluation in women with uterine leiomyosarcoma. A nationwide cohort study. Acta Obstetricia et Gynecologica Scandinavica.  ISSN 0001-6349.  95(11), s 1228- 1234 . doi: 10.1111/aogs.13008
• Skorstad, Mette; Kent, Andrew & Lieng, Marit (2016). Uterine leiomyosarcoma - incidence, treatment, and the impact of morcellation. A nation-wide cohort study. Acta Obstetricia et Gynecologica Scandinavica.  ISSN 0001-6349.  95(9), s 984- 990 . doi: 10.1111/aogs.12930
• Berner, Espen; Qvigstad, Erik; MYRVOLD, ANNE KRISTINA & Lieng, Marit (2015). Pain reduction after total laparoscopic hysterectomy and laparoscopic supracervical hysterectomy among women with dysmenorrhoea: A randomised controlled trial. BJOG: An International Journal of Obstetrics and Gynaecology.  ISSN 1470-0328.  122(8), s 1102- 1111 . doi: 10.1111/1471-0528.13362
• Lieng, Marit; Berner, Espen & Busund, Bjørn (2015). Risk of Morcellation of Uterine Leiomyosarcomas in Laparoscopic Supracervical Hysterectomy and Laparoscopic Myomectomy, a Retrospective Trial Including 4791 Women. Journal of minimally invasive gynecology.  ISSN 1553-4650.  22(3), s 410- 414 . doi: 10.1016/j.jmig.2014.10.022
• Berner, Espen; Qvigstad, Erik; MYRVOLD, ANNE KRISTINA & Lieng, Marit (2014). Pelvic pain and patient satisfaction after laparoscopic supracervical hysterectomy: a prospective trial. Journal of minimally invasive gynecology.  ISSN 1553-4650.  21(3), s 406- 411 . doi: 10.1016/j.jmig.2013.10.011
• Hald, Kirsten & Lieng, Marit (2014). Assessment of Periodic Blood Loss: Interindividual and Intraindividual Variations of Pictorial Blood Loss Assessment Chart Registrations. Journal of minimally invasive gynecology.  ISSN 1553-4650.  21(4), s 662- 668 . doi: 10.1016/j.jmig.2014.01.015
• Berner, Espen; Qvigstad, Erik; Langebrekke, Anton & Lieng, Marit (2013). Laparoscopic Supracervical Hysterectomy Performed With and Without Excision of the Endocervix: A Randomized Controlled Trial. Journal of minimally invasive gynecology.  ISSN 1553-4650.  20(3), s 368- 375 . doi: 10.1016/j.jmig.2013.01.003
• Høyer-Sørensen, Christian Espen; Hortemo, Sigurd & Lieng, Marit (2013). Changing the route of hysterectomy into a minimal invasive approach. ISRN Obstetrics and Gynecology.  ISSN 2090-4436.  2013 . doi: 10.1155/2013/249357
• Hvingel, Bodil; Lieng, Marit; Roald, Borghild & Ørbo, Anne (2012). Vascular markers CD31, CD34, actin, VEGFB, and VEGFR2, are prognostic markers for malignant development in benign endometrial polyps. Open Journal of Obstetrics and Gynecology.  ISSN 2160-8792.  2, s 18- 26 . doi: 10.4236/ojog.2012.21004
• Kozinszky, Zoltan; Bakken, Ragnhild Tøsse & Lieng, Marit (2011). Ectopic pregnancy after levonorgestrel emergency contraception. Contraception.  ISSN 0010-7824.  83(3), s 281- 283 . doi: 10.1016/j.contraception.2010.08.008
• Majak, Guri B; Lieng, Marit & Qvigstad, Erik (2011). Clinical outcome after laparoscopic and open abdominal myomectomy. Gynecological Surgery.  ISSN 1613-2076.  9(2), s 231- 234 . doi: 10.1007/s10397-011-0699-z
• Qvigstad, Erik & Lieng, Marit (2011). Surgical treatment of endometrial cancer and atypical hyperplasia: a trend shift from laparotomy to laparoscopy. Obstetrics and Gynecology International.  ISSN 1687-9589. . doi: 10.1155/2011/829425
• Lieng, Marit; ISTRE, OLAV & Qvigstad, Eirik (2010). Treatment of endometrial polyps: a systematic review. Acta Obstetricia et Gynecologica Scandinavica.  ISSN 0001-6349.  89(8), s 992- 1002 . doi: 10.3109/00016349.2010.493196
• Lieng, Marit; ISTRE, OLAV; Sandvik, Leiv; Qvigstad, Erik & Engh, Tove Vibeke (2010). Clinical Effectiveness of Transcervical Polyp Resection in Women with Endometrial Polyps: Randomized Controlled Trial. Journal of minimally invasive gynecology.  ISSN 1553-4650.  17(3), s 351- 357 . doi: 10.1016/j.jmig.2010.01.019
• Oppegaard, Kevin Sunde; Lieng, Marit; Istre, Olav; Berg, Anette; Qvigstad, Erik & Nesheim, Britt-Ingjerd (2010). A combination of misoprostol and estradiol for preoperative cervical ripening in postmenopausal women: a randomised controlled trial. BJOG: An International Journal of Obstetrics and Gynaecology.  ISSN 1470-0328.  117(1), s 53- 61 . doi: 10.1111/j.1471-0528.2009.02435.x
• Goderstad, Jeanne Mette; Lieng, Marit & Busund, Bjørn (2009). Kirurgisk behandling av benigne gynekologiske lidelser. Tidsskrift for Den norske legeforening.  ISSN 0029-2001.  129(15), s 1460- 1463
• Lieng, Marit; Qvigstad, Erik; Dahl, Gunn Fallås & ISTRE, OLAV (2008). Flow differences between endometrial polyps and cancer: a prospective study using intravenous contrast-enhanced transvaginal color flow Doppler and three-dimensional power Doppler ultrasound. Ultrasound in Obstetrics and Gynecology.  ISSN 0960-7692.  32(7), s 935- 940 . doi: 10.1002/uog.6267
• Lieng, Marit; Qvigstad, Erik; Sandvik, Leiv; Jorgensen, H; Langebrekke, Anton & ISTRE, OLAV (2007). Hysteroscopic resection of symptomatic and asymptomatic endometrial polyps. Journal of minimally invasive gynecology.  ISSN 1553-4650.  14 . doi: 10.1016/j.jmig.2006.09.018

