{"id":6178,"date":"2026-10-19T09:48:36","date_gmt":"2026-10-19T09:48:36","guid":{"rendered":"https:\/\/phd.hi.is\/doktorsvorn\/doktorsvorn-i-laeknavisindum-hulda-hjartardottir\/"},"modified":"2026-10-19T09:48:36","modified_gmt":"2026-10-19T09:48:36","slug":"doktorsvorn-i-laeknavisindum-hulda-hjartardottir","status":"publish","type":"phd_defence","link":"https:\/\/phd.hi.is\/en\/doktorsvorn\/doktorsvorn-i-laeknavisindum-hulda-hjartardottir\/","title":{"rendered":"Doktorsv\u00f6rn \u00ed l\u00e6knav\u00edsindum – Hulda Hjartard\u00f3ttir"},"content":{"rendered":"
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F\u00f6studaginn 28. ma\u00ed ver Hulda Hjartard\u00f3ttir doktorsritger\u00f0 s\u00edna \u00ed l\u00e6knav\u00edsindum vi\u00f0 L\u00e6knadeild H\u00e1sk\u00f3la \u00cdslands. Ritger\u00f0in ber heiti\u00f0: \u00d3msko\u00f0anir til a\u00f0 meta framgang og sn\u00faning f\u00f3sturh\u00f6fu\u00f0s \u00ed f\u00e6\u00f0ingum frumbyrja. <\/strong>Use of ultrasound to describe descent and rotation of the fetal head in spontaneous nulliparous labors.<\/strong><\/p>\n

Andm\u00e6lendur eru dr. Vincenzo Berghella, pr\u00f3fessor vi\u00f0 Thomas Jefferson University\/Hospital \u00ed Philadelphia, og dr. Niels Uldbjerg, pr\u00f3fessor vi\u00f0 H\u00e1sk\u00f3lann \u00ed \u00c1r\u00f3sum.<\/p>\n

Umsj\u00f3narkennari var dr. \u00de\u00f3ra Steingr\u00edmsd\u00f3ttir, pr\u00f3fessor og lei\u00f0beinandi var dr. Torbj\u00f8rn Moe Eggeb\u00f8, pr\u00f3fessor vi\u00f0 NTNU, Noregi. Auk \u00feeirra s\u00e1tu \u00ed doktorsnefnd dr. Sigr\u00fan Helga Lund, t\u00f6lfr\u00e6\u00f0ingur og dr. Reynir T. Geirsson, pr\u00f3fessor.<\/p>\n

Ingibj\u00f6rg Har\u00f0ard\u00f3ttir, pr\u00f3fessor og varadeildarforseti L\u00e6knadeildar H\u00e1sk\u00f3la \u00cdslands, stj\u00f3rnar ath\u00f6fninni sem fer fram \u00ed H\u00e1t\u00ed\u00f0asal H\u00e1sk\u00f3la \u00cdslands og hefst kl. 13.00. V\u00f6rninni ver\u00f0ur streymt:\u00a0<\/p>\n

https:\/\/livestream.com\/hi\/doktorsvornhuldahjartardottir<\/a><\/p>\n

\u00c1grip af ranns\u00f3kn<\/strong><\/p>\n

\u00de\u00e6r hef\u00f0bundnu kl\u00edn\u00edsku sko\u00f0anir \u00e1 kvi\u00f0i og um legg\u00f6ng sem beitt er til a\u00f0 fylgjast me\u00f0 framgangi f\u00e6\u00f0ingar eru \u00ed e\u00f0li s\u00ednu \u00f3n\u00e1kv\u00e6mar. Undanfarin 20 \u00e1r hafa \u00f3munara\u00f0fer\u00f0ir, \u00fear sem b\u00e6\u00f0i er sko\u00f0a\u00f0 um kvi\u00f0 en einnig fr\u00e1 spangarsv\u00e6\u00f0i, veri\u00f0 \u00fer\u00f3a\u00f0ar til a\u00f0 h\u00e6gt s\u00e9 meta \u00fatv\u00edkkun legh\u00e1lsins, legu f\u00f3sturh\u00f6fu\u00f0sins og hve dj\u00fapt \u00fea\u00f0 er gengi\u00f0 ni\u00f0ur \u00ed grindina.<\/p>\n

