Facilitating workplace learning in clinical practice, an evaluation among medical specialists.

Purpose: Training of medical students, interns and residents (junior professionals, JP) happens predominantly through workplace learning. This is supported by medical specialists (MS) and varies by MS, workplace, medical specialty, and social context. This study aimed to gain insights into the facilitation of workplace learning in clinical practice by MS.

The contribution of birth plans to shared decision-making from the perspectives of women, their partners and their healthcare providers.

Background: The birth plan is a document expressing a pregnant woman's childbirth preferences, enabling communication of expectations and facilitating discussions among women, their partners, and healthcare providers for key birthing decisions. There has been limited research on the role of birth plans in shared decision-making (SDM). Our study aims to explore how the use of birth plans can contribute to SDM from women's, partners, and healthcare providers' perspectives.

Provider and client perspectives on the use of maternity waiting homes in rural Rwanda.

Background: The World Health Organization recommends the implementation of maternity waiting homes (MWH) to reduce delays in access to obstetric care, particularly for high-risk pregnancies and mothers living far from health facilities, and as a result, several countries have rolled out MWHs. However, Rwanda has not implemented this recommendation on a large scale. There is only one MWH in the country, hence a gap in knowledge regarding the potential utilisation and benefits of MWHs.

Cost-effectiveness analysis of induction of labour at 41 weeks and expectant management until 42 weeks in low risk women (INDEX trial).

Objective: To assess the cost-effectiveness of elective induction of labour (IOL) at 41 weeks and expectant management (EM) until 42 weeks.

Design: Cost-effectiveness analysis from a healthcare perspective alongside a randomised controlled trial (INDEX).

Setting: 123 primary care midwifery practices and 45 obstetric departments of hospitals in the Netherlands.

The role of birth plans for shared decision-making around birth choices of pregnant women in maternity care: A scoping review.

Background: Birth plans can be used to facilitate shared decision-making in childbirth. A birth plan is a document reflecting women's preferences for birth, which they discuss with their maternity care provider.

Aim: This scoping review aims to synthesize current findings on the role of birth plans for shared decision-making around birth choices of pregnant women in maternity care.

Elective induction of labour and expectant management in late-term pregnancy: A prospective cohort study alongside the INDEX randomised controlled trial.

Objective: To assess adverse perinatal outcomes and caesarean section of low-risk women receiving elective induction of labour at 41 weeks or expectant management until 42 weeks according to their preferred and actual management strategy.

Design: Multicentre prospective cohort study alongside RCT.

Setting: 90 midwifery practices and 12 hospitals in the Netherlands.

Neonatal hypoglycaemia and body proportionality in small for gestational age newborns: a retrospective cohort study.

Small for gestational age (SGA) newborns are at risk of developing neonatal hypoglycaemia. SGA newborns comprise a heterogeneous group including both constitutionally small and pathologically growth restricted newborns. The process of fetal growth restriction may result in brain sparing at the expense of the rest of the body, resulting in disproportionally small newborns.

Lessons learned from the perinatal audit of uterine rupture in the Netherlands: A mixed-method study.

Background And Aims: To analyze outcomes of nationwide local audits of uterine rupture to draw lessons for clinical care.

Methods: Descriptive cohort study. Critical incident audit sessions within all local perinatal cooperation groups in the Netherlands.

Pregnant women's willingness to participate in a randomized trial comparing induction of labor at 39 weeks versus expectant management: A survey in the Netherlands.

Introduction: A randomized controlled trial (RCT) in the United States, the ARRIVE trial, has indicated that induction of labor (IOL) in low-risk nulliparous women with a gestational age (GA) of 39 weeks compared to expectant management (EM) resulted in a significant lower rate of cesarean deliveries. The Dutch maternity care system is different compared to the United States with, among other factors, an overall significantly lower percentage of caesarean sections (CS). To investigate whether IOL has a favorable outcome in the Dutch maternity care system, a new trial is advised.

Automatic Placenta Localization From Ultrasound Imaging in a Resource-Limited Setting Using a Predefined Ultrasound Acquisition Protocol and Deep Learning.

Placenta localization from obstetric 2-D ultrasound (US) imaging is unattainable for many pregnant women in low-income countries because of a severe shortage of trained sonographers. To address this problem, we present a method to automatically detect low-lying placenta or placenta previa from 2-D US imaging. Two-dimensional US data from 280 pregnant women were collected in Ethiopia using a standardized acquisition protocol and low-cost equipment.

Centralisation of acute obstetric care in the Netherlands: a qualitative study to explore the experiences of stakeholders with adaptations in organisation of care.

Background: In the past decade, acute obstetric care (AOC) has become centralised in many high-income countries. In this qualitative study, we explored how stakeholders in maternity care perceived and experienced adaptations in the organisation of maternity care in areas in the Netherlands where AOC was centralised.

Methods: A heterogenic group of fifteen maternity care stakeholders, including patients, were purposively selected for semi-structured interviews.