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• Dormagen, Johann Baptist; Matic, Gordana; Lieng, Marit & Qvigstad, Erik (2019). OP07.07: MUSA‐classification of junctional zone appearance in MRI shows a good diagnostic prediction of adenomyosis, while junctional zone measurement does not.
• Mortensen, Berit; Lukasse, Mirjam; Diep, Lien My; Lieng, Marit; Abu-Awad, Amal; Suleiman, Munjid & Fosse, Erik (2018). CAN A MIDWIFERY-LED CONTINUITY MODEL IMPROVE MATERNAL SERVICES IN A LOW RESOURCE SETTING? – A NON-RANDOMIZED CLUSTER INTERVENTION STUDY IN PALESTINE.
• Ravlo, Merethe; Lieng, Marit; Bukholm, Ida Rashida Khan; Moen, Mette Haase & Vanky, Eszter (2018). Erstatningssaker i gynekologi - hva kan vi lære?.
• Lieng, Marit; Matic, Gordana & Skovholt, Else K. (2017). OC22.05: *3D transvaginal ultrasound in adenomyosis: are we looking at all there is?.
• Mortensen, Berit; Lukasse, Mirjam; Diep, Lien My; Lieng, Marit; Abu-Awad, Amal; Suleiman, Munjid & Fosse, Erik (2017). How a Continuity of Midwifery Care Model affect the usage and quality of maternal services in rural Palestine. Show summary