Markmi\u00f0 ranns\u00f3knanna sem ritger\u00f0in byggir \u00e1 var a\u00f0 kanna m\u00f6guleika \u00f3msko\u00f0ana til a\u00f0 fylgjast me\u00f0 framgangi f\u00f3sturh\u00f6fu\u00f0sins \u00ed f\u00e6\u00f0ingu og bera saman vi\u00f0 hef\u00f0bundnar \u00fereifingar um legg\u00f6ng. Allar ranns\u00f3knirnar voru framskyggnar. \u00cd ranns\u00f3knum I-III var ranns\u00f3knarh\u00f3purinn frumbyrjur \u00ed sj\u00e1lfkrafa s\u00f3tt eftir fulla me\u00f0g\u00f6ngu (>37 vikur) me\u00f0 einbura \u00ed h\u00f6fu\u00f0st\u00f6\u00f0u. Fr\u00e1 \u00fev\u00ed a\u00f0 virkur fasi f\u00e6\u00f0ingar greindist og \u00fear til konurnar f\u00e6ddu var \u00f3msko\u00f0un b\u00e6tt vi\u00f0 allar kl\u00edn\u00edskar sko\u00f0anir. \u00d3msko\u00f0un um spangarsv\u00e6\u00f0i var notu\u00f0 til a\u00f0 m\u00e6la h\u00f6fu\u00f0-spangarfjarl\u00e6g\u00f0 (head-perineum distance) og framgangshorn (angle of progression). Lega h\u00f6fu\u00f0sins \u00ed grindinni var sko\u00f0u\u00f0 me\u00f0 \u00f3mun um kvi\u00f0 og \u00e1 spangarsv\u00e6\u00f0i. Breytingum \u00e1 st\u00f6\u00f0u og legu h\u00f6fu\u00f0s og \u00fatv\u00edkkun legh\u00e1ls var l\u00fdst og einnig innbyr\u00f0is afst\u00f6\u00f0u \u00feessara \u00fe\u00e1tta og tengslum vi\u00f0 stig og lengd f\u00e6\u00f0ingar. \u00cd ranns\u00f3kn IV myndu\u00f0u konur \u00ed f\u00e6\u00f0ingu ranns\u00f3knarh\u00f3pinn. H\u00f6fu\u00f0-spangarm\u00e6lingar ger\u00f0ar af l\u00e6knum og lj\u00f3sm\u00e6\u00f0rum me\u00f0 mismunandi reynslu og me\u00f0 tveim mismunandi t\u00e6kjum voru bornar saman. Konurnar voru be\u00f0nar a\u00f0 meta s\u00e1rsauka\/\u00f3\u00fe\u00e6gindi sem fylgdi sko\u00f0uninni. Ranns\u00f3knir I-III voru ger\u00f0ar \u00e1 Landsp\u00edtala en ranns\u00f3kn IV b\u00e6\u00f0i \u00fear og \u00e1 H\u00e1sk\u00f3lasj\u00fakrah\u00fasinu \u00ed Lundi.<\/p>\n

S\u00fdnt var fram \u00e1 a\u00f0 framgangur f\u00f3sturh\u00f6fu\u00f0sins \u00ed f\u00e6\u00f0ingu fylgdi \u00e1kve\u00f0nu ferli sem au\u00f0velt var a\u00f0 meta me\u00f0 \u00f3mun. \u00d3msko\u00f0anir um spangarsv\u00e6\u00f0i voru \u00e1rei\u00f0anlegar, n\u00e1kv\u00e6mari en kl\u00edn\u00edskar sko\u00f0anir og ollu konunum minni \u00f3\u00fe\u00e6gindum. \u00d3mun vi\u00f0 innl\u00f6gn \u00ed f\u00e6\u00f0ingu gat a\u00f0 nokkru leyti sp\u00e1\u00f0 fyrir um f\u00e6\u00f0ingarm\u00e1ta og lengd f\u00e6\u00f0ingar.<\/p>\n

Abstract<\/strong><\/p>\n

The progress of labor is traditionally assessed clinically with subjective abdominal and vaginal examinations. Until recently no adequate objective tools have been available for this purpose. Ultrasound methods have been suggested as an objective way to follow labor progress but this has not been tested in prospective longitudinal studies.<\/p>\n

The overall aim of this thesis was to investigate the patterns of fetal head descent and rotation during labor, using ultrasound methods and comparing the methods to vaginal digital examinations to assess labor progression. All the studies were prospective. In studies I-III primigravid women in spontaneous labor, with a single cephalic fetus at term (>37 weeks) were studied from when the active stage could be diagnosed until delivery. Transperineal ultrasound was used to measure head-perineum distance and angle of progression. Fetal head position was assessed with transabdominal and transperineal ultrasound. Descent, rotation and dilatation patterns were described and how these factors are interrelated and associated with the stages and duration of labor. \u00a0In study IV head-perineum distance measurements were done by novel and experienced examiners with two different types of equipment in women in active labor. The level of pain associated with the examination was assessed. All the studies were performed at the labor unit in Landsp\u00edtali but study IV also in Lund University Hospital in Sweden.<\/p>\n

