Numero 4/2026

Lähteet

Karoliina Aro: Kohdunrungon syöpä – yleistyvä elintasosairaus?

Suomen Gynekologisen Onkologian Erikoislääkärit (FIN-GOG). Gynekologisten syöpien Kelpo hoito -suositus, 2024 (viitattu 06.10.2025). https://gynekologiyhdistys.fi/pienryhmat/onkologia/fingog-kelpohoito/

Concin N, Matias-Guiu X, Cibula D, ym. ESGO-ESTRO-ESP guidelines for the management of patients with endometrial carcinoma: update 2025. Lancet Oncol 2025;26(8):e423-e435

 

Riikka Helakisa: Viimesilaus matkalla terveeksi

Kristiina Airola. Tatuointi ja kestopigmentointi..Duodecim .2026. Luettu 15.8.2026.
https://www.terveyskirjasto.fi/dlk00514

HUS. Rintasyövän hoito. Luettu 15.8.2026.
https://www.hus.fi/potilaalle/hoidot-ja-tutkimukset/syopa/rintasyovan-hoitopolku/rintasyovan-hoito

Tiina Jahkola, Maija Kolehmainen, Sinikka Suominen, Catarina Svarvar ja Susanna Kauhanen. Rintarekonstruktio perustuu moniammatilliseen rintasyövän hoidon kokonaissuunnitteluun ja omakudossiirteiden käyttöön. Duodecim 2021. Luettu 15.8.2026.
https://www.duodecimlehti.fi/duo16391

Rintasyöpäyhdistys – Europa Donna Finland ry. Korjausleikkaukset. Luettu 8.8.2026.
https://europadonna.fi/hoitopolku/korjausleikkaukset/

Rintasyöpäyhdistys – Europa Donna Finland ry:n Järjestösihteerin Kirsi Haapamäen sähköpostivastaukset.

 

Saara Kyllönen: HPV-omanäytteenotto on uusi tapa osallistua kohdunkaulasyövän seulontaan

Suomen Syöpärekisteri. Seulontatilastosovellus. Saatavilla: https://syoparekisteri.fi/tilastot/seulontatilastot/

Käypä hoito -suositus. Kohdunkaulan, emättimen ja ulkosynnytinten solumuutokset. Suomalainen Lääkäriseura Duodecim. Saatavilla: https://www.kaypahoito.fi/hoi50049

Andersson H, Dillner J. Population-based cervical screening with Human Papillomavirus self-sampling at home and incidence of cervical cancer in Sweden. Prev Med. 2026. doi.org/10.1016/j.ypmed.2026.108540

Kyllönen S, Saloranta S, Kares S, Mustila A, Louvanto K. Introducing self-sampling for cervical cancer screening: A regional implementation study in Pirkanmaa, Finland. Acta Obstet Gynecol Scand. 2026. doi:10.1111/aogs.70273

 

Tiina Murto & Mika Gissler: Synnytysten medikalisoituminen Suomessa: mitä rekisterit kertovat

Swift E, Elvander C, Blix E, Gissler M, Murto T, Maimburg Damkjær, Dalbye R, Gottfreðsdottir H, Nielsen Groenemeijer C, Ulfsdottir H, Rydahl E. (2026). Birth interventions and outcomes among first time mothers: A population-based register study in four Nordic countries. Sexual & Reproductive Healthcare. 47:101185. https://doi.org/10.1016/j.srhc.2026.101185

World Health Organization. (2025). Transitioning to midwifery models of care.

Pedersen A.W & Kuhnle S. (2017). The Nordic welfare state model: The concept of a “Nordic model”. In Knutsen O.P. (Ed.), The Nordic Models in Political Science: Challenged, but Still Viable? (249-272). Bergen. Fagbokforlaget.

van Teijlingen, E. (2005). A Critical Analysis of the Medical Model as used in the Study of Pregnancy and Childbirth. Sociological Research Online, 10(2), 63-77. https://doi-org.ezproxy.turkuamk.fi/10.5153/sro.1034 

Sandall J, Fernandez Turienzo C, Devane D, Soltani H, Gillespie P, Gates S, Jones LV, Shennan AH, Rayment-Jones H. (2024). Midwife continuity of care models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews. Issue 4. Art. No.: CD004667. DOI: 10.1002/14651858.CD004667.pub6. 