How to Make the Hospital an Option Again: Midwives' and Obstetricians' Experiences with a Designated Clinic for Women Who Request Different Care than Recommended in the Guidelines.

Background: An increasing number of maternity care providers encounter pregnant women who request less care than recommended. A designated outpatient clinic for women who request less care than recommended was set up in Nijmegen, the Netherlands. The clinic's aim is to ensure that women make well-informed choices and arrive at a care plan that is acceptable to all parties.

Maternal and Perinatal Outcomes among Maternity Waiting Home Users and Non-Users in Rural Rwanda.

Most maternal and perinatal deaths could be prevented through timely access to skilled birth attendants. Women should access appropriate obstetric care during pregnancy, labor, and puerperium. Maternity waiting homes (MWHs) permit access to emergency obstetric care when labor starts.

Role of male partners in the long-term well-being of women who have experienced severe pre-eclampsia and eclampsia in rural Tanzania: a qualitative study.

Men can be essential sources of support in maternal health, even more so in case of severe acute maternal morbidity (SAMM), affecting 1-2% of childbearing women in low-resource settings. In a qualitative study using semi-structured interviews, we explored the perspectives of nine male partners of women who suffered from (pre-)eclampsia six to seven years earlier in rural Tanzania. Male partners considered their role to be pivotal regarding finances, decision-making in healthcare-seeking and family planning and provided physical and emotional support.

[Treatment for non-viable pregnancy in primary care].

Objective: To explore the experiences of women and health care professionals with misoprostol as a first line treatment for non-viable pregnancy. Additionally, we investigated to what extent adding this treatment to primary care will prevent a referral to secondary care.

Design: Retrospective mixed methods study METHOD: Pregnant women with a non-viable pregnancy with a gestational age shorter than 12 weeks treated by community midwives in Nijmegen Lent as part of an on-going pilot project were included.

First-time fathers' experiences and needs during childbirth: A systematic review.

Objective: Fathers have been increasingly involved in childbirth since 1990. Attendance at childbirth is considered to benefit fathers' health as well as that of their partner and children. However, childbirth is a life event that parents may experience differently.

Induction of labour at 41 weeks or expectant management until 42 weeks: A systematic review and an individual participant data meta-analysis of randomised trials.

Background: The risk of perinatal death and severe neonatal morbidity increases gradually after 41 weeks of pregnancy. Several randomised controlled trials (RCTs) have assessed if induction of labour (IOL) in uncomplicated pregnancies at 41 weeks will improve perinatal outcomes. We performed an individual participant data meta-analysis (IPD-MA) on this subject.

Assessing Implementation of Maternal and Perinatal Death Surveillance and Response in Rwanda.

Maternal deaths remain a major public health concern in low- and middle-income countries. Implementation of maternal and perinatal deaths surveillance and response (MPDSR) is vital to reduce preventable deaths. The study aimed to assess implementation of MPDSR in Rwanda.

'She convinced me'- partner involvement in choosing a high risk birth setting against medical advice in the Netherlands: A qualitative analysis.

Home births in high risk pregnancies and unassisted childbirth seem to be increasing in the Netherlands. There is a lack of qualitative data on women's partners' involvement in these choices in the Dutch maternity care system, where integrated midwifery care and home birth are regular options in low risk pregnancies. The majority of available literature focuses on the women's motivations, while the partner's influence on these decisions is much less well understood.

Risk of adverse pregnancy outcomes of late- and postterm pregnancies in advanced maternal age: A national cohort study.

Introduction: There is an increase in women delivering ≥35 years of age. We analyzed the association between advanced maternal age and pregnancy outcomes in late- and postterm pregnancies.

Material And Methods: A national cohort study was performed on obstetrical low-risk women using data from the Netherlands Perinatal Registry from 1999 to 2010.

The contribution of Dutch doctors in Global Health and Tropical Medicine to research in global health in low- and middle-income countries: an exploration of the evidence.

Results from medical research from high-income countries may not apply to low- and middle-income countries. Some expatriate physicians combine clinical duties with research. We present global health research conducted by Dutch medical doctors in Global Health and Tropical Medicine in low- and middle-income countries and explore the value of their research.

Understanding variation in health service coverage and maternal health outcomes among districts in Rwanda - A qualitative study of local health workers' perceptions.

Objective: To obtain the perspectives of health professionals and community health workers on factors that determine health service coverage and maternal health outcomes so as to understand variations between districts.

Methods: 16 Focus group discussions involving four different groups of participants were conducted in May 2015 in four purposively selected districts, complemented by three key informant interviews in one of the districts.

Results: The solidarity support for poor people and the interconnectedness between local leaders and heads of health facilities were identified as enablers of health service utilization.

Prevalence, characteristics, and satisfaction of women with a birth plan in The Netherlands.

Background: The use of birth plans to facilitate shared decision making in childbirth is widely recommended by international agencies and by the Dutch Integrated Birth Care protocol (2016). This study evaluated the use of birth plans in The Netherlands.

Methods: A retrospective study was conducted during 2017 in a Dutch academic hospital.