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51. A core outcome set for pre-eclampsia research: an international consensus development study.

Author: Ghosh S.K., Daly M.C., Darmochwal-Kolarz D.A., Davies R.E., Davies M.W., Dawson J.S., Dobson N., Dodd C.N., Donald F., Duley L., Epstein-Mares J., Erez O., Evans E., Farlie R.N., Ferris A.V., Frankland E.M., Freeman D.J., Gainder S., Ganzevoort W., Hamilton L.M., Hammond S.J., Harlow S.D., Hays K.E., Hickey S.C., Higgins M., Hinton L., Hobson S.R., Hogg M.J., Hollands H.J., EH C.S.E., Hoodbhoy Z., Howell P., Huppertz B., Husain S., Jacoby S.D., Jacqz-Aigrain E., Jenkins G., Jewel D., Johnson M.J., Johnston C.L., Jones P.M., Kantrowitz-Gordon I., Khan R.-U., Kirby L.J., Kirk C., Knight M., Korey M.T., Lee G.J., Lee V.W., Levene L.S., Londero A.P., Lust K.M., MacKenzie V., Malha L., Mattone M., McCartney D.E., McFadden A., McKinstry B.H., Middleton P.F., Mistry H.D., Mitchell C.A., Mockler J.C., Molsher S.-A., Monast E.S., Moodley E.J., Mooij R., Moore E.L., Morgan L., Moulson A., Mughal F., Mundle S.R., Munoz M.A., Murray E., Nagata C., Nair A.S., Nakimuli A., Nath G., Newport R.S., Oakeshott P., Ochoa-Ferraro M.R., Odendaal H., Ohkuchi A., Oliveira L., Ortiz-Panozo E., Oudijk M.A., Oygucu S.E., Paech M.J., Painter R.C., Parry C.L., Payne B.A., Pearson E.L., Phupong V., Pickett N., Pickles K.A., Plumb L.K., Prefumo F., Preston R., Ray J.G., Rayment J., Regan L.V., Rey E., Robson E.J., Rubin A.N., Rubio-Romero A.N., Rull K., Sass N., Sauve N., Savory N.A., Scott J.R., Seaton S.E., Seed P.T., Shakespeare J.M., Shand A.W., Sharma S., Shaw T.Y., Smedley K.L., Smith D., Conk A.S., Soward D., Stepan H., Stroumpoulis K., SurenDr A., Takeda S., Tan L., Theriot B.S., Thomas H.F., Thompson K., Thompson P.I., Thompson M.J., Toms L., Torney K.L.H.T., Treadwell J.S., Tucker K.L., Turrentine M.A., Van Hecke O., Van Oostwaard M.F., Vasquez D.N., AV D.J.A., VInturache A., Walker J., Wardle S.P., Wasim T., Waters J.H., Whitehead C.L., Wolfson A., Yeo S., Duffy J.M.N., Cairns A.E., Richards-Doran D., van 't Hooft J., Gale C., Brown M., Chappell L.C., Grobman W.A., Fitzpatrick R., Karumanchi S.A., Khalil A., Lucas D.N., Magee L.A., Mol B.W., Stark M., Thangaratinam S., Wilson M.J., von Dadelszen P., Williamson P.R., Ziebland S., McManus R.J., Abalos E.J., DA C.C.D., AkaDr A.A., Akturk Z., Allegaert K., Angel-Muller E., Antretter J., Ashdown H.F., Audibert F., Auger N., Aygun C., Babic I., Bagga R., Baker J.M., Bhakta P., Bhandari V., Bhattacharya S., Blanker M.H., Bloomfield F.H., Bof A., Brennan S.M., Broekhuijsen K., Pipkin E.F.B., Browne J.L., Browning R.M., Bull J.W., Butt A., Button D., Campbell J.P., Campbell D.M., Carbillon L., Carthy S., Casely E., Cave J.A., Cecatti J.G., Chamillard M.E., Chassard D., Checheir N.C., Chulkov V.S., Cluver C.A., Crawford C.F., Gbinigie O.A., Glogowska M., Goodlife A., Gough K.L., Green J.R., Gul F., Haggerty L., Hall D.R., Hallman M., Ghosh S.K., Daly M.C., Darmochwal-Kolarz D.A., Davies R.E., Davies M.W., Dawson J.S., Dobson N., Dodd C.N., Donald F., Duley L., Epstein-Mares J., Erez O., Evans E., Farlie R.N., Ferris A.V., Frankland E.M., Freeman D.J., Gainder S., Ganzevoort W., Hamilton L.M., Hammond S.J., Harlow S.D., Hays K.E., Hickey S.C., Higgins M., Hinton L., Hobson S.R., Hogg M.J., Hollands H.J., EH C.S.E., Hoodbhoy Z., Howell P., Huppertz B., Husain S., Jacoby S.D., Jacqz-Aigrain E., Jenkins G., Jewel D., Johnson M.J., Johnston C.L., Jones P.M., Kantrowitz-Gordon I., Khan R.-U., Kirby L.J., Kirk C., Knight M., Korey M.T., Lee G.J., Lee V.W., Levene L.S., Londero A.P., Lust K.M., MacKenzie V., Malha L., Mattone M., McCartney D.E., McFadden A., McKinstry B.H., Middleton P.F., Mistry H.D., Mitchell C.A., Mockler J.C., Molsher S.-A., Monast E.S., Moodley E.J., Mooij R., Moore E.L., Morgan L., Moulson A., Mughal F., Mundle S.R., Munoz M.A., Murray E., Nagata C., Nair A.S., Nakimuli A., Nath G., Newport R.S., Oakeshott P., Ochoa-Ferraro M.R., Odendaal H., Ohkuchi A., Oliveira L., Ortiz-Panozo E., Oudijk M.A., Oygucu S.E., Paech M.J., Painter R.C., Parry C.L., Payne B.A., Pearson E.L., Phupong V., Pickett N., Pickles K.A., Plumb L.K., Prefumo F., Preston R., Ray J.G., Rayment J., Regan L.V., Rey E., Robson E.J., Rubin A.N., Rubio-Romero A.N., Rull K., Sass N., Sauve N., Savory N.A., Scott J.R., Seaton S.E., Seed P.T., Shakespeare J.M., Shand A.W., Sharma S., Shaw T.Y., Smedley K.L., Smith D., Conk A.S., Soward D., Stepan H., Stroumpoulis K., SurenDr A., Takeda S., Tan L., Theriot B.S., Thomas H.F., Thompson K., Thompson P.I., Thompson M.J., Toms L., Torney K.L.H.T., Treadwell J.S., Tucker K.L., Turrentine M.A., Van Hecke O., Van Oostwaard M.F., Vasquez D.N., AV D.J.A., VInturache A., Walker J., Wardle S.P., Wasim T., Waters J.H., Whitehead C.L., Wolfson A., Yeo S., Duffy J.M.N., Cairns A.E., Richards-Doran D., van 't Hooft J., Gale C., Brown M., Chappell L.C., Grobman W.A., Fitzpatrick R., Karumanchi S.A., Khalil A., Lucas D.N., Magee L.A., Mol B.W., Stark M., Thangaratinam S., Wilson M.J., von Dadelszen P., Williamson P.R., Ziebland S., McManus R.J., Abalos E.J., DA C.C.D., AkaDr A.A., Akturk Z., Allegaert K., Angel-Muller E., Antretter J., Ashdown H.F., Audibert F., Auger N., Aygun C., Babic I., Bagga R., Baker J.M., Bhakta P., Bhandari V., Bhattacharya S., Blanker M.H., Bloomfield F.H., Bof A., Brennan S.M., Broekhuijsen K., Pipkin E.F.B., Browne J.L., Browning R.M., Bull J.W., Butt A., Button D., Campbell J.P., Campbell D.M., Carbillon L., Carthy S., Casely E., Cave J.A., Cecatti J.G., Chamillard M.E., Chassard D., Checheir N.C., Chulkov V.S., Cluver C.A., Crawford C.F., Gbinigie O.A., Glogowska M., Goodlife A., Gough K.L., Green J.R., Gul F., Haggerty L., Hall D.R., and Hallman M.
Abstract: Objective: To develop a core outcome set for pre-eclampsia. Design(s): Consensus development study. Setting(s): International. Population: Two hundred and eight-one healthcare professionals, 41 researchers and 110 patients, representing 56 countries, participated. Method(s): Modified Delphi method and Modified Nominal Group Technique. Result(s): A long-list of 116 potential core outcomes was developed by combining the outcomes reported in 79 pre-eclampsia trials with those derived from thematic analysis of 30 in-depth interviews of women with lived experience of pre-eclampsia. Forty-seven consensus outcomes were identified from the Delphi process following which 14 maternal and eight offspring core outcomes were agreed at the consensus development meeting. Maternal core outcomes: death, eclampsia, stroke, cortical blindness, retinal detachment, pulmonary oedema, acute kidney injury, liver haematoma or rupture, abruption, postpartum haemorrhage, raised liver enzymes, low platelets, admission to intensive care required, and intubation and ventilation. Offspring core outcomes: stillbirth, gestational age at delivery, birthweight, small-for-gestational-age, neonatal mortality, seizures, admission to neonatal unit required and respiratory support. Conclusion(s): The core outcome set for pre-eclampsia should underpin future randomised trials and systematic reviews. Such implementation should ensure that future research holds the necessary reach and relevance to inform clinical practice, enhance women's care and improve the outcomes of pregnant women and their babies. Tweetable abstract: 281 healthcare professionals, 41 researchers and 110 women have developed #preeclampsia core outcomes @HOPEoutcomes @jamesmnduffy. [Correction added on 29 June 2020, after first online publication: the order has been corrected.].Copyright © 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetr
Published: 2021

