Search PubMed⌕ Search
Home/Archive/PubMed

PubMed · 7589749

The Dutch obstetric intervention study--variations in practice patterns.

M H Heres·M Pel·P M Elferink-Stinkens·O J Van Hemel·P E Treffers
View original source ↗Export metadata ↓

Abstract

OBJECTIVE: To compare obstetric intervention rates between Dutch hospitals. METHODS: A total of 28,934 hospital births under secondary care (specialist care for medium-/high-risk pregnancies) in 1990 were analyzed in a stratified, random sample of Dutch hospitals based on the records of the Dutch Netherlands perinatal database. Comparisons were made of the intervention rates between hospitals. RESULTS: The intervention rates of the various hospitals differed widely. The most striking difference was in the cesarean section (CS) rate for non-vertex first twins, with a range of 0-100% and a mean rate of 47.6%. On average a CS for a term breech was performed in 30.8% of cases and sedation or analgesics were administered in 16.2% of cases. The mean rate of episiotomy for a term breech was 71.5%, the lowest rate being 18.8%. CONCLUSION: Our results show relatively low intervention rates with considerable interhospital variation.

Explore related subjects

Birth WeightCesarean SectionEpisiotomyFemaleHumansLabor, InducedNetherlandsPractice Patterns, Physicians'PregnancyJournal ArticleMulticenter StudyResearch Support, Non-U.S. Gov't

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

M H Heres, M Pel, P M Elferink-Stinkens, O J Van Hemel, P E Treffers. 1995. The Dutch obstetric intervention study--variations in practice patterns.. https://doi.org/10.1016/0020-7292(95)02424-b

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Infant growth, development and tooth emergence patterns: A longitudinal study from birth to 6 years of age.

OBJECTIVE: To test the association of child's growth/development status and socioeconomic variables with dental emergence patterns. DESIGN: A sample of 359 children belonging to a birth cohort of over 5000 children born in 1993 in Pelotas (Brazil) was studied in 1998-1999. Previously trained observers collected birthweight, head circumference at birth, birth height, gestational age, smoking during pregnancy, child's sex and skin colour, height by age at 6 months of age, caries experience in the deciduous teeth, number of emerged teeth at 6 and 12 months of age and emergence stages of the first permanent molars at 6 years of age. Family income, parental educational attainment and anthropometric measurements were collected at children's homes. Poisson regression models were applied in order to select best predictors of pairs of emerged teeth at 6 and 12 months of age and emerged (yes/no) first permanent molars at 6 years of age. RESULTS: Children shorter than 49cm had, on average, less pairs of emerged teeth at 6 months of age. Twelve-month-old children with birth height < or =49cm, presenting height-for-age deficit at 6 months of age and the females also presented less pairs of emerged teeth. Stunted children at 6 months of age were more likely to have non-emerged first upper left and lower right permanent molars at 6 years of age. CONCLUSIONS: Important developmental and nutritional variables at birth and throughout the early life may predict the numbers of emerged teeth children have in their oral cavity.

Birth Weight↗
PubMed2007

Long-term neurodevelopmental outcome of triplets.

OBJECTIVE: To analyze the incidence of neurodevelopmental disabilities in triplets and to find out possible connection between the outcome and perinatal events. DESIGN: Retrospective cohort study of 94 triplets and their outcome at 24-144 months of age correlated with gestational age, birth weight, pregnancy complications, early neonatal period, neonatal cranial ultrasound, period of birth (1985-1995, 1996-2000) and type of antenatal care. RESULTS: Sixty-two triplets are healthy, 15 suffer cerebral palsy (CP) and 17 minimal cerebral dysfunction (MCD). Adverse outcome correlates significantly with prematurity, low birth weight and maternal age. In multivariate analysis, both cerebral palsy and minor disabilities correlate significantly with early neonatal complications, neonatal cranial ultrasound with later CP (p<0.01), and MCD with preterm rupture of membranes (p=0.047). Children conceived spontaneously do worse than those born after assisted reproduction (p=0.004), those born in the time period 1996-2000 do better than those born before (p=0.021). Seventy-seven percent (77%) of newborns delivered in the time period 1996-2000 and after level 1 antenatal care was introduced, compared with 54% being delivered in the time period before 1996 and with less meticulous types of antenatal care, remain healthy (p=0.015). CONCLUSION: Triplets are still at high risk for long-term neurodevelopmental complications. Stringent perinatal care might appear important determinant of their long-term outcome.

Birth Weight↗