The patterns of fetal head descent and rotation were demonstrated and easily followed with ultrasound. Trans-perineal ultrasound methods were more accurate than clinical examinations and more acceptable to the women. Ultrasound on admission in active labor showed potential in predicting duration of labor and mode of delivery. HPD measurements showed good reproducibility.<\/p>\n

Um doktorsefni\u00f0<\/strong><\/p>\n

Hulda Hjartard\u00f3ttir er f\u00e6dd 30. j\u00fal\u00ed 1962 \u00e1 Akureyri. H\u00fan var\u00f0 st\u00fadent fr\u00e1 Menntask\u00f3lanum vi\u00f0 Sund \u00ed ma\u00ed 1980 og stunda\u00f0i fyrst n\u00e1m \u00ed m\u00e1lv\u00edsindum vi\u00f0 H\u00e1sk\u00f3la \u00cdslands en h\u00f3f svo n\u00e1m \u00ed l\u00e6knisfr\u00e6\u00f0i hausti\u00f0 1982 og lauk cand. med. et chir. pr\u00f3fi \u00ed j\u00fan\u00ed 1988. A\u00f0 loknu kand\u00eddats\u00e1ri \u00e1 Fj\u00f3r\u00f0ungssj\u00fakrah\u00fasinu \u00e1 Akureyri stunda\u00f0i h\u00fan s\u00e9rn\u00e1m \u00ed kvensj\u00fakd\u00f3mum og f\u00e6\u00f0ingarhj\u00e1lp \u00e1 Kvennadeild Landsp\u00edtala 1989-1991 og s\u00ed\u00f0an \u00ed Leeds og Bradford \u00ed Bretlandi \u00e1 \u00e1runum 1991-1998. H\u00fan lauk bresku s\u00e9rfr\u00e6\u00f0ipr\u00f3fi \u00ed ma\u00ed 1994 og var\u00f0 \u00fe\u00e1 me\u00f0limur (MRCOG) \u00ed Royal College of Obstetricians and Gynaecologists og s\u00ed\u00f0an fellow (FRCOG) \u00ed september 2015. H\u00fan f\u00e9kk s\u00e9rfr\u00e6\u00f0ileyfi \u00e1 \u00cdslandi \u00ed okt\u00f3ber 1997 og h\u00f3f st\u00f6rf sem s\u00e9rfr\u00e6\u00f0ingur \u00e1 Kvennadeild Landsp\u00edtala \u00ed september 1998. Fr\u00e1 \u00e1rinu 2017 hefur h\u00fan veri\u00f0 yfirl\u00e6knir f\u00e6\u00f0ingateymis. Hulda hefur veri\u00f0 stundakennari vi\u00f0 H\u00e1sk\u00f3la \u00cdslands en einnig lei\u00f0beint BS- og MS-nemum. H\u00fan sat \u00ed stj\u00f3rn L\u00e6knaf\u00e9lags \u00cdslands, sem ritari 2000-2004 og s\u00ed\u00f0an varaforma\u00f0ur 2004-2006. H\u00fan var forma\u00f0ur F\u00e9lags \u00edslenskra f\u00e6\u00f0inga- og kvensj\u00fakd\u00f3mal\u00e6kna 2010-2012. Foreldrar Huldu eru Hj\u00f6rtur P\u00e1lsson, rith\u00f6fundur og prestur, og Steinunn Bjarman, ritari. Hulda er gift Eggert P\u00e9turssyni myndlistarmanni og b\u00f6rn \u00feeirra eru Eyvindur, P\u00e9tur, Gu\u00f0r\u00fan Inga og Hj\u00f6rtur P\u00e1ll.<\/p>\n<\/div><\/div>","protected":false},"featured_media":4935,"template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_phd_date_start":"2021-05-28T13:00:00+00:00","_phd_date_end":"2021-05-28T16:00:00+00:00","_phd_location":"A\u00f0albygging H\u00e1t\u00ed\u00f0asalur","_phd_admission":"A\u00f0gangur \u00f3keypis","_phd_thesis_title":"\u00d3msko\u00f0anir til a\u00f0 meta framgang og sn\u00faning f\u00f3sturh\u00f6fu\u00f0s \u00ed f\u00e6\u00f0ingum frumbyrja. 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