  For the Lancet Palestinian Health Alliance (LPHA) conference 2017: How a Continuity of Midwifery Care Model affect the usage and quality of maternal services in rural Palestine Authors: Berit Mortensen MSc (beritmor@me.com) and Erik Fosse MD, Phd Medical Faculty, University of Oslo, and the Intervention Center Oslo University Hospital, Oslo, Norway Abstract 465 words: Background: The Palestinian Ministry of Health provided care for 45,6% of the pregnant women in the occupied West Bank in 2013. No report described the difference between urban and rural areas; nevertheless, private service providers are more available to women in urban areas. Women living in remote areas are vulnerable because Israeli armed soldier and settlers make it dangerous to move. Abdul Rahim et al. described governmental maternal services with poor quality and antenatal-visits lacking content, short consultation time and dissatisfaction with care. In 2013 the Ministry of Health started a stepwise implementation of a Continuity of Midwifery Care Model in rural areas on the West Bank in cooperation with Norwegian aid Committee (NORWAC). The model entailed deploying midwives from the local governmental hospital to ante-and postnatal care in rural clinics. This study explored if the model increased the usage and the quality of health services after two years’ experience in Nablus and Jericho regions. Methods: The study was based on registry data at cluster level. Data from 14 clinics offering the new model was compared with data from 25 clinics offering standard care. Primary outcome was: mean number of antenatal visits per woman, number of pregnant referred to higher level of care, number of women receiving postnatal home visits. We compared the change in outcomes two years before with two years after the implementation. Multilevel Poisson regression was used to examine difference between the intervention and standard care groups and testing the change. Findings: A statistical significant difference was found between the intervention and control group (p-value < 0.001) in all primary outcomes. In clinics with the new model the mean number of ante-natal visits per woman increased from 3.7 to 4.7, while in the clinics with standard care a decline was observed from 4.6 to 4.2 visits. The percentage of pregnant women referred to higher level of care increased from 7% to 25,6% in the intervention clinics. No such increase was observed in the control clinics. The percentage of postnatal home visits increased from 2% to 42% at the intervention clinics, while at the control clinics the visits dropped from 1.5% to 0.7%. Interpretation: The continuity model improved the usage and quality of maternal services in rural clinics in the West Bank. Continuity of care allows building a relationship where women experience respect and gain trust in the health care provided. The findings indicate that this relationship, as well as the care being provided by midwives from the hospitals, near the women`s home, increased usage of care and quality of service.

• Mortensen, Berit; Lukasse, Mirjam; Diep, Lien My; Lieng, Marit & Fosse, Erik (2017). Does outreaching Continuity of Midwifery-care improve usage and quality of services in Palestine?. Show summary

  Does outreaching Continuity of Midwifery-care improve usage and quality of services in Palestine?

• Mortensen, Berit; Lukasse, Mirjam; Diep, Lien; Lieng, Marit; Abu-Awad, Amal; Suleiman, Munjid & Fosse, Erik (2017). Kan kontinuitet i jordmoromsorgen forbedre helsetjenesten for gravide og barselkvinner i et lavinntektsland? – En ikke-randomisert intervensjonsstudie i Palestina. Show summary