Malin M, Hemminki E. (1992). Midwives as providers of prenatal care in Finland–past and present. Women Health. 1992;18(4):17-34. doi: 10.1300/j013v18n04_02. PMID: 11608075. 

World Health Organization. (2018). Intrapartum care for a positive childbirth experience.

 

Sanna-Mari Manninen: Kätilötyö kattaa koko naisen elämänkaaren – näkyikö se ICM 2026 -konferenssissa?

Boyce MR, Nove A, Drandić D, White J, Dunkley-Bent J, Ugglas AA. A critical crisis persists: Updated estimate of global midwife shortage requires urgent action. Women Birth. 2026;39(1):102161. doi:10.1016/j.wombi.2026.102161

ICM 2026. Call for One Million More Midwives. Viitattu 25.6.2026. Saatavilla: https://millionmore.org/petition/ 

Lez JL, Ugglas AA, Bogren M. Transitioning to midwifery models of care: An evidence-based imperative for sexual and reproductive health. Sex Reprod Healthc. 2026;47:101184. doi:10.1016/j.srhc.2026.101184 

THL 2025. Yläkoulun aloittaneiden HPV-rokotuskattavuus on Suomessa huomattavasti muita Pohjoismaita matalampi. Viitattu 26.6.2026. Saatavilla: https://thl.fi/-/ylakoulun-aloittaneiden-hpv-rokotuskattavuus-on-suomessa-huomattavasti-muita-pohjoismaita-matalampi#ylakoulun-aloittaneiden-hpv-rokotuskattavuus-on-suomessa-huomattavasti-muita-pohjoismaita-matalampi

 

Hannakaisa Niela-Vilen: Suojaako imetys rintasyövältä?

Chowdhury R, Sinha B, Sankar MJ, Taneja S, Bhandari N, Rollins N, Bahl R, Martines J. Breastfeeding and maternal health outcomes: a systematic review and meta-analysis. Acta Paediatr. 2015;104(467):96-113. doi: 10.1111/apa.13102

Fan D, Xia Q, Lin D, Ma Y, Rao J, Liu L, Tang H, Xu T, Li P, Chen G, Zhou Z, Guo X, Zhang Z, Liu Z. Role of breastfeeding on maternal and childhood cancers: An umbrella review of meta-analyses. J Glob Health. 2023;13:04067. doi: 10.7189/jogh.13.04067

Islami F, Liu Y, Jemal A, Zhou J, Weiderpass E, Colditz G, Boffetta P, Weiss M. Breastfeeding and breast cancer risk by receptor status–a systematic review and meta-analysis. Ann Oncol. 2015;26(12):2398-407. doi: 10.1093/annonc/mdv379

Unar-Munguía M, Torres-Mejía G, Colchero MA, González de Cosío T. Breastfeeding Mode and Risk of Breast Cancer: A Dose-Response Meta-Analysis. J Hum Lact. 2017 May;33(2):422-434. doi: 10.1177/0890334416683676

Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC; Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. doi: 10.1016/S0140-6736(15)01024-7

 

Anu Nemi: Tutkimusnäyttö tukee laajempaa rintasyövän seulontaa

American Cancer Society: Survival rates for breast cancer https://www.cancer.org/cancer/types/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.html

Lund University 30.1.2026: AI support in breast cancer screening: Fewer missed cancer cases https://www.lunduniversity.lu.se/article/ai-support-breast-cancer-screening-fewer-missed-cancer-cases

Lääketieteellinen Aikakauskirja Duodecim numero 7, 2024: Mazen Sudah ja Johanna Alanko: Rintasyövän mammografiaseulonta: quo vadis? https://www.duodecimlehti.fi/duo18169

Pirkanmaan hyvinvointialue 17.12.2025: Voiko tekoäly keventää radiologien työtaakkaa rintasyövän seulonnassa? Tutkimusta valmistellaan Taysissa https://www.pirha.fi/w/voiko-tekoaly-keventaa-radiologien-tyotaakkaa-rintasyovan-seulonnassa-tutkimusta-valmistellaan-taysissa

Rintasyöpäyhdistys – Europa Donna Finland ry 25.4.2023: Rintasyövän seulonta laajennettava  45-74-vuotiaisiin https://www.europadonna.fi/ajankohtaista/verkkouutiset/kannanotto-rintasyovan-seulonta-laajennettava-45-74-vuotiaisiin/ 

