Unplanned cesarean sections in advanced maternal age: A predictive model.

Introduction: As maternal age during pregnancy is rising all over the world, there is a growing need for prognostic factors that determine maternal and perinatal outcomes in older women.

Material And Methods: This study is a retrospective cohort study of women aged 40 years or older at the time of delivery in four Santeon hospitals across the Netherlands between January 2016 and December 2019. Outcomes were compared between women of 40-44 years (advanced maternal age) and 45 years and older (very advanced maternal age).

Confidential enquiry into maternal deaths in the Netherlands, 2006-2018.

Introduction: To calculate the maternal mortality ratio (MMR) for 2006-2018 in the Netherlands and compare this with 1993-2005, and to describe women's characteristics, causes of death and improvable factors.

Material And Methods: We performed a nationwide, cohort study of all maternal deaths between January 1, 2006 and December 31, 2018 reported to the Audit Committee Maternal Mortality and Morbidity. Main outcome measures were the national MMR and causes of death.

Thyroid-stimulating hormone and free thyroxine fail to predict the severity and clinical course of hyperemesis gravidarum: A prospective cohort study.

Introduction: Little is known about the pathophysiology of hyperemesis gravidarum (HG). Proposed underlying causes are multifactorial and thyroid function is hypothesized to be causally involved. In this study, we aimed to assess the utility of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) as a marker and predictor for the severity and clinical course of HG.

Determinants of disease course and severity in hyperemesis gravidarum.

Objective: We aimed to identify determinants that predict hyperemesis gravidarum (HG) disease course and severity.

Study Design: For this study, we combined data of the Maternal and Offspring outcomes after Treatment of HyperEmesis by Refeeding (MOTHER) randomized controlled trial (RCT) and its associated observational cohort with non-randomised patients. Between October 2013 and March 2016, in 19 hospitals in the Netherlands, women hospitalised for HG were approached for study participation.

Fetal heart rate abnormalities during and after external cephalic version: Which fetuses are at risk and how are they delivered?

Background: Fetal heart rate abnormalities (FHR) during and after external cephalic version (ECV) are relatively frequent. They may raise concern about fetal wellbeing. Only occasionally they may lead to an emergency cesarean section.

Practice variation of vaginal birth after cesarean and the influence of risk factors at patient level: a retrospective cohort study.

Introduction: Large practice variation exists in mode of delivery after cesarean section, suggesting variation in implementation of contemporary guidelines. We aim to evaluate this practice variation and to what extent this can be explained by risk factors at patient level.

Material And Methods: This retrospective cohort study was performed among 17 Dutch hospitals in 2010.

The HAPPY study (Holistic Approach to Pregnancy and the first Postpartum Year): design of a large prospective cohort study.

Background: The HAPPY study is a large prospective longitudinal cohort study in which pregnant women (N ≈ 2,500) are followed during the entire pregnancy and the whole first year postpartum. The study collects a substantial amount of psychological and physiological data investigating all kinds of determinants that might interfere with general well-being during pregnancy and postpartum, with special attention to the effect of maternal mood, pregnancy-related somatic symptoms (including nausea and vomiting (NVP) and carpal tunnel syndrome (CTS) symptoms), thyroid function, and human chorionic gonadotropin (HCG) on pregnancy outcome of mother and foetus.

Methods/design: During pregnancy, participants receive questionnaires at 12, 22 and 32 weeks of gestation.

Fear for external cephalic version and depression: predictors of successful external cephalic version for breech presentation at term?

Background: Objective was to determine whether fear for external cephalic version (ECV) and depression are associated with the success rate of ECV in women with a breech presentation at term.

Methods: Prospective study conducted in the Catharina Hospital Eindhoven between October 2007 and May 2012. Participants fulfilled The Edinburgh Depression Scale (EDS) questionnaire and expressed their degree of fear on a visual analogue scale from one to ten before ECV.

Prediction of postpartum hemorrhage in women with gestational hypertension or mild preeclampsia at term.

Objective: To assess whether postpartum hemorrhage can be predicted in women with gestational hypertension or mild preeclampsia at term.