52. External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis.

Author: Kingdom J., Poston L., Thilaganathan B., Staff A.C., Smith G.C.S., Ganzevoort W., Laivuori H., Odibo A.O., Arenas Ramirez J., Daskalakis G., Farrar D., Baschat A.A., Seed P.T., Prefumo F., da Silva Costa F., Groen H., Audibert F., Masse J., Skrastad R.B., Salvesen K.A., Haavaldsen C., Nagata C., Rumbold A.R., Heinonen S., Askie L.M., Smits L.J.M., Vinter C.A., Magnus P., Eero K., Villa P.M., Jenum A.K., Andersen L.B., Norman J.E., Ohkuchi A., Eskild A., Bhattacharya S., McAuliffe F.M., Galindo A., Herraiz I., Carbillon L., Klipstein-Grobusch K., Yeo S.A., Browne J.L., Moons K.G.M., Riley R.D., Thangaratinam S., Snell K.I.E., Allotey J., Smuk M., Hooper R., Chan C., Ahmed A., Chappell L.C., Von Dadelszen P., Green M., Kenny L., Khalil A., Khan K.S., Mol B.W., Myers J., Kingdom J., Poston L., Thilaganathan B., Staff A.C., Smith G.C.S., Ganzevoort W., Laivuori H., Odibo A.O., Arenas Ramirez J., Daskalakis G., Farrar D., Baschat A.A., Seed P.T., Prefumo F., da Silva Costa F., Groen H., Audibert F., Masse J., Skrastad R.B., Salvesen K.A., Haavaldsen C., Nagata C., Rumbold A.R., Heinonen S., Askie L.M., Smits L.J.M., Vinter C.A., Magnus P., Eero K., Villa P.M., Jenum A.K., Andersen L.B., Norman J.E., Ohkuchi A., Eskild A., Bhattacharya S., McAuliffe F.M., Galindo A., Herraiz I., Carbillon L., Klipstein-Grobusch K., Yeo S.A., Browne J.L., Moons K.G.M., Riley R.D., Thangaratinam S., Snell K.I.E., Allotey J., Smuk M., Hooper R., Chan C., Ahmed A., Chappell L.C., Von Dadelszen P., Green M., Kenny L., Khalil A., Khan K.S., Mol B.W., and Myers J.
Abstract: BACKGROUND: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk during pregnancy is required to plan management. Although there are many published prediction models for pre-eclampsia, few have been validated in external data. Our objective was to externally validate published prediction models for pre-eclampsia using individual participant data (IPD) from UK studies, to evaluate whether any of the models can accurately predict the condition when used within the UK healthcare setting. METHOD(S): IPD from 11 UK cohort studies (217,415 pregnant women) within the International Prediction of Pregnancy Complications (IPPIC) pre-eclampsia network contributed to external validation of published prediction models, identified by systematic review. Cohorts that measured all predictor variables in at least one of the identified models and reported pre-eclampsia as an outcome were included for validation. We reported the model predictive performance as discrimination (C-statistic), calibration (calibration plots, calibration slope, calibration-in-the-large), and net benefit. Performance measures were estimated separately in each available study and then, where possible, combined across studies in a random-effects meta-analysis. RESULT(S): Of 131 published models, 67 provided the full model equation and 24 could be validated in 11 UK cohorts. Most of the models showed modest discrimination with summary C-statistics between 0.6 and 0.7. The calibration of the predicted compared to observed risk was generally poor for most models with observed calibration slopes less than 1, indicating that predictions were generally too extreme, although confidence intervals were wide. There was large between-study heterogeneity in each model's calibration-in-the-large, suggesting poor calibration of the predicted overall risk across populations. In a subset of models, the net benefit of using the models to inform clinical decis
Published: 2021

53. Validation and development of models using clinical, biochemical and ultrasound markers for predicting pre-eclampsia: An individual participant data meta-analysis.

Author: Allotey J., Smuk M., Hooper R., Chan C.L., Ahmed A., Chappell L.C., von Dadelszen P., Dodds J., Green M., Kenny L., Khalil A., Khan K.S., Mol B.W., Myers J., Poston L., Thilaganathan B., Eskild A., Bhattacharya S., McAuliffe F.M., Galindo A., Herraiz I., Carbillon L., Klipstein-Grobusch K., Yeo S., Teede H.J., Browne J.L., Moons K.G.M., Riley R.D., Thangaratinam S., Snell K.I.E., Staff A.C., Smith G.C.S., Ganzevoort W., Laivuori H., Odibo A.O., Ramirez J.A., Kingdom J., Daskalakis G., Farrar D., Baschat A.A., Seed P.T., Prefumo F., da Silva Costa F., Groen H., Audibert F., Masse J., Skrastad R.B., Salvesen K.A., Haavaldsen C., Nagata C., Rumbold A.R., Heinonen S., Askie L.M., Smits L.J.M., Vinter C.A., Magnus P.M., Eero K., Villa P.M., Jenum A.K., Andersen L.B., Norman J.E., Ohkuchi A., Allotey J., Smuk M., Hooper R., Chan C.L., Ahmed A., Chappell L.C., von Dadelszen P., Dodds J., Green M., Kenny L., Khalil A., Khan K.S., Mol B.W., Myers J., Poston L., Thilaganathan B., Eskild A., Bhattacharya S., McAuliffe F.M., Galindo A., Herraiz I., Carbillon L., Klipstein-Grobusch K., Yeo S., Teede H.J., Browne J.L., Moons K.G.M., Riley R.D., Thangaratinam S., Snell K.I.E., Staff A.C., Smith G.C.S., Ganzevoort W., Laivuori H., Odibo A.O., Ramirez J.A., Kingdom J., Daskalakis G., Farrar D., Baschat A.A., Seed P.T., Prefumo F., da Silva Costa F., Groen H., Audibert F., Masse J., Skrastad R.B., Salvesen K.A., Haavaldsen C., Nagata C., Rumbold A.R., Heinonen S., Askie L.M., Smits L.J.M., Vinter C.A., Magnus P.M., Eero K., Villa P.M., Jenum A.K., Andersen L.B., Norman J.E., and Ohkuchi A.
Abstract: Background: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk is needed to plan management. Objective(s): To assess the performance of existing pre-eclampsia prediction models and to develop and validate models for pre-eclampsia using individual participant data meta-analysis. We also estimated the prognostic value of individual markers. Design(s): This was an individual participant data meta-analysis of cohort studies. Setting(s): Source data from secondary and tertiary care. Predictors: We identified predictors from systematic reviews, and prioritised for importance in an international survey. Primary outcomes: Early-onset (delivery at < 34 weeks' gestation), late-onset (delivery at >= 34 weeks' gestation) and any-onset pre-eclampsia. Analysis: We externally validated existing prediction models in UK cohorts and reported their performance in terms of discrimination and calibration.We developed and validated 12 new models based on clinical characteristics, clinical characteristics and biochemical markers, and clinical characteristics and ultrasound markers in the first and second trimesters. We summarised the data set-specific performance of each model using a random-effects meta-analysis. Discrimination was considered promising for C-statistics of >= 0.7, and calibration was considered good if the slope was near 1 and calibration-in-the-large was near 0. Heterogeneity was quantified using I2 and 2. A decision curve analysis was undertaken to determine the clinical utility (net benefit) of the models. We reported the unadjusted prognostic value of individual predictors for pre-eclampsia as odds ratios with 95% confidence and prediction intervals. Result(s): The International Prediction of Pregnancy Complications network comprised 78 studies (3,570,993 singleton pregnancies) identified from systematic reviews of tests to predict pre-eclampsia. Twenty-four of the 131 published prediction models c
Published: 2021