  Kan kontinuitet i jordmoromsorgen forbedre helsetjenesten for gravide og barselkvinner i et lavinntektsland? – En ikke-randomisert intervensjonsstudie i Palestina Innledning: For å bedre helsetilbudet for gravide og barselkvinner på landsbygda lanserte palestinsk helsedepartement i 2013 en modell for kontinuitet i jordmoromsorgen på den israel-okkuperte Vestbredden, i samarbeid med Norwegian Aid Committee (NORWAC). Modellen innebærer at jordmødre fra offentlige sykehus drar ut til landsbyer for å drive svangerskaps- og barselomsorg. Den samme jordmoren besøker samme landsby hver uke. De fleste føder ved det sykehuset jordmoren jobber. Mål: Studien undersøkte virkningen modellen hadde på bruken av tjenesten og noen kvalitetsforbedringsindikatorer etter to års erfaring. Materialer og metode: Intervensjonen var allerede i gang og en ikke-randomisert intervensjons design ble valgt. Studiet er basert på registerdata, kun tilgjengelig på institusjonsnivå (cluster), to år før (2011 & 2012) og to år etter (2014 & 2015) intervensjonen startet. Totalt ble 53 primærhelse klinikker i regionene Nablus og Jeriko, stratifisert for inkludering. Primærutfallet var gjennomsnittlig antall svangerskapskontroller. Viktige sekundære utfall var antall henvisninger til spesialisthelsetjenesten og antall hjemmebesøk etter fødsel. Forskjellen I endring før og etter intervensjonen ble sammenlignet mellom klinikker som hadde jordmormodellen og klinikker med ordinær svangerskaps- og barselomsorg. Resultater: Det ble inkludert 14 intervensjons-klinikker og 25 kontroll-klinikker i studien. Antall svangerskapskontroller økte med 1.16 per kvinne i klinikker med jordmormodellen, mens antall kontroller ble redusert med 0.39 kontroller per kvinne i klinikkene som ikke hadde jordmormodell. Dette ga en signifikant forskjell i endring på 1.55 kontroller [95% CI 0.90 – 2.21]. En signifikant forskjell i endring av antall henvisninger ble også observert mellom gruppene med en endringsratio på 3.65 [2.78 – 4.78]. Antall henvisninger økte med en rate ratio på 3.87 I klinikker med jordmormodellen, mens det ikke var noen signifikant endring i kontrollgruppen som hadde en ratio på 1.06. Jordmormodellen førte til at hjemmebesøk ble gjennomført i stor grad, mens klinikker med ordinær tjeneste nesten ikke utfører hjemmebesøk, en forskjell i endrings ratio på 97.65 (45.20 - 210.96) Konklusjon: Den palestinske modellen for kontinuitet i jordmoromsorgen økte kvinnenes bruk av helsetjenesten og noen kvalitetsindikatorer for svangerskaps og barselomsorg. Mer forskning bør utføres for å undersøke modellens innvirkning på individuelle helseutfall for mor og barn og på brukertilfredshet.

• Lieng, Marit; Busund, Bjørn; Ræder, Johan & Iversen, Tor (2013). Innsatsstyrt finansiering og dagkirurgi. Tidsskrift for Den norske legeforening.  ISSN 0029-2001.  133, s 974- 976 . doi: 10.4045/tidsskr.13.0155
• Kozinszky, Zoltan & Lieng, Marit (2011). The Copper IUD and emergency contraception Response. Contraception.  ISSN 0010-7824.  84(2), s 207- 207 . doi: 10.1016/j.contraception.2010.12.007
• Holte, Therese Opsahl; Goderstad, Jeanne Mette; Lieng, Marit; Busund, Bjørn & Norderhaug, Inger Natvig (2009). Kikkhullskirurgi ved godartede gynekologiske lidelser. Rapport fra Kunnskapssenteret. 26/2009. Full text in Research Archive. Show summary

  Det er stor variasjon i bruk av kikkhullskirurgi mellom de ulike gynekologiske avdelingene i Norge. Den nasjonale veilederen i generell gynekologi anbefaler kikkhullskirurgi ved kirurgisk behandling av kvinner med graviditet utenfor livmor, men gir ingen klare anbefalinger om hvilken operasjonsmetode som er å foretrekke ved behandling av cyster på eggstokk eller ved fjerning av livmor. Fagmiljøet ved Kvinneklinikken, Oslo universitetssykehus, Ullevål, henvendte seg til Kunnskapssenteret i forbindelse med en kartlegging av prosedyrevalg ved kirurgisk behandling av godartede gynekologiske lidelser i Norge. Oppdragsgiver ønsket en kunnskapsoppsummering om effekt og sikkerhet ved kikkhullskirurgi sammenliknet med tradisjonell åpen eller vaginal prosedyre.

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