Design: A cohort study in which we used data from our multicentre randomized controlled trial (HYPITAT trial).

Setting: The study was conducted in 38 hospitals in the Netherlands between 2005 and 2008.

Determinants of pain perception after external cephalic version in pregnant women.

Objective: A considerable proportion of pregnant women with a fetus in breech position refuses external cephalic version (ECV), with fear of pain as important barrier. As a consequence, they are at high risk for caesarean section at term. The current study investigated determinants of pain perception during ECV, with special attention to maternal mental state such as depression and fear of ECV.

Mode of delivery following successful external cephalic version: comparison with spontaneous cephalic presentations at delivery.

Objective: To compare the obstetric outcomes of pregnant women after successful external cephalic version (ECV) (cases) with a large group of pregnant women with a spontaneously occurring cephalic fetal position at delivery (controls).

Methods: We conducted a retrospective matched cohort study in a teaching hospital in the Netherlands. Delivery outcomes of women with a successful ECV were compared with those of women with spontaneously occurring cephalic presentations, controlling for maternal age, parity, gestational age at delivery, and onset of labour (spontaneous or induced).

Maternal thyroid parameters, body mass index and subsequent weight gain during pregnancy in healthy euthyroid women.

Context: Obesity and too much weight gain during gestation have a negative effect on obstetric and neonatal outcomes.

Objective: To determine the relationship between thyroid hormone parameters, body mass index (BMI) and weight gain during gestation.

Design: Prospective follow-up study of thyroid parameters and gestational weight gain.

SIMPLE: implementation of recommendations from international evidence-based guidelines on caesarean sections in the Netherlands. Protocol for a controlled before and after study.

Background: Caesarean section (CS) rates are rising worldwide. In the Netherlands, the most significant rise is observed in healthy women with a singleton in vertex position between 37 and 42 weeks gestation, whereas it is doubtful whether an improved outcome for the mother or her child was obtained. It can be hypothesized that evidence-based guidelines on CS are not implemented sufficiently.

The relation between umbilical cord characteristics and the outcome of external cephalic version.

Background: Umbilical cords of fetuses in breech presentation differ in length and coiling from their cephalic counterparts and it might be hypothesised that these cord characteristics may in turn affect ECV outcome.

Aim: To investigate the relation between umbilical cord characteristics and the outcome of external cephalic version (ECV).

Study Design: Prospective cohort study.

Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study.

Background: To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV) in breech presentation.

Methods: Prospective cohort study in 141 women (≥ 35 weeks gestation) with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV.

Implementation of the external cephalic version in breech delivery. Dutch national implementation study of external cephalic version.

Background: Breech presentation occurs in 3 to 4% of all term pregnancies. External cephalic version (ECV) is proven effective to prevent vaginal breech deliveries and therefore it is recommended by clinical guidelines of the Royal Dutch Organisation for Midwives (KNOV) and the Dutch Society for Obstetrics and Gynaecology (NVOG). Implementation of ECV does not exceed 50 to 60% and probably less.

[Fewer breech deliveries after implementation of a modified cephalic version protocol].

Aim: To investigate the effect of implementation of a number of process policy guidelines (protocol), on the success rate of external cephalic version (ECV) for breech presentation.

Design: Prospective study.

Methods: During a 3-year period (2004-2006) a standardized protocol for an ECV consultation was developed, evaluated and adapted.

Vaginal stones in a 5-year-old girl: a novel approach of removal.

Background: Primary vaginal stones in children are extremely rare and removal can be difficult. We describe a procedure for safe extraction of vaginal stones.

Case: A 5-year-old, wheelchair-bound girl was referred to the urologic department with recurrent febrile urinary tract infection.

Pregnancy in classic galactosemia despite undetectable anti-Müllerian hormone.

Objective: To report a pregnancy in a patient with classic galactosemia despite signs of no ovarian reserve to draw attention to the limited predictive value of ovarian reserve tests in these patients.

Design: Case report.

Setting: Secondary and tertiary care center.