54. Cerebroplacental ratio in predicting adverse perinatal outcome: a meta-analysis of individual participant data.

Author: Vollgraff Heidweiller-Schreurs, CA, van Osch, IR, Heymans, MW, Ganzevoort, W, Schoonmade, LJ, Bax, CJ, Mol, B, de Groot, C, Bossuyt, P, de Boer, MA, CPR IPD Study Group, Vollgraff Heidweiller-Schreurs, CA, van Osch, IR, Heymans, MW, Ganzevoort, W, Schoonmade, LJ, Bax, CJ, Mol, B, de Groot, C, Bossuyt, P, de Boer, MA, and CPR IPD Study Group
Abstract: OBJECTIVE: To investigate if cerebroplacental ratio (CPR) adds to the predictive value of umbilical artery pulsatility index (UA PI) alone - standard of practice - for adverse perinatal outcome in singleton pregnancies. DESIGN AND SETTING: Meta-analysis based on individual participant data (IPD). POPULATION OR SAMPLE: Ten centres provided 17 data sets for 21 661 participants, 18 731 of which could be included. Sample sizes per data set ranged from 207 to 9215 individuals. Patient populations varied from uncomplicated to complicated pregnancies. METHODS: In a collaborative, pooled analysis, we compared the prognostic value of combining CPR with UA PI, versus UA PI only and CPR only, with a one-stage IPD approach. After multiple imputation of missing values, we used multilevel multivariable logistic regression to develop prediction models. We evaluated the classification performance of all models with receiver operating characteristics analysis. We performed subgroup analyses according to gestational age, birthweight centile and estimated fetal weight centile. MAIN OUTCOME MEASURES: Composite adverse perinatal outcome, defined as perinatal death, caesarean section for fetal distress or neonatal unit admission. RESULTS: Adverse outcomes occurred in 3423 (18%) participants. The model with UA PI alone resulted in an area under the curve (AUC) of 0.775 (95% CI 0.709-0.828) and with CPR alone in an AUC of 0.778 (95% CI 0.715-0.831). Addition of CPR to the UA PI model resulted in an increase in the AUC of 0.003 points (0.778, 95% CI 0.714-0.831). These results were consistent across all subgroups. CONCLUSIONS: Cerebroplacental ratio added no predictive value for adverse perinatal outcome beyond UA PI, when assessing singleton pregnancies, irrespective of gestational age or fetal size. TWEETABLE ABSTRACT: Doppler measurement of cerebroplacental ratio in clinical practice has limited added predictive value to umbilical artery alone.
Published: 2021

55. Groene vrijwilligers in de schijnwerpers

Author: Ganzevoort, W., Born, R. van den, Ganzevoort, W., and Born, R. van den
Abstract: Vrijwilligers leveren een cruciale bijdrage aan de bescherming van de Nederlandse natuur: denk aan landschapsbeheer, ecologisch onderzoek, excursies begeleiden en bestuurswerk. Maar wie deze vrijwilligers zijn, en wat hen drijft, blijft vaak onderbelicht. Voor de toekomst van groen vrijwilligerswerk is het belangrijk dat organisaties aansluiten bij de leefwereld van hun vrijwilligers. In dit artikel schetsen wij vier routes om hiermee aan de slag te gaan.
Published: 2021

56. Temporizing management vs immediate delivery in early-onset severe preeclampsia between 28 and 34 weeks of gestation (TOTEM study): An open-label randomized controlled trial

Author: Duvekot, J.J., Duijnhoven, RG, van Horen, E, Bax, CJ, Bloemenkamp, KW, Brussé, Ingrid, Dijk, PH, Franssen, MT, Franx, A (Arie), Oudijk, MA, Porath, MM, Scheepers, HCJ, van Wassenaer-Leemhuis, AG, van Drongelen, J, Mol, BW, Ganzevoort, W, Duvekot, J.J., Duijnhoven, RG, van Horen, E, Bax, CJ, Bloemenkamp, KW, Brussé, Ingrid, Dijk, PH, Franssen, MT, Franx, A (Arie), Oudijk, MA, Porath, MM, Scheepers, HCJ, van Wassenaer-Leemhuis, AG, van Drongelen, J, Mol, BW, and Ganzevoort, W
Abstract: Introduction: There is little evidence to guide the timing of delivery of women with early-onset severe preeclampsia. We hypothesize that immediate delivery is not inferior for neonatal outcome but reduces maternal complications compared with temporizing management. Material and methods: This Dutch multicenter open-label randomized clinical trial investigated non-inferiority for neonatal outcome of temporizing management as compared with immediate delivery (TOTEM NTR 2986) in women between 27+5 and 33+5 weeks of gestation admitted for early-onset severe preeclampsia with or without HELLP syndrome. In participants allocated to receive immediate delivery, either induction of labor or cesarean section was initiated at least 48 hours after admission. Primary outcomes were adverse perinatal outcome, defined as a composite of severe respiratory distress syndrome, bronchopulmonary dysplasia, culture proven sepsis, intraventricular hemorrhage grade 3 or worse, periventricular leukomalacia grade 2 or worse, necrotizing enterocolitis stage 2 or worse, and perinatal death. Major maternal complications were secondary outcomes. It was estimated 1130 women needed to be enrolled. Analysis was by intention-to-treat. Results: The trial was halted after 35 months because of slow recruitment. Between February 2011 and December 2013, a total of 56 women were randomized to immediate delivery (n = 26) or temporizing management (n = 30). Median gestational age at randomization was 30 weeks. Median prolongation of pregnancy was 2 days (interquartile range 1-3 days) in the temporizing management group. Mean birthweight was 1435 g after immediate delivery vs 1294 g after temporizing management (P =.14). The adverse perinatal outcome rate was 55% in the immediate delivery group vs 52% in the temporizing management group (relative risk 1.06; 95% confidence interval 0.67-1.70). In both groups there was one neonatal death and no maternal deaths. In the temporizing treatm
Published: 2021

57. OP02_6. Nationwide pregnancy outcomes after kidney transplantation and prediction of adverse pregnancy outcomes: A Dutch cohort study

Author: Gosselink, M., Van Buren, M., Kooiman, J., Groen, H., Ganzevoort, W., Van Hamersvelt, H., Van Der Heijden, O., Van De Wetering, J., and Lely, T.
Published: 2023
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58. PO1_11. Optimal timing of antenatal corticosteroid administration in pregnancies complicated by early-onset fetal growth restriction: The opticore study protocol

Author: van de Meent, M., Onland, W., Ganzevoort, W., Gordijn, S., Kooi, E., Schuit, E., Bekker, M., Groenendaal, F., Lely, T., and Kooiman, J.
Published: 2023
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59. Critical umbilical artery Doppler abnormalities in early fetal growth restriction and the timing of delivery: an overestimated clinical challenge in daily obstetric practice?

