Numero 3/2022

Teemana naistentaudit

Sisällys 4/22

 3 Pääkirjoitus 

4 Ajankohtaista 

6 Mobiilisovellus lähisuhdeväkivallan tunnistamiseen ja ennaltaehkäisyyn

8 Tunteet kätilötyössä 

10 Virtsainkontinenssista kärsii jopa puolet naisista 

14 Kierukan voi asettaa myös hoitaja 

17 Seksuaalisuus on vakavasti otettava iloinen asia 

20 Synnytyksen käynnistäminen yleistyy Suomessa ja Pohjoismaissa 

24 Ledare 

25 Tidigt ingripande förebygger negativa följder av graviditetsanemi 

27 Katse tänne! Se hit! 

28 Kätilöt pomoina: Terhi Virtanen 

32 Varhainen puuttuminen ehkäisee raskausajan anemian haittoja 

35 Vauvojen äidit kokevat ristiriitaisia paineita 

37 Kätilön kirjahylly 

38 “Synnyttäjät tulevat luokseni, koska kohtelen heitä hyvin” 

41 Kolumni: Kätilöopiskelijan ääni 

42 Kätilön urapolku: Anita Wikberg 

44 Käypä Hoito -suositus: Vastasyntyneen elvytys 

45 Imetysviikko tuo imetyksen yhteiskunnalliseen keskusteluun 

46 Uutisia 

48 Synnytysseminaari 2022 

Juttujen lähteet

Gissler & Heino: Synnytyksen käynnistäminen yleistyy Suomessa ja Pohjoismaissa 

Joensuu J, Saarijärvi H, Gissler M, Ulander V-M, Heinonen S, Torkki P, Mikkola T: Maternal childbirth experience and induction of labour in each mode of delivery: A retrospective seven-year cohort study of 95,051 parturients in Finland. BMC Pregnancy and Childbirth 2022, painossa.

THL: Perinataalitilastot – synnytykset, synnyttäjät ja vastasyntyneet: https://thl.fi/fi/tilastot-ja-data/tilastot-aiheittain/seksuaali-ja-lisaantymisterveys/synnyttajat-synnytykset-ja-vastasyntyneet/perinataalitilasto-synnyttajat-synnytykset-ja-vastasyntyneet 

Tiitinen Aila: Synnytyksen käynnistäminen. Lääkärikirja Duodecim 9.5.2022. https://www.terveyskirjasto.fi/dlk01136

Manninen: Kierukan voi asettaa myös hoitaja 

Raskaudenkeskeytykset 2021. Tilastoraportti 29/2022. THL. Saatavilla: https://www.julkari.fi/bitstream/handle/10024/144588/Raskaudenkeskeytykset_2021.pdf?sequence=1&isAllowed=y [Luettu 18.6.2022].

Raskauden ehkäisy. Käypä hoito -suositus. 2022. Duodecim. Saatavilla: https://www.kaypahoito.fi/hoi50104 Luettu [19.6.2022].

Winner, B., Peipert, J. F., Zhao, Q., Buckel, C., Madden, T., Allsworth, J. E., & Secura, G. M. Effectiveness of long-acting reversible contraception. N Engl J Med. 2012;366(21):1998-2007.

Suvivuo, P. 2022. Maksuttoman ehkäisyn kokeilut Tulevaisuuden sote-keskus -ohjelmassa. Luento. Maksuttoman ehkäisyn kokeilu: aloitustilaisuus 18.3.2022. Saatavilla: https://innokyla.fi/sites/default/files/2022-03/Suvivuo_Maksuttoman%20ehk%C3%A4isyn%20kokeilut_aloitustilaisuus_18.3.2022_ps_0.pdf Luettu [19.6.2022].

Terveyden ja hyvinvoinnin laitos. 2022. Maksuttoman ehkäisyn kokeilu. Saatavilla:  https://thl.fi/fi/tutkimus-ja-kehittaminen/tutkimukset-ja-hankkeet/maksuttoman-ehkaisyn-kokeilu [Luettu 19.6.2022].

Osallistava ja osaava Suomi – sosiaalisesti, taloudellisesti ja ekologisesti kestävä yhteiskunta. Pääministeri Sanna Marinin hallituksen ohjelma 10.12.2019. Valtioneuvoston julkaisuja 2019:31. Saatavilla: https://julkaisut.valtioneuvosto.fi/bitstream/handle/10024/161931/VN_2019_31.pdf?sequence=1&isAllowed=y [Luettu 19.6.2022].

Socialstyrelsen. Rätt för barnmorskor att förskriva läkemedel i födelsekontrollerande syfte. SOSFS 1996:21 (M) Föreskrifter och allmänna råd. Saatavilla: https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/foreskrifter-och-allmanna-rad/1996-10-21.pdf [Luettu 24.6.2022].

Ouyang M, Peng K, Botfield JR, McGeechan K. Intrauterine contraceptive device training and outcomes for healthcare providers in developed countries: A systematic review. PLoS One. 2019;14(7):e0219746. 

Andrews GD, French K, Wilkinson CL. Appropriately trained nurses are competent at inserting intrauterine devices: an audit of clinical practice. Eur J Contracept Reprod Health Care. 1999;4(1):41-44.

Yadav, V., Balasubramaniam, S., Das, S., Srivastava, A., Srivastava, A., Kumar, S., & Sood, B. (2016). Comparison of outcomes at 6 weeks following postpartum intrauterine contraceptive device insertions by doctors and nurses in India: a case-control study. Contraception. 2016;93(4):347-355.

Rowlands S, Oloto E, Horwell DH. Intrauterine devices and risk of uterine perforation: current perspectives. Open Access J Contracept. 2016;7:19-32. 

Hiekka-aho, A. 2022. Työtä ehkäisyn parissa ja maksuton ehkäisy. Luento. Maksuttoman ehkäisyn kansallinen tilaisuus 18.5.2022. Saatavilla: https://innokyla.fi/sites/default/files/2022-05/7_Hiekka-AhoAnnu_p%C3%A4ivitetty.pdf Luettu [24.6.2022].

Seidman G, Atun R. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries. Hum Resour Health. 2017;15(1):29.

Grant KL, Simmons MB, Davey CG. Three Nontraditional Approaches to Improving the Capacity, Accessibility, and Quality of Mental Health Services: An Overview. Psychiatr Serv. 2018;69(5):508-516.

Callaghan M, Ford N, Schneider H. A systematic review of task-shifting for HIV treatment and care in Africa. Hum Resour Health. 2010;8:8.

Zachariah R, Ford N, Philips M, et al. Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa. Trans R Soc Trop Med Hyg. 2009;103(6):549-558.

Colvin, C. J., de Heer, J., Winterton, L., Mellenkamp, M., Glenton, C., Noyes, J., Lewin, S., & Rashidian, A. (2013). A systematic review of qualitative evidence on barriers and facilitators to the implementation of task-shifting in midwifery services. Midwifery. 2013;29(10):1211-1221.

van Schalkwyk, M. C., Bourek, A., Kringos, D. S., Siciliani, L., Barry, M. M., De Maeseneer, J., McKee, M., & European Commission Expert Panel on Effective ways of Investing in Health (2020). The best person (or machine) for the job: Rethinking task shifting in healthcare. Health Policy. 2020;124(12):1379-1386.

Manninen: Virtsainkontinenssista kärsii jopa puolet naisista 

Tiitinen, A. 2021. Virtsankarkailu naisella. Lääkärikirja Duodecim. Saatavilla:
https://www.terveyskirjasto.fi/dlk00182 [viitattu 11.6.2022]
Virtsankarkailu (naiset). 2017. Käypä hoito -suositus. Saatavilla:
https://www.kaypahoito.fi/hoi50050 [viitattu 11.6.2022]

Murto & Berglund: Mobiilisovellus lähisuhdeväkivallan tunnistamiseen ja ennaltaehkäisyyn 

Dahlen, H.G., Munoz, A.M. & Schmied, v. & Thornton, C. 2018. The relationship between intimate partner violence reported at the first antenatal booking visit and obstetric and perinatal outcomes in an ethnically diverse group of Australian pregnant women: a population-based study over 10-years. BMJ Open.8:e019566 http://dx.doi.org/10.1136/bmjopen-2017-019566

Ensi- ja Turvakotien liitto.2020. Tunnista väkivalta. Viitattu 16.6.22. https://ensijaturvakotienliitto.fi/tukea-ammattilaiselle/perhe-ja-lahisuhdevakivalta/tunnista-vakivalta/

Leppäkoski. T., Flinck, A. & Paavilainen, E. 2014. Assessing and Enhancing Health Care Providers’ Response to Domestic Violence. Nursing Research and Practice. 2014: 759682.http://dx.doi.org/10.1155/2014/759682

NHS. 2017. Domestic abuse: A resource for health professionals. Department of Health and Social Care. Uk Government. United Kingdom.

Rikostorjuntaneuvosto. 2020. Lähisuhdeväkivalta. Rikoksentorjunta.fi. 2020. Viitattu 16.6.22. https://rikoksentorjunta.fi/lahisuhdevakivalta

Su Z, McDonnell D, Roth S, Li Q , Šegalo S, Shi F, Wagers S. Mental health solutions for domestic violence victims amid COVID-19: a review of the literature. Globalization and Health (2021) 17:67. https://doi.org/10.1186/s12992-021-00710-7

UN WOMEN. 2020. The COVID Shadow pandemic. Domestic violence in the world of work. A call to action for the private sector, 1-11. Viitattu 16.6.22. https://www.weps.org/sites/default/files/2020-05/COVID-19%20DOMESTIC%20VIOLENCE%202020%20%28FINAL%29.pdf

WHO 2020. COVID-19 and violence against women. What the health sector/system can do. Available https://www.who.int/publications/i/item/WHO-SRH-20.04. Viitattu 16.6.22.

Raudasoja: Vauvojen äidit kokevat ristiriitaisia paineita

Blair-Loy, M. (2003). Competing devotions: Career and family among women executives. Harvard University Press.

Choi, P., Henshaw, C., Baker, S., & Tree, J. (2005). Supermum, superwife, supereverything: Performing femininity in the transition to motherhood. Journal of Reproductive and Infant Psychology, 23(2), 167–180. https://doi-org.ezproxy/10.1080/02646830500129487

Collins, C. (2019). Making Motherhood Work: How Women Manage Careers and Caregiving. Princeton University Press.

Douglas, S. J., & Michaels, M. W. (2004). The mommy myth: The idealization of motherhood and how it has undermined all women. Free Press.

Henderson, A., Harmon, S., & Newman, H. (2016). The price mothers pay, even when they are not buying it: Mental health consequences of idealized motherhood. Sex Roles, 74(11–12), 512–526. https://doi.org/10.1007/s11199-015-0534-5

Mikolajczak, M., & Roskam, I. (2018). A theoretical and clinical framework for parental burnout: the balance between risks and resources (BR2). Frontiers of Psychology, 9, 886. https://doi.org/10.3389/fpsyg.2018.00886

Närvi, J. (2012). Negotiating care and career within institutional constraints – Work insecurity and gendered ideals of parenthood in Finland. Community, Work & Family, 15(4), 451470. https://doi.org/10.1080/13668803.2012.724827

Perälä-Littunen, S. (2007). Gender equality or primacy of the mother? Ambivalent descriptions of good parents. Journal of Marriage and Family69, 341–351. https://doi.org/10.1111/j.1741-3737.2007.00369.x

Preis, H., Eisner, M., Chen, R., & Benyamini, Y. (2019b). First-time mothers’ birth beliefs, preferences, and actual birth: A longitudinal observational study. Women and Birth, 32(1), e110–e117. https://doi.org/10.1016/j.wombi.2018.04.019.

Raudasoja, M., Sorkkila, M., Laitila, A. & Aunola, K. (2022). ”I feel many contradictory emotions”: Finnish mothers’ discursive struggles with motherhood. Journal of Marriage and Family, 84(3), 752–772. https://doi.org/10.1111/jomf.12828

Schneider, D. A. (2013). Helping women cope with feelings of failure in childbirth. International Journal of Childbirth Education, 28(1), 46–50.

Schneider D. A. (2018). Birthing failures: Childbirth as a female fault line. The Journal of Perinatal Education, 27(1), 20–31. https://doi.org/10.1891/1058-1243.27.1.20

Rinta-Lusa: Varhainen puuttuminen ehkäisee raskausajan anemian haittoja

Ekholm, E. 2019. Raskauden aiheuttamat laboratoriomuutokset. in: Tapanainen, J., Heikinheimo, O. & Mäkikallio, K. (eds.). Naistentaudit ja synnytykset. 6th edition. Helsinki; Kustannus Oy Duodecim, 355–356.

Kellar, P.S. & Kelvin, E.A. 2013. Munro’s Statistical Methods for Health Care Research. 6th Edition. Wolters Kluwer | Lippincott Williams & Wilkins.

Kemppinen, L., Mattila, M., Ekholm, E., Paalasmaa, N., Torma, A., Varakas, L. & Mäkikallio, K. 2020. Gestational iron deficiency anemia is associated with preterm birth, fetal growth restriction, and postpartum infections. Journal of Perinatal Health, 49 (4), 431-438. 

Lamminpää, R., Gissler, M. & Vehviläinen-Julkunen, K. 2017. Utilization of Large Data Sets in Maternal Health in Finland: A Case for Global Health Research. The Journal of perinatal & neonatal nursing31(3), 236–243. 

Räisänen, S., Kancherla, V., Gissler, M., Kramer, M.R. & Heinonen, S. 2014. Adverse Perinatal Outcomes Associated with Moderate or Severe Maternal Anaemia Based on Parity in Finland during 2006–10. Paediatric and perinatal epidemiology, 28 (5), 372–380.

Voutilainen, E., Fogelholm, M. & Mutanen, M. 2016. Ravitsemustaito. 1st-3rd edition. Helsinki: Sanoma Pro.

Vääräsmäki, M. & Kaaja, R. 2019. Perussairaudet ja raskaus. in: Tapanainen, J., Heikinheimo, O. & Mäkikallio, K. (eds.). Naistentaudit ja synnytykset. 6th edition. Helsinki; Kustannus Oy Duodecim, 473–496.

Sähköiset lähteet:

American College of Gynecology. 2008. Practice Bulletin No. 95: Anemia in Pregnancy, Obstetrics & Gynecology, 112 (1), 201-207. doi: 10.1097/AOG.0b013e3181809c0d

The Rectors´ Conference of Finnish Universities of Applied Sciences ARENE. 2019. Ethical recommendations for thesis writing at universities of applied sciences. Accessed 26.5.2021. https://www.arene.fi/wp-content/uploads/Raportit/2020/ETHICAL%20RECOMMENDATIONS%20FOR%20THESIS%20WRITING%20AT%20UNIVERSITIES%20OF%20APPLIED%20SCIENCES_2020.pdf?_t=1578480382

Beck, K.L., Conlon, C.A., Kruger, R. & Coad, J. 2014. Dietary determinants of and Possible Solutions to Iron Deficiency for Young Women Living in Industrialized Countries: A Review. Nutrients, 6 (9), 3747-3776. https://doi.org/10.3390/nu6093747

Bencaiova, G. & Breymann, C. 2014. Mild anemia and Pregnancy Outcome in a Swiss Collective. Journal of Pregnancy, 2014, 307535. https://doi.org/10.1155/2014/307535

Bhattacherjee, A. 2012. Social Science Research: Principles, Methods, and Practices. E-book. Florida: Scholar Commons. 

Camaschella, C. 2019. Iron deficiency. Blood, 133 (1), 30-39. https://doi.org/10.1182/blood-2018-05-815944

Centers for Disease Control and Prevention. 1998. Recommendations to Prevent and Control Iron Deficiency in the United States. Morbidity and mortality weekly report, 47 (RR-3). Accessed 12.5.2021. https://stacks.cdc.gov/view/cdc/5659#

Daru, J., Zamora, J., Fernández-Félix, B. M., Vogel, J., Oladapo, O. T., Morisaki, N., Tunçalp, Ö., Torloni, M., R., Mittal, S., Jayratne, K., Lumbiganon, P., Togoobaatar, G., Thangaratinam, S. & Khan, K. S. 2018. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis. The Lancet, 6 (5), e548-e554. https://doi.org/10.1016/S2214-109X(18)30078-0

Demuth, I.R., Martin, A. & Weissenborn, A. 2018. Iron supplementation during pregnancy – a cross-sectional study undertaken in four German states. BMC Pregnancy Childbirth, 18 (491). https://doi.org/10.1186/s12884-018-2130-5

Desai, M., ter Kuile, F. O., Nosten, F., McGready, R., Asamoa, K., Brabin, B. & Newman, R. 2007. Epidemiology and burden of malaria in pregnancy. The Lancet. Infectious Diseases, 7 (2), 93-104. https://doi.org/10.1016/S1473-3099(07)70021-X

Di Renzo, G.C., Spano, F., Giardina, I., Brillo, E., Clerici, G. & Roura, L.C. 2015. Iron Deficiency Anemia in Pregnancy. Womens Health (Lond Engl), 11 (6), 891-900. https://doi.org/10.2217%2Fwhe.15.35

Eating together – food recommendations for families with children. 2019. Publication of Finnish Institute for Health and Welfare and Finnish Food Authority. 2nd edition. Helsinki. Accessed 25.5.2021. http://urn.fi/URN:ISBN:978-952-343-264-2

Ebeling, F., Sinisalo, M., Säily, M., Widenius, T., Kuittinen, T., Itälä-Remes, M. & Remes, K. 2019. Raudanpuute ilman anemiaa -miten ferritiiniarvoa tulkitaan. Potilaan lääkärilehti. Accessed 7.12.2021. https://www.potilaanlaakarilehti.fi/artikkelit/raudanpuute-ilman-anemiaa-ndash-miten-ferritiiniarvoa-tulkitaan/

Gárdenas, J. 2019. Quantitative Analysis. The guide for the beginners. Accessed 11.11.2021. https://www.researchgate.net/publication/337826695_Quantitative_Analysis_the_guide_for_beginners

Georgieff, M.K. 2020. Iron deficiency in pregnancy. American Journal of Obstetrics & Gynecology, 223 (4), 516-524. https://doi.org/10.1016/j.ajog.2020.03.006

Global Burden of Disease 2016. Disease and Injury Incidence and Prevalence Collaborators. 2017. Global, regional. and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 390 (10100), 1211-1259. https://doi.org/10.1016/S0140-6736(17)32154-2

Haider, B.A., Olofin, I., Wang, M., Spegelman, D., Ezzati, M. & Fawzi, W. W. 2013. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ 2013, 346, f3443. https://doi:10.1136/bmj.f3443

Hanson, M.A., Bardsley, A., De-Regil, L.M., Moore, S.E., Oken, E., Poston, L., Ma, R.C., McAuliffe, F.M., Maleta, K., Purandare, C.N., Yajnik, C.S., Rushwan, H. & Morris, J.L. 2015. The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: “Think Nutrition First”. International Journal of Gynecology & Obstetrics, 131, S213-S253. https://doi.org/10.1016/S0020-7292(15)30034-5

Harvey, T., Zkik, A., Auges, M. & Clavel, T. 2016. Assessment of Iron Deficiency and Anemia in Pregnant Women: An Observational French Study. Women´s Health, 12 (1), 95-102. Accessed 2.6.2021. https://journals.sagepub.com/doi/10.2217/whe.15.91?icid=int.sj-full-text.similar-articles.1#articleCitationDownloadContainer

Helin, A., Kinnunen, T.I., Raitanen, J., Ahonen, S., Virtanen, S.M. & Luoto, R. 2012. Iron intake, haemoglobin and risk of gestational diabetes: a prospective cohort study. BMJ Open, 2 (5). doi: 10.1136/bmjopen-2012-001730

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Finnish Institute for Health and Welfare. 2021b. Medical Birth Register. Accessed 19.5.2021. https://thl.fi/en/web/thlfi-en/statistics/information-on-statistics/register-descriptions/newborns 

Finnish National Board on Research Integrity TENK. 2019. The ethical principles of research with human participants and ethical review in the human sciences in Finland. Finnish National Board on Research Integrity TENK guidelines 2019. Publications of the Finnish National Board on Research Integrity TENK 3/2019. Accessed 6.5.2021. https://tenk.fi/sites/tenk.fi/files/Ihmistieteiden_eettisen_ennakkoarvioinnin_ohje_2019.pdf

Jouanne, M., Oddoux, S., Noël, A., & Voisin-Chiret, A. S. 2021. Nutrient Requirements during Pregnancy and Lactation. Nutrients, 13 (2), 692. https://doi.org/10.3390/nu13020692

Jung, J., Rahman, M.M., Rahman, M.S., Swe, K.T., Islam, M.R., Rahman, M.O. & Akter, S. 2019. Effects of hemoglobin levels during pregnancy on adverse maternal and infant outcomes: a systematic review and meta-analysis. Annals of the New York Academy of Sciences, 1450 (1), 69-82. https://doi.org/10.1111/nyas.14112

Kassebaum, N.J., Jasrasaria, R., Naghavi, M., Wulf, S.K., Johns, N., Lozano, R., Regan, M., Weatherall, D., Chou, D.P., Eisele, T.P., Flaxman, S.R., Pullan, R.L., Brooker, S.J. & Murray, C.J.L. 2014. A systematic analysis of global anemia burden from 1990 to 2010. Blood, 123 (5), 615-624. https://doi.org/10.1182/blood-2013-06-508325

Klemetti, R. & Hakulinen-Viitanen, T. 2013. Äitiysneuvolaopas – Suosituksia äitiysneuvolatoimintaan. Helsinki: THL. Accessed 1.6.2021. https://www.julkari.fi/bitstream/handle/10024/110521/THL_OPA2013_029_verkko.pdf?sequence=3&isAllowed=y

Koletzko, B., Bauer, C., P, Bung, P., Cremer, M., Flothkötter, M., Hellmers, C., Kersting, M., Krawinkel, M., Przyrembel, H., Rasenack, R., Schäfer, T., Vetter, K., Wahn, U., Weissenborn, A. & Wöckel, A. 2016. German National Consensus Recommendations on Nutrition and Lifestyle in Pregnancy by the ‘Healthy Start – Young Family Network’. Annals of Nutrition and Metabolism, 63, 311-322. https://doi.org/10.1159/000358398

Kozuki, N., Lee, A.C., Katz, J. & on behalf of the Child Health Epidemiology Reference Group. 2012. Moderate to Severe, but Not Mild, Maternal Anemia Is Associated with Increased Risk of Small-for-Gestational-Age Outcomes. The Journal of Nutrition, 142 (2), 358–362. https://doi.org/10.3945/jn.111.149237

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Milman, N., Paszkowski, T., Cetin, I. & Castelo-Branco, C. 2016. Supplementation during pregnancy: beliefs and science. Gynecological Endocrinology, 32 (7), 509-516. https://doi.org/10.3109/09513590.2016.1149161

Morisset, A-S., Weiler, H.A., Dubois, L., Ashley-Martin, J., Shapiro, G.D., Dodds, L., Massarelli, I., Vigneault, M., Arbuckle, T.E. & Fraser, W.D. 2016. Rankin of iron, vitamin D and calcium intakes in relation to maternal characteristics of pregnant Canadian women. Applied Physiology, Nutrition, and Metabolism, 41 (7), 749-757. https://doi.org/10.1139/apnm-2015-0588

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Pavord, S., Daru, J., Prasannan, N., Robinson, S., Stanworth, S., Girling, J. & on behalf of the BSH Committee. 2019. UK guidelines on the management of iron deficiency in pregnancy. British Journal of Haematology, 188 (6), 819-830. https://doi.org/10.1111/bjh.16221

Peña-Rosas, J. P., De-Regil, L. M., Gomez Malave, H., Flores-Urrutia, M. C. & Dowswell, T. 2015. Intermittent oral iron supplementation during pregnancy. The Cochrane database of systematic reviews, 2015 (10), CD009997. https://doi.org/10.1002/14651858.CD009997.pub2 

Peuranpää, P., Heliövaara-Peippo, S., Fraser, I., Paavonen, J. & Hurskainen, R. 2014b. Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding. Acta Obstetricia et Gynecologica Scandinavica, 93 (7), 654-660. https://doi.org/10.1111/aogs.12394

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