Sosiaali- ja terveysministeriö, Kansallinen syöpästrategia 2026-2035 https://stm.fi/kansallinen-syopastrategia 

Suomen Syöpärekisteri, Rintasyövän seulontaohjelman vuosiraportti 2023 https://syoparekisteri.fi/assets/files/2025/06/Rintasyovan-seulontaohjelma-vuosiraportti-2023-seulonnasta.pdf 

Syöpäjärjestöt 13.3.2025: Uusi suositus: Rintasyövän seulonta laajennettava  46-74-vuotiaisiin https://www.syopajarjestot.fi/ajankohtaista/uusi-suositus-rintasyovan-seulonta-laajennettava-46-74-vuotiaisiin/

Tunne rintasi ry, videokirjasto https://tunnerintasi.fi/opi-itse/videokirjasto/

 

Mikko Tarvonen: Mount Everest kohdussa – mitä napavaltimoveren pH-arvo kertoo?

Giussani DA, Bennet L, Sferruzzi-Perri AN, Vaughan OR, Fowden AL. Hypoxia, fetal and neonatal physiology: 100 years on from Sir Joseph Barcroft. J Physiol 2016;594(5):1105-11.

Grocott MP, Martin DS, Levett DZ, McMorrow R, Windsor J, Montgomery HE; Caudwell Xtreme Everest Research Group. Arterial blood gases and oxygen content in climbers on Mount Everest. N Engl J Med 2009;360(2):140-9.

Lagercrantz H. The good stress of being born. Acta Paediatr 2016;105(12):1413-1416.

Manning JM, Manning LR, Dumoulin A, Padovan JC, Chait B. Embryonic and fetal human hemoglobins: structures, oxygen binding, and physiological roles. Subcell Biochem 2020;94:275-96.

Hägnevik K, Faxelius G, Irestedt L, Lagercrantz H, Lundell B, Persson B. Catecholamine surge and metabolic adaptation in the newborn after vaginal delivery and caesarean section. Acta Paediatr Scand 1984 Sep;73(5):602-9.

Hillman NH, Kallapur SG, Jobe AH. Physiology of transition from intrauterine to extrauterine life. Clin Perinatol 2012;39(4):769-83.

Lear CA, Wassink G, Westgate JA, Nijhuis JG, Ugwumadu A, Galinsky R, ym. The peripheral chemoreflex: indefatigable guardian of fetal physiological adaptation to labour. J Physiol 2018;596(23):5611-23.

Alexander JM, McIntire DM, Leveno KJ. Chorioamnionitis and the prognosis for term infants. Obstet Gynecol 1999;94(2):274-8.

Tarvonen MJ, Lear CA, Andersson S, Gunn AJ, Teramo KA. Increased variability of fetal heart rate during labour: a review of preclinical and clinical studies. BJOG 2022;129(12):2070-81.

Lear CA, Dhillon SK, Nakao M, Lear BA, Georgieva A, Ugwumadu A, ym. The peripheral chemoreflex and fetal defenses against intrapartum hypoxic-ischemic brain injury at term gestation. Semin Fetal Neonatal Med 2024;29(4-5):101543.

Juhantalo M, Hautakangas T, Palomäki O, Uotila J. Uterine contractile activity and neonatal outcome – A blind analysis of a randomized controlled trial cohort. Acta Obstet Gynecol Scand 2024;103(7):1396-1407.

Cuerva MJ, Garrido L, Ramirez-Castan A, Prieto D, Lopez F, Bartha JL. Is immediate arterial cord blood sampling necessary in vigorous term neonates? A retrospective study of the impact of cord clamping timing on cord blood gas analysis. Eur J Obstet Gynecol Reprod Biol 2025;312:114517.

Rosén KG, Murphy KW. How to assess fetal metabolic acidosis from cord samples. J Perinat Med 1991;19(3):221-6.

Olofsson P. Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. Am J Obstet Gynecol 2023;228(5S):S1222-S1240.

Malin GL, Morris RK, Khan KS. Strength of association between umbilical cord pH and perinatal and long term outcomes: systematic review and meta-analysis. BMJ 2010;340:c1471.

Armstrong L, Stenson BJ. Use of umbilical cord blood gas analysis in the assessment of the newborn. Arch Dis Child Fetal Neonatal Ed. 2007 Nov;92(6):F430-4.

Lee JH, Jung J, Park H, Kim SY, Kwon DY, Choi SJ, Oh SY, Roh CR. Umbilical cord arterial blood gas analysis in term singleton pregnancies: a retrospective analysis over 11 years. Obstet Gynecol Sci 2020;63(3):293-304.

Yeh P, Emary K, Impey L. The relationship between umbilical cord arterial pH and serious adverse neonatal outcome: analysis of 51,519 consecutive validated samples. BJOG 2012;119(7):824-31.

Gilstrap LC 3rd, Leveno KJ, Burris J, Williams ML, Little BB. Diagnosis of birth asphyxia on the basis of fetal pH, Apgar score, and newborn cerebral dysfunction. Am J Obstet Gynecol 1989;161(3):825-30.

Goodwin TM, Belai I, Hernandez P, Durand M, Paul RH. Asphyxial complications in the term newborn with severe umbilical acidemia. Am J Obstet Gynecol 1992;167(6):1506-12.

van den Berg PP, Nelen WL, Jongsma HW, Nijland R, Kollée LA, Nijhuis JG, Eskes TK. Neonatal complications in newborns with an umbilical artery pH < 7.00. Am J Obstet Gynecol 1996;175(5):1152-7.

Tarvonen M, Jernman R, Stefanovic V, Tuppurainen V, Karikoski R, Haataja L, Andersson S. Hypoxic-ischemic encephalopathy following intrapartum asphyxia: is it avoidable? Am J Obstet Gynecol 2025;233(5):475.e1-475.e13.

Tarvonen M, Markkanen J, Tuppurainen V, Jernman R, Stefanovic V, Andersson S. Intrapartum cardiotocography with simultaneous maternal heart rate registration improves neonatal outcome. Am J Obstet Gynecol 2024;230(4):379.e1-379.e12.

Tarvonen M, Riehunkangas T, Tuppurainen V, Jernman R, Stefanovic V, Torkki P, Gissler M, Andersson S. Optimal obstetric care reduces neonatal healthcare costs compared with substandard care in hypoxic-ischemic encephalopathy. Am J Obstet Gynecol 2025:S0002-9378(25)00880-4. doi: 10.1016/j.ajog.2025.12.007. Epub ahead of print.

American College of Obstetrics and Gynecology, Task Force on Neonatal Encephalopathy and Cerebral Palsy, American Academy of Pediatrics. Neonatal encephalopathy and cerebral palsy: defining the pathogenesis and pathophysiology. Edited by Washington, DC, American College of Obstetricians and Gynecologists, 2003.

ACOG Clinical Practice Guideline No. 10:Intrapartum Fetal Heart Rate Monitoring: Interpretation and Management. Obstet Gynecol 2025;146(4):583-99.

Tarvonen M, Stefanovic V, Andersson S. Neonatal acidemia as a definitive adverse outcome of labor should be used with caution. Am J Obstet Gynecol 2024;231(3):e115.

MacLennan A. A template for defining a causal relation between acute intrapartum events and cerebral palsy: international consensus statement. BMJ 1999;319(7216):1054-9.

Chakkarapani E, de Vries LS, Ferriero DM, Gunn AJ. Neonatal encephalopathy and hypoxic-ischemic encephalopathy: the state of the art. Pediatr Res 2025;98(7):2444-2458.

Wong L, Kwan AHW, Lau SL, Sin WTA, Leung TY. Umbilical cord prolapse: revisiting its definition and management. Am J Obstet Gynecol 2021;225(4):357-66.

Thorp JA, Rushing RS. Umbilical cord blood gas analysis. Obstet Gynecol Clin North Am 1999;26(4):695-709.

Westgate J, Garibaldi JM, Greene KR. Umbilical cord blood gas analysis at delivery: a time for quality data. Br J Obstet Gynaecol 1994;101(12):1054-63.

Zaigham M, Källén K, Olofsson P. Gestational age-related reference values for Apgar score and umbilical cord arterial and venous pH in preterm and term newborns. Acta Obstet Gynecol Scand. 2019 Dec;98(12):1618-23.

Wiberg N, Källén K, Olofsson P. Physiological development of a mixed metabolic and respiratory umbilical cord blood acidemia with advancing gestational age. Early Hum Dev 2006;82(9):583-9.

Wiberg N, Källén K, Olofsson P. Delayed umbilical cord clamping at birth has effects on arterial and venous blood gases and lactate concentrations. BJOG 2008;115(6):697-703.

Mokarami P, Wiberg N, Olofsson P. Hidden acidosis: an explanation of acid-base and lactate changes occurring in umbilical cord blood after delayed sampling. BJOG 2013;120(8):996-1002.

Xodo S, Xodo L, Berghella V. Delayed cord clamping and cord gas analysis at birth. Acta Obstet Gynecol Scand 2018;97(1):7-12.

Andersson O, Hellström-Westas L, Andersson D, Clausen J, Domellöf M. Effects of delayed compared with early umbilical cord clamping on maternal postpartum hemorrhage and cord blood gas sampling: a randomized trial. Acta Obstet Gynecol Scand 2013;92(5):567-74.

Nudelman MJR, Belogolovsky E, Jegatheesan P, Govindaswami B, Song D. Effect of delayed cord clamping on umbilical blood gas values in term newborns: a systematic review. Obstet Gynecol 2020;135(3):576-82.

Svirko E, Mellanby J, Impey L. The association between cord pH at birth and intellectual function in childhood. Early Hum Dev 2008;84(1):37-41.

Johnson GJ, Salmanian B, Denning SG, Belfort MA, Sundgren NC, Clark SL. Relationship between umbilical cord gas values and neonatal outcomes: implications for electronic fetal heart rate monitoring. Obstet Gynecol 2021;138(3):366-73.

Zaigham M, Källén K, Sundberg TM, Olofsson P. Long-term outcomes after neonatal acidemia. Am J Obstet Gynecol 2025;233(3):195.e1-195.e11.

Jonsson M, Ågren J, Nordén-Lindeberg S, Ohlin A, Hanson U. Neonatal encephalopathy and the association to asphyxia in labor. Am J Obstet Gynecol 2014;211:667.e1-8.

Leinonen E, Gissler M, Haataja L, Rahkonen P, Andersson S, Metsäranta M, ym. Low Apgar scores at both one and five minutes are associated with long-term neurological morbidity. Acta Paediatr 2018;107(6):942-51.

Metsäranta M, Rahkonen L, Haataja L. Apgarin pisteet – pinttynyt tapa vai hyödyllinen käytäntö? Duodecim 2021;137(15):1473-4.

Thorp JA, Sampson JE, Parisi VM, Creasy RK. Routine umbilical cord blood gas determinations? Am J Obstet Gynecol 1989;161(3):600-5.

Tarvonen M, Stefanovic, V, Jernman, R. Sikiön fysiologiaan perustuva kardiotokografian tulkinta. Suomen Lääkärilehti 2021;76(34):1728-34.

Tarvonen M, Andersson S, Teramo K. Sikiön synnytyksenaikaisen hapenpuutteen uusi tunnistamiskeino. Duodecim 2021;137:668–70.

Perlman JM. Intrapartum hypoxic-ischemic cerebral injury and subsequent cerebral palsy: medicolegal issues. Pediatrics 1997;99(6):851-9.

Graham EM, Ruis KA, Hartman AL, Northington FJ, Fox HE. A systematic review of the role of intrapartum hypoxia-ischemia in the causation of neonatal encephalopathy. Am J Obstet Gynecol 2008;199(6):587-95.

Berglund S, Grunewald C, Pettersson H, Cnattingius S. Severe asphyxia due to delivery-related malpractice in Sweden 1990-2005. BJOG 2008;115(3):316-23.

Albrecht KD, Denning S, Hosek K, Burnett BA, Sangi-Haghpeykar H, Belfort MA, ym. Umbilical cord gas analysis: clinical implications of a comprehensive, contemporary determination of normal ranges. Am J Obstet Gynecol MFM 2023;5(10):101134.

Andersson CB, Klingenberg C, Thellesen L, Johnsen SP, Kesmodel US, Petersen JP. Umbilical cord pH levels and neonatal morbidity and mortality. JAMA Netw Open 2024;7(8):e2427604.