Author: Lees, C., Marlow, N., Arabin, B., Bilardo, C. M., Brezinka, C., Derks, J. B., Duvekot, J., Frusca, T., Diemert, A., Ferrazzi, E., Ganzevoort, W., Hecher, K., Martinelli, P., Ostermayer, E., Papageorghiou, A. T., Schlembach, D., Schneider, K. T., Thilaganathan, B., Todros, T., van Wassenaer-Leemhuis, A., Valcamonico, A., Visser, G. H., and Wolf, H.
Published: 2014
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60. A core outcome set for pre‐eclampsia research : an international consensus development study

Author: Duffy, JMN, Cairns, AE, Richards‐Doran, D, van 't Hooft, J, Gale, C, Brown, M, Chappell, LC, Grobman, WA, Fitzpatrick, R, Karumanchi, SA, Khalil, A, Lucas, DN, Magee, LA, Mol, BW, Stark, M, Thangaratinam, S, Wilson, MJ, von Dadelszen, P, Williamson, PR, Ziebland, S, McManus, RJ, Abalos, EJ, Adamson, CCD, Akadri, AA, Akturk, Z, Allegaert, K, Angel‐Müller, E, Antretter, J, Audibert, F, Auger, N, Aygun, C, Babic, I, Bagga, R, Baker, JM, Bhandari, V, Bhattacharya, S, Blanker, MH, Bloomfield, FH, Bof, A, Brennan, SM, Broekhuijsen, K, Fiona Broughton Pipkin, E, Browne, JL, Browning, RM, Bull, JW, Butt, A, Button, D, Campbell, JP, Campbell, DM, Carbillon, L, Carthy, S, Casely, E, Cave, JA, Cecatti, JG, Chamillard, ME, Chassard, D, Checheir, NC, Chulkov, VS, Cluver, CA, Crawford, CF, Daly, MC, Darmochwal‐Kolarz, DA, Davies, RE, Davies, MW, Dawson, JS, Dobson, N, Dodd, CN, Donald, F, Duley, L, Epstein‐Mares, J, Erez, O, Evans, E, Farlie, RN, Ferris, AV, Frankland, EM, Freeman, DJ, Gainder, S, Ganzevoort, W, Gbinigie, OA, Ghosh, SK, Glogowska, M, Goodlife, A, Gough, KL, Green, JR, Gul, F, Haggerty, L, Hall, DR, Hallman, M, Hammond, SJ, Harlow, SD, Hays, KE, Hickey, SC, Higgins, M, Hinton, L, Hobson, SR, Hogg, MJ, Hollands, HJ, Homer, CSE, Hoodbhoy, Z, Howell, P, Huppertz, B, Husain, S, Jacoby, SD, Jacqz‐Aigrain, E, Jenkins, G, Jewel, D, Johnson, MJ, Johnston, CL, Jones, PM, Kantrowitz‐Gordon, I, Khan, R, Kirby, LJ, Kirk, C, Knight, M, Korey, MT, Lee, GJ, Lee, VW, Levene, LS, Londero, AP, Lust, KM, MacKenzie, V, Malha, L, Mattone, M, McCartney, DE, McFadden, A, McKinstry, BH, Middleton, PF, Mistry, HD, Mitchell, CA, Mockler, JC, Molsher, S, Monast, ES, Moodley, J, Mooij, R, Moore, EL, Morgan, L, Moulson, A, Mughal, F, Mundle, SR, Angel Munoz, M, Murray, E, Nagata, C, Nair, AS, Nakimuli, A, Nath, G, Newport, RS, Oakeshott, P, Ochoa‐Ferraro, MR, Odendaal, H, Ohkuchi, A, Oliveira, L, Ortiz‐Panozo, E, Oudijk, MA, Oygucu, SE, Paech, MJ, Painter, RC, Parry, CL, Payne, BA, Pearson, EL, Phupong, V, Pickett, N, Pickles, KA, Plumb, LK, Prefumo, F, Preston, R, Ray, JG, Rayment, J, Regan, LV, Rey, E, Robson, EJ, Rubin, AN, Rubio‐Romero, JA, Rull, K, Sass, N, Sauvé, N, Savory, NA, Scott, JR, Seaton, SE, Seed, PT, Shakespeare, JM, Shand, AW, Sharma, S, Shaw, TY, Smedley, KL, Smith, D, Smith Conk, A, Soward, D, Stepan, H, Stroumpoulis, K, Surendran, A, Takeda, S, Tan, L, Theriot, BS, Thomas, HF, Thompson, K, Thompson, PI, Thompson, MJ, Torney, KLHT, Treadwell, JS, Tucker, KL, Turrentine, MA, Van Hecke, O, Van Oostwaard, MF, Vasquez, DN, Vaughan, DJA, VInturache, A, Walker, J, Wardle, SP, Wasim, T, Waters, JH, Whitehead, CL, Wolfson, A, Yeo, S, and Zermansky, AG
Subjects: reproductive and urinary physiology
Abstract: Objective\ud To develop a core outcome set for pre‐eclampsia.\ud \ud Design\ud Consensus development study.\ud \ud Setting\ud International.\ud \ud Population\ud Two hundred and eight‐one healthcare professionals, 41 researchers and 110 patients, representing 56 countries, participated.\ud \ud Methods\ud Modified Delphi method and Modified Nominal Group Technique.\ud \ud Results\ud A long‐list of 116 potential core outcomes was developed by combining the outcomes reported in 79 pre‐eclampsia trials with those derived from thematic analysis of 30 in‐depth interviews of women with lived experience of pre‐eclampsia. Forty‐seven consensus outcomes were identified from the Delphi process following which 14 maternal and eight offspring core outcomes were agreed at the consensus development meeting. Maternal core outcomes: death, eclampsia, stroke, cortical blindness, retinal detachment, pulmonary oedema, acute kidney injury, liver haematoma or rupture, abruption, postpartum haemorrhage, raised liver enzymes, low platelets, admission to intensive care required, and intubation and ventilation. Offspring core outcomes: stillbirth, gestational age at delivery, birthweight, small‐for‐gestational‐age, neonatal mortality, seizures, admission to neonatal unit required and respiratory support.\ud \ud Conclusions\ud The core outcome set for pre‐eclampsia should underpin future randomised trials and systematic reviews. Such implementation should ensure that future research holds the necessary reach and relevance to inform clinical practice, enhance women's care and improve the outcomes of pregnant women and their babies.
Published: 2020

61. Consensus diagnostic criteria and monitoring of twin anemia polycythemia sequence: a Delphi procedure

Author: Khalil, A, Gordijn, S, Ganzevoort, W, Thilaganathan, B, Johnson, A, Baschat, A, Hecher, K, Reed, K, Lewi, L, Deprest, J, Oepkes, D, and Lopriore, E
Abstract: OBJECTIVES: Twin anemia polycythemia sequence (TAPS) is associated with increased perinatal mortality and morbidity. Inconsistencies in the diagnostic criteria for TAPS exist, which hinder the ability to establish robust evidence-based management or monitoring protocols. The main aim of this study was to determine, by expert consensus using a Delphi procedure, the key diagnostic features and optimal monitoring approach for TAPS. METHODS: A Delphi process was conducted among an international panel of experts. Panel members were provided with a list of literature-based parameters for diagnosing and monitoring TAPS. They were asked to rate their importance on a five-point Likert scale. Consensus was sought to determine the cut-off values for accepted parameters, as well as parameters used in the monitoring and assessment of outcome of twin pregnancy complicated by TAPS. RESULTS: A total of 132 experts were approached, 50 joined the first round; of whom 33 (66%) completed all three rounds. There was agreement that the monitoring interval for the development of TAPS should be every 2 weeks and that the severity should be assessed antenatally using a classification system based on the middle cerebral artery (MCA) peak systolic velocity (PSV), but no agreement on the gestation at which to start. Once the diagnosis is made, monitoring should be scheduled weekly. For the diagnosis of TAPS, the combination of MCA PSV ≥ 1.5MoM in the anemic twin and ≤ 0.8MoM in the polycythemic twin was agreed. Alternatively, MCA PSV discordance ≥ 1MoM can be used to diagnose TAPS. Postnatally, hemoglobin difference ≥ 8 g/dL and inter-twin reticulocyte ratio ≥ 1.7 were agreed criteria. There was no agreement on the cut-off of the MCA PSV or its discordance for prenatal intervention. The panel agreed on prioritising perinatal and long-term survival outcomes in follow-up studies. CONCLUSIONS: Consensus-based diagnostic features of TAPS, as well as cut-off values for the parameters involved, were agreed upon by a panel of experts. Future studies are needed to validate these diagnostic features before they can be used in clinical trials of interventions. This article is protected by copyright. All rights reserved.
Published: 2020

62. Comparative analysis of 2-year outcomes in GRIT and TRUFFLE trials

Author: Ganzevoort, W., Thornton, J. G., Marlow, N., Thilaganathan, B., Arabin, B., Prefumo, F., Lees, C., Wolf, H., Van Bulck, B, Kalakoutis, G M, Sak, P, Schneider, K T M, Karpathios, S E, Major, T, Todros, T, Arduini, D, Flumini, C, Tenore, A C, Roncaglia, N, Frusca, T, Ferretti, G, Weinans, M J N, Roosmalen, J, Slikke, J W, Geijn, H, Pernet, P J M, Wolf, H, Stigter, R H, Wilczynski, J, Vasco, E, Abdullah, M, Novak‐Antolic, Z, Danielian, P, Jenkinson, S D, Welch, C R, Griffin, C, Gee, H, Tuffnell, D, Cresswell, J, Tariq, T, Sengupta, B, Tydeman, G, Churchill, D, Bewley, S, Fusi, L, Lindow, S W, Johal, W, Fairlie, F M, Neales, K, Mason, G, Scudamore, I, Konje, J, Walkinshaw, S A, Griffiths, M, Dawson, A, Mires, G, Johanson, R, Fraser, R B, Ibbs, P Hendy, Steel, S A, Ramsay, M, Robins, J B, Heard, M J, Tonge, H M, Manyonda, I T, Walker, J, Maresh, M, Yoong, A, Soothill, P, Cameron, H, Byrne, D, Beattie, B, Bober, S, Van Damme, M, Kyriakides, S, Pokorna, P, Zimmerman, A, Tsitsikas, H, Mani, E, Bosisio, P, Mastritta, E, Nicocia, M, Fabris, C, Eken, P, De Vries, L, Kubicka, Z, Ramalho, R, Rashid, M, Cerar‐Kornhauser, L, Thomas, S, Elliman, A, Sim, T, Swaminathan, S, Walker, L, McCormick, D, Sibanda, Z, Hughes, J, Kilding, J, O'Hara, A, Harpin, V, Porter, N, Pandey, S, Murtagh, K, Burton, K, MacGregor, R, Stewart, B, Klenke, H, Hallam, P, Kai, N, Graham, M, Harrison, A, Saharia, E, McGhee, T, Rowsell, P, Howie, P, Parmar, Max, Field, D, Grant, A, Steer, P, Breart, G, Levene, M, Torgeson, D, Kitzinger, S, Marlowe, N, Wolke, Dieter, Johnson, A, Arabin, Birgit, Bilardo, Caterina M, Brezinka, Christoph, Cornette, Jerome M J, Derks, Jan B, Diemert, Anke, Duvekot, Johannes J, Ferrazzi, Enrico, Fratelli, Nicola, Frusca, Tiziana, Ganzevoort, Wessel, Hecher, Kurt, Leemhuis, Aleid, Lees, Christoph C, Lobmaier, Silvia, Marlow, Neil, Martinelli, Pasquale, Maso, Gianpaolo, Missfelder‐Lobos, Hannah, Napolitano, Raffaele, Ostermayer, Eva, Papageorghiou, Aris T, Prefumo, Federico, Schlembach, Dietmar, Thilaganathan, Baskaran, Todros, Tullia, Valcamonico, Adriana, Visser, Gerard H A, Wolf, Hans, Kingdom, John, Marsal, Karel, Thornton, Jim, Valensise, Herbert, Athena Institute, APH - Global Health, APH - Quality of Care, Obstetrics and gynaecology, Papageorghiou, AT, Obstetrics and Gynaecology, AR&D - Amsterdam Reproduction & Development, and APH - Digital Health
Subjects: short‐term variation, Technology, FLOW, INFANTS, cardiotocography, ductus venosus, fetal growth restriction, monitoring, short-term variation, Umbilical Arteries, Cohort Studies, 0302 clinical medicine, Obstetrics and gynaecology, Pregnancy, GROWTH RESTRICTION, Cardiotocography, 030212 general & internal medicine, Randomized Controlled Trials as Topic, Fetal Growth Retardation, 030219 obstetrics & reproductive medicine, Radiological and Ultrasound Technology, medicine.diagnostic_test, Obstetrics, Radiology, Nuclear Medicine & Medical Imaging, short term variation, Pregnancy Outcome, Obstetrics & Gynecology, Obstetrics and Gynecology, Gestational age, General Medicine, Original Papers, TRUFFLE Study Group, Settore MED/40, Pulsatile Flow, Gestation, Female, Life Sciences & Biomedicine, INTERVENTION, Blood Flow Velocity, Ductus venosus, Cohort study, medicine.medical_specialty, Birth weight, FETAL HEART-RATE, Ultrasonography, Prenatal, 03 medical and health sciences, SDG 3 - Good Health and Well-being, FETUSES, medicine, Humans, Radiology, Nuclear Medicine and imaging, Obstetrics & Reproductive Medicine, Fetal Death, GRIT Study Group, Original Paper, Fetus, Science & Technology, business.industry, Infant, Newborn, Acoustics, Reproductive Medicine, 1114 Paediatrics and Reproductive Medicine, business
Abstract: Objective To explore the effect on perinatal outcome of different fetal monitoring strategies for early‐onset fetal growth restriction (FGR). Methods This was a cohort analysis of individual participant data from two European multicenter trials of fetal monitoring methods for FGR: the Growth Restriction Intervention Study (GRIT) and the Trial of Umbilical and Fetal Flow in Europe (TRUFFLE). All women from GRIT (n = 238) and TRUFFLE (n = 503) who were randomized between 26 and 32 weeks' gestation were included. The women were grouped according to intervention and monitoring method: immediate delivery (GRIT) or delayed delivery with monitoring by conventional cardiotocography (CTG) (GRIT), computerized CTG (cCTG) only (GRIT and TRUFFLE) or cCTG and ductus venosus (DV) Doppler (TRUFFLE). The primary outcome was survival without neurodevelopmental impairment at 2 years of age. Results Gestational age at delivery and birth weight were similar in both studies. Fetal death rate was similar between the GRIT and TRUFFLE groups, but neonatal and late death were more frequent in GRIT (18% vs 6%; P, This article's abstract has been translated into Spanish and Chinese. Follow the links from the http://onlinelibrary.wiley.com/doi/10.1002/uog.20354/abstract to view the translations. This article has been selected for Journal Club. Click https://www.isuog.org/resource/uog-journal-club-January-2020.html to view slides and discussion points.
Published: 2020

63. Core outcome set for studies investigating management of selective fetal growth restriction in twins

Author: Townsend, R., Duffy, J. M. N., Sileo, F., Perry, H., Ganzevoort, W., Reed, K., Baschat, A. A., Deprest, J., Gratacos, E., Hecher, K., Lewi, L., Lopriore, E., Oepkes, D., Papageorghiou, A., Gordijn, S. J., Khalil, A., Baschat, A., Perales-Marin, A., Johnson, A., Silvana, A., Papageorghious, A., Khurana, A., Trinder, B., Combs, C. A., Bailie, C., Huddy, C., Bolch, C., Coutinho, C. M., Skupski, D., Hake, D., Schlembach, D., Lindahl, E., Carreras, E., Mantovani, E., Giallongo, E., Marler, E., Bertucci, E., Prefumo, F., Sileo, F. G., Guy, G., Rizzo, G., King, H., Valensise, H., Samarage, H., Duffy, J., Denton, J., Curado, J., Marsden, J., Tolosa, J. E., Toms, J., Copel, J., Richards, J., Ishii, K., Palmer, K., Watkins, K., Mcgrath, L., Canolini, L., Dhuri, M. V., Kyriakidou, M., Lanna, M., Treadwell, M., Watson, M., Rankin, M., Fenwick, N., Moore, P., O'Brien, P., Cincotta, R., Linton, S., Robinson, S., Mcsorley, T., Fuchs, T., Ghi, T., Omosebi, W., Acheampong, Y., Obstetrics and Gynaecology, Amsterdam Reproduction & Development (AR&D), APH - Digital Health, and APH - Quality of Care
Subjects: Delphi Technique, multiple pregnancy, Delphi method, Obstetric Surgical Procedures, consensus, core outcome set, Delphi consensus, fetal growth restriction, Outcome (game theory), NOMINAL GROUP TECHNIQUE, 0302 clinical medicine, Nominal group technique, Outcome Assessment, Health Care, Birth Weight, 030212 general & internal medicine, 030219 obstetrics & reproductive medicine, Fetal Growth Retardation, Radiological and Ultrasound Technology, Obstetrics and Gynecology, Gestational age, General Medicine, Treatment Outcome, PREGNANCY, Female, Live birth, Live Birth, medicine.medical_specialty, Endpoint Determination, Birth weight, Gestational Age, Likert scale, 03 medical and health sciences, medicine, Humans, Radiology, Nuclear Medicine and imaging, fetal growth restriction, multiple pregnancy, core outcome set, consensus, business.industry, Infant, Newborn, Twins, Monozygotic, Reproductive Medicine, Family medicine, Sonographer, Pregnancy, Twin, Settore MED/40 - Ginecologia e Ostetricia, business
Abstract: OBJECTIVE: Selective fetal growth restriction (sFGR) occurs in monochorionic twin pregnancies when unequal placental sharing leads to restriction in the growth of just one twin. Management options include laser separation of the fetal circulations, selective reduction or expectant management, but what constitutes the best treatment is not yet known. New trials in this area are urgently needed but, in this rare and complex group, maximizing the relevance and utility of clinical research design and outputs is paramount. A core outcome set ensures standardized outcome collection and reporting in future research. The objective of this study was to develop a core outcome set for studies evaluating treatments for sFGR in monochorionic twins. METHODS: An international steering group of clinicians, researchers and patients with experience of sFGR was established to oversee the process of development of a core outcome set for studies investigating the management of sFGR. Outcomes reported in the literature were identified through a systematic review and informed the design of a three-round Delphi survey. Clinicians, researchers, and patients and family representatives participated in the survey. Outcomes were scored on a Likert scale from 1 (limited importance for making a decision) to 9 (critical for making a decision). Consensus was defined a priori as a Likert score of ≥ 8 in the third round of the Delphi survey. Participants were then invited to take part in an international meeting of stakeholders in which the modified nominal group technique was used to consider the consensus outcomes and agree on a final core outcome set. RESULTS: Ninety-six outcomes were identified from 39 studies in the systematic review. One hundred and three participants from 23 countries completed the first round of the Delphi survey, of whom 88 completed all three rounds. Twenty-nine outcomes met the a priori criteria for consensus and, along with six additional outcomes, were prioritized in a consensus development meeting, using the modified nominal group technique. Twenty-five stakeholders participated in this meeting, including researchers (n = 3), fetal medicine specialists (n = 3), obstetricians (n = 2), neonatologists (n = 3), midwives (n = 4), parents and family members (n = 6), patient group representatives (n = 3), and a sonographer. Eleven core outcomes were agreed upon. These were live birth, gestational age at birth, birth weight, intertwin birth-weight discordance, death of surviving twin after death of cotwin, loss during pregnancy or before final hospital discharge, parental stress, procedure-related adverse maternal outcome, length of neonatal stay in hospital, neurological abnormality on postnatal imaging and childhood disability. CONCLUSIONS: This core outcome set for studies investigating the management of sFGR represents the consensus of a large and diverse group of international collaborators. Use of these outcomes in future trials should help to increase the clinical relevance of research on this condition. Consensus agreement on core outcome definitions and measures is now required. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. ispartof: ULTRASOUND IN OBSTETRICS & GYNECOLOGY vol:55 issue:5 pages:652-660 ispartof: location:England status: published
Published: 2020

64. Validation and development of models using clinical, biochemical and ultrasound markers for predicting pre-eclampsia: An individual participant data meta-analysis

Author: Allotey, J. Snell, K.I.E. Smuk, M. Hooper, R. Chan, C.L. Ahmed, A. Chappell, L.C. von Dadelszen, P. Dodds, J. Green, M. Kenny, L. Khalil, A. Khan, K.S. Mol, B.W. Myers, J. Poston, L. Thilaganathan, B. Staff, A.C. Smith, G.C.S. Ganzevoort, W. Laivuori, H. Odibo, A.O. Ramírez, J.A. Kingdom, J. Daskalakis, G. Farrar, D. Baschat, A.A. Seed, P.T. Prefumo, F. da Silva Costa, F. Groen, H. Audibert, F. Massé, J. Skråstad, R.B. Salvesen, K.A. Haavaldsen, C. Nagata, C. Rumbold, A.R. Heinonen, S. Askie, L.M. Smits, L.J.M. Vinter, C.A. Magnus, P.M. Eero, K. Villa, P.M. Jenum, A.K. Andersen, L.B. Norman, J.E. Ohkuchi, A. Eskild, A. Bhattacharya, S. McAuliffe, F.M. Galindo, A. Herraiz, I. Carbillon, L. Klipstein-Grobusch, K. Yeo, S. Teede, H.J. Browne, J.L. Moons, K.G.M. Riley, R.D. Thangaratinam, S. The IPPIC Collaborative Network
Abstract: Background: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk is needed to plan management. Objectives: To assess the performance of existing pre-eclampsia prediction models and to develop and validate models for pre-eclampsia using individual participant data meta-analysis. We also estimated the prognostic value of individual markers. Design: This was an individual participant data meta-analysis of cohort studies. Setting: Source data from secondary and tertiary care. Predictors: We identified predictors from systematic reviews, and prioritised for importance in an international survey. Primary outcomes: Early-onset (delivery at < 34 weeks’ gestation), late-onset (delivery at ≥ 34 weeks’ gestation) and any-onset pre-eclampsia. Analysis: We externally validated existing prediction models in UK cohorts and reported their performance in terms of discrimination and calibration.We developed and validated 12 new models based on clinical characteristics, clinical characteristics and biochemical markers, and clinical characteristics and ultrasound markers in the first and second trimesters. We summarised the data set-specific performance of each model using a random-effects meta-analysis. Discrimination was considered promising for C-statistics of ≥ 0.7, and calibration was considered good if the slope was near 1 and calibration-in-the-large was near 0. Heterogeneity was quantified using I2 and 2. A decision curve analysis was undertaken to determine the clinical utility (net benefit) of the models. We reported the unadjusted prognostic value of individual predictors for pre-eclampsia as odds ratios with 95% confidence and prediction intervals. Results: The International Prediction of Pregnancy Complications network comprised 78 studies (3,570,993 singleton pregnancies) identified from systematic reviews of tests to predict pre-eclampsia. Twenty-four of the 131 published prediction models could be validated in 11 UK cohorts. Summary C-statistics were between 0.6 and 0.7 for most models, and calibration was generally poor owing to large between-study heterogeneity, suggesting model overfitting. The clinical utility of the models varied between showing net harm to showing minimal or no net benefit. The average discrimination for IPPIC models ranged between 0.68 and 0.83. This was highest for the second-trimester clinical characteristics and biochemical markers model to predict early-onset pre-eclampsia, and lowest for the first-trimester clinical characteristics models to predict any pre-eclampsia. Calibration performance was heterogeneous across studies. Net benefit was observed for International Prediction of Pregnancy Complications first and second-trimester clinical characteristics and clinical characteristics and biochemical markers models predicting any pre-eclampsia, when validated in singleton nulliparous women managed in the UK NHS. History of hypertension, parity, smoking, mode of conception, placental growth factor and uterine artery pulsatility index had the strongest unadjusted associations with pre-eclampsia. Limitations: Variations in study population characteristics, type of predictors reported, too few events in some validation cohorts and the type of measurements contributed to heterogeneity in performance of the International Prediction of Pregnancy Complications models. Some published models were not validated because model predictors were unavailable in the individual participant data. Conclusion: For models that could be validated, predictive performance was generally poor across data sets. Although the International Prediction of Pregnancy Complications models show good predictive performance on average, and in the singleton nulliparous population, heterogeneity in calibration performance is likely across settings. © 2020, NIHR Journals Library. All rights reserved.
Published: 2020

65. Maternal Sildenafil vs Placebo in Pregnant Women With Severe Early-Onset Fetal Growth Restriction A Randomized Clinical Trial

Author: Pels, Anouk, Derks, Jan, Elvan-Taspinar, Ayten, Drongelen, J. van, Boer, M.A. de, Duvekot, Hans, Gordijn, Sanne, Ganzevoort, W., Pels, Anouk, Derks, Jan, Elvan-Taspinar, Ayten, Drongelen, J. van, Boer, M.A. de, Duvekot, Hans, Gordijn, Sanne, and Ganzevoort, W.
Abstract: Contains fulltext : 220808.pdf (publisher's version ) (Open Access)
Published: 2020

66. Standardising definitions for the pre-eclampsia core outcome set: A consensus development study.

Author: Donald F., Morgan L., Moulson A., Mughal F., Mundle S.R., Munoz M.A., Murray E., Nagata C., Nair A.S., Nakimuli A., Nath G., Newport R.S., Oakeshott P., Ochoa-Ferraro M.R., Odendaal H., Ohkuchi A., Oliveira L., Ortiz-Panozo E., Oudijk M.A., Oygucu S.E., Paech M.J., Painter R.C., Parry C.L., Payne B.A., Pearson E.L., Phupong V., Pickett N., Pickles K.A., Plumb L.K., Prefumo F., Preston R., Ray J.G., Rayment J., Regan L.V., Rey E., Robson E.J., Rubin A.N., Rubio-Romero J.A., Rull K., Sass N., Sauve N., Savory N.A., Scott J.R., Seaton S.E., Seed P.T., Shakespeare J.M., Shand A.W., Sharma S., Shaw T.Y., Smedley K.L., Smith D., Smith Conk A., Soward D., Stepan H., Stroumpoulis K., Surendran A., Takeda S., Tan L., Theriot B.S., Thomas H.F., Thompson K., Thompson P.I., Thompson M.J., Toms L., Torney K.L.H.T., Treadwell J.S., Tucker K.L., Turrentine M.A., Van Hecke O., Van Oostwaard M.F., Vasquez D.N., Vaughan D.J.A., Vinturache A., Walker J., Wardle S.P., Wasim T., Waters J.H., Whitehead C.L., Wolfson A., Yeo S., Zermansky A.G., Mol B., Duffy J.M.N., Cairns A.E., Magee L.A., von Dadelszen P., van 't Hooft J., Gale C., Brown M., Chappell L.C., Grobman W.A., Fitzpatrick R., Karumanchi S.A., Lucas D.N., Stark M., Thangaratinam S., Wilson M.J., Williamson P.R., Ziebland S., McManus R.J., Abalos E.J., Adamson C.C.D., Akadri A.A., Akturk Z., Allegaert K., Angel-Muller E., Antretter J., Ashdown H.F., Audibert F., Auger N., Aygun C., Babic I., Bagga R., Baker J.M., Beebeejaun Y., Bhakta P., Bhandari V., Bhattacharya S., Blanker M.H., Bloomfield F.H., Bof A., Brennan S.M., Broekhuijsen K., Broughton Pipkin F., Browne J.L., Browning R.M., Bull J.W., Butt A., Button D., Campbell J.P., Campbell D.M., Carbillon L., Carthy S., Casely E., Cave J.A., Cecatti J.G., Chamillard M.E., Chassard D., Checheir N.C., Chulkov V.S., Cluver C.A., Crawford C.F., Daly M.C., Darmochwal-Kolarz D.A., Davies R.E., Davies M.W., Dawson J.S., Dobson N., Dodd C.N., Duley L., Epstein-Mares J., Erez O., Evans E., Farlie R.N., Ferris A.V., Frankland E.M., Freeman D.J., Gainder S., Ganzevoort W., Gbinigie O.A., Gerval M.-O., Ghosh S.K., Gingel L.J., Glogowska M., Goodlife A., Gough K.L., Green J.R., Gul F., Haggerty L., Hall D.R., Hallman M., Hamilton L.M., Hammond S.J., Harlow S.D., Hays K.E., Hickey S.C., Higgins M., Hinton L., Hobson S.R., Hogg M.J., Hollands H.J., Homer C.S.E., Hoodbhoy Z., Howell P., Huppertz B., Husain S., Jacoby S.D., Jacqz-Aigrain E., Jenkins G., Jewel D., Johnson M.J., Johnston C.L., Jones P.M., Kantrowitz-Gordon I., Khan R.-U., Kirby L.J., Kirk C., Knight M., Korey M.T., Lee G.J., Lee V.W., Levene L.S., Londero A.P., Lust K.M., MacKenzie V., Malha L., Mattone M., McCartney D.E., McFadden A., McKinstry B.H., Middleton P.F., Mills D.J., Mistry H.D., Mitchell C.A., Mockler J.C., Molsher S.-A., Monast E.S., Moodley J., Mooij R., Moore E.L., Donald F., Morgan L., Moulson A., Mughal F., Mundle S.R., Munoz M.A., Murray E., Nagata C., Nair A.S., Nakimuli A., Nath G., Newport R.S., Oakeshott P., Ochoa-Ferraro M.R., Odendaal H., Ohkuchi A., Oliveira L., Ortiz-Panozo E., Oudijk M.A., Oygucu S.E., Paech M.J., Painter R.C., Parry C.L., Payne B.A., Pearson E.L., Phupong V., Pickett N., Pickles K.A., Plumb L.K., Prefumo F., Preston R., Ray J.G., Rayment J., Regan L.V., Rey E., Robson E.J., Rubin A.N., Rubio-Romero J.A., Rull K., Sass N., Sauve N., Savory N.A., Scott J.R., Seaton S.E., Seed P.T., Shakespeare J.M., Shand A.W., Sharma S., Shaw T.Y., Smedley K.L., Smith D., Smith Conk A., Soward D., Stepan H., Stroumpoulis K., Surendran A., Takeda S., Tan L., Theriot B.S., Thomas H.F., Thompson K., Thompson P.I., Thompson M.J., Toms L., Torney K.L.H.T., Treadwell J.S., Tucker K.L., Turrentine M.A., Van Hecke O., Van Oostwaard M.F., Vasquez D.N., Vaughan D.J.A., Vinturache A., Walker J., Wardle S.P., Wasim T., Waters J.H., Whitehead C.L., Wolfson A., Yeo S., Zermansky A.G., Mol B., Duffy J.M.N., Cairns A.E., Magee L.A., von Dadelszen P., van 't Hooft J., Gale C., Brown M., Chappell L.C., Grobman W.A., Fitzpatrick R., Karumanchi S.A., Lucas D.N., Stark M., Thangaratinam S., Wilson M.J., Williamson P.R., Ziebland S., McManus R.J., Abalos E.J., Adamson C.C.D., Akadri A.A., Akturk Z., Allegaert K., Angel-Muller E., Antretter J., Ashdown H.F., Audibert F., Auger N., Aygun C., Babic I., Bagga R., Baker J.M., Beebeejaun Y., Bhakta P., Bhandari V., Bhattacharya S., Blanker M.H., Bloomfield F.H., Bof A., Brennan S.M., Broekhuijsen K., Broughton Pipkin F., Browne J.L., Browning R.M., Bull J.W., Butt A., Button D., Campbell J.P., Campbell D.M., Carbillon L., Carthy S., Casely E., Cave J.A., Cecatti J.G., Chamillard M.E., Chassard D., Checheir N.C., Chulkov V.S., Cluver C.A., Crawford C.F., Daly M.C., Darmochwal-Kolarz D.A., Davies R.E., Davies M.W., Dawson J.S., Dobson N., Dodd C.N., Duley L., Epstein-Mares J., Erez O., Evans E., Farlie R.N., Ferris A.V., Frankland E.M., Freeman D.J., Gainder S., Ganzevoort W., Gbinigie O.A., Gerval M.-O., Ghosh S.K., Gingel L.J., Glogowska M., Goodlife A., Gough K.L., Green J.R., Gul F., Haggerty L., Hall D.R., Hallman M., Hamilton L.M., Hammond S.J., Harlow S.D., Hays K.E., Hickey S.C., Higgins M., Hinton L., Hobson S.R., Hogg M.J., Hollands H.J., Homer C.S.E., Hoodbhoy Z., Howell P., Huppertz B., Husain S., Jacoby S.D., Jacqz-Aigrain E., Jenkins G., Jewel D., Johnson M.J., Johnston C.L., Jones P.M., Kantrowitz-Gordon I., Khan R.-U., Kirby L.J., Kirk C., Knight M., Korey M.T., Lee G.J., Lee V.W., Levene L.S., Londero A.P., Lust K.M., MacKenzie V., Malha L., Mattone M., McCartney D.E., McFadden A., McKinstry B.H., Middleton P.F., Mills D.J., Mistry H.D., Mitchell C.A., Mockler J.C., Molsher S.-A., Monast E.S., Moodley J., Mooij R., and Moore E.L.
Abstract: Objectives: To develop consensus definitions for the core outcome set for pre-eclampsia. Study design: Potential definitions for individual core outcomes were identified across four formal definition development initiatives, nine national and international guidelines, 12 Cochrane systematic reviews, and 79 randomised trials. Eighty-six definitions were entered into the consensus development meeting. Ten healthcare professionals and three researchers, including six participants who had experience of conducting research in low- and middle-income countries, participated in the consensus development process. The final core outcome set was approved by an international steering group. Result(s): Consensus definitions were developed for all core outcomes. When considering stroke, pulmonary oedema, acute kidney injury, raised liver enzymes, low platelets, birth weight, and neonatal seizures, consensus definitions were developed specifically for low- and middle-income countries because of the limited availability of diagnostic interventions including computerised tomography, chest x-ray, laboratory tests, equipment, and electroencephalogram monitoring. Conclusion(s): Consensus on measurements for the pre-eclampsia core outcome set will help to ensure consistency across future randomised trials and systematic reviews. Such standardization should make research evidence more accessible and facilitate the translation of research into clinical practice. Video abstract can be available at: www.dropbox.com/s/ftrgvrfu0u9glqd/6.%20Standardising%20definitions%20in%20teh%20pre-eclampsia%20core%20outcome%20set%3A%20a%20consensus%20development%20study.mp4?dl=0.Copyright © 2020 International Society for the Study of Hypertension in Pregnancy
Published: 2020

67. Temporizing management vs immediate delivery in early-onset severe preeclampsia between 28 and 34 weeks of gestation (TOTEM study): An open-label randomized controlled trial

Author: Duvekot, J.J. (Hans), Duijnhoven, R.G. (Ruben), van Horen, E. (Eva), Bax, C.J. (Caroline), Bloemenkamp, K.W.M. (Kitty), Brussé, I.A. (Ingrid), Dijk, P.H. (Peter), Franssen, M.T.M. (Maureen), Franx, A. (Arie), Oudijk, M.A. (Martijn), Porath, M. (Martina), Scheepers, H.C.J. (Hubertina), Wassenaer-Leemhuis, A.G. (Aleid) van, van Drongelen, J. (Joris), Mol, B.W.J. (Ben), Ganzevoort, W. (Wessel), Duvekot, J.J. (Hans), Duijnhoven, R.G. (Ruben), van Horen, E. (Eva), Bax, C.J. (Caroline), Bloemenkamp, K.W.M. (Kitty), Brussé, I.A. (Ingrid), Dijk, P.H. (Peter), Franssen, M.T.M. (Maureen), Franx, A. (Arie), Oudijk, M.A. (Martijn), Porath, M. (Martina), Scheepers, H.C.J. (Hubertina), Wassenaer-Leemhuis, A.G. (Aleid) van, van Drongelen, J. (Joris), Mol, B.W.J. (Ben), and Ganzevoort, W. (Wessel)
Abstract: Introduction: There is little evidence to guide the timing of delivery of women with early-onset severe preeclampsia. We hypothesize that immediate delivery is not inferior for neonatal outcome but reduces maternal complications compared with temporizing management. Material and methods: This Dutch multicenter open-label randomized clinical trial investigated non-inferiority for neonatal outcome of temporizing management as compared with immediate delivery (TOTEM NTR 2986) in women between 27+5 and 33+5 weeks of gestation admitted for early-onset severe preeclampsia with or without HELLP syndrome. In participants allocated to receive immediate delivery, either induction of labor or cesarean section was initiated at least 48 hours after admission. Primary outcomes were adverse perinatal outcome, defined as a composite of severe respiratory distress syndrome, bronchopulmonary dysplasia, culture proven sepsis, intraventricular hemorrhage grade 3 or worse, periventricular leukomalacia grade 2 or worse, necrotizing enterocolitis stage 2 or worse, and perinatal death. M
Published: 2020
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68. Maternal Sildenafil vs Placebo in Pregnant Women With Severe Early-Onset Fetal Growth Restriction: A Randomized Clinical Trial

Author: Pels, A. (Anouk), Derks, J.B. (Jan), Elvan-Taşpinar, A. (Ayten), van Drongelen, J. (Joris), de Boer, M. (Marjon), Duvekot, J.J. (Hans), van Laar, J. (Judith), Eyck, J. (Jim) van, Al-Nasiry, S. (Salwan), Sueters, M. (Marieke), Post, M. (Marinka), Onland, W. (Wes), Wassenaer-Leemhuis, A.G. (Aleid) van, Naaktgeboren, C. (Christiana), Jakobsen, J.C. (Janus C.), Gluud, C. (Christian), Duijnhoven, R.G. (Ruben), Lely, T. (Titia), Gordijn, S. (Sanne), Ganzevoort, W. (Wessel), Pels, A. (Anouk), Derks, J.B. (Jan), Elvan-Taşpinar, A. (Ayten), van Drongelen, J. (Joris), de Boer, M. (Marjon), Duvekot, J.J. (Hans), van Laar, J. (Judith), Eyck, J. (Jim) van, Al-Nasiry, S. (Salwan), Sueters, M. (Marieke), Post, M. (Marinka), Onland, W. (Wes), Wassenaer-Leemhuis, A.G. (Aleid) van, Naaktgeboren, C. (Christiana), Jakobsen, J.C. (Janus C.), Gluud, C. (Christian), Duijnhoven, R.G. (Ruben), Lely, T. (Titia), Gordijn, S. (Sanne), and Ganzevoort, W. (Wessel)
Abstract: Importance: Severe early onset fetal growth restriction caused by placental dysfunction leads to high rates of perinatal mortality and neonatal morbidity. The phosphodiesterase 5 inhibitor, sildenafil, inhibits cyclic guanosine monophosphate hydrolysis, thereby activating the effects of nitric oxide, and might improve uteroplacental function and subsequent perinatal outcomes. Objective: To determine whether sildenafil reduces perinatal mortality or major morbidity. Design, Setting, and Participants: This placebo-controlled randomized clinical trial was conducted at 10 tertiary referral centers and 1 general hospital in the Netherlands from January 20, 2015, to July 16, 2018. Participants included pregnant women between 20 and 30 weeks of gestation with severe fetal growth restriction, defined as fetal abdominal circumference below the third percentile or estimated fetal weight below the fifth percentile combined with Dopplers measurements outside reference ranges or a maternal hypertensive disorder. The trial was stopped early owing to safety concerns on July 19, 2018, whereas benefit on the primary outcome was unlikely. Data were analyzed from January 20, 2015, to January 18, 2019. The prespecified primary analysis was an intention-to-treat analysis including all randomized participants. Interventions: Participants were randomized to sildenafil, 25 mg, 3 times a day vs placebo. Main Outcomes and Measures: The primary outcome was a composite of perinatal mortality or major neonatal morbidity until hospital discharge. Results: Out of 360 planned participants, a total of 216 pregnant women were included, with 108 women randomized to sildenafil (median gestational age at randomization, 24 weeks 5 days [interquartile range, 23 weeks 3 days to 25 weeks 5 days]; mean [SD] estimated fetal weight, 458 [160] g) and 108 women randomized to placebo (median gestational age, 25 weeks 0 days [interquartile range, 22 weeks 5 days to 26 weeks 3 days]; mean [SD] estimated fetal weig
Published: 2020
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69. External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis.

Author: Snell, KIE, Allotey, J, Smuk, M, Hooper, R, Chan, C, Ahmed, A, Chappell, LC, Von Dadelszen, P, Green, M, Kenny, L, Khalil, A, Khan, KS, Mol, BW, Myers, J, Poston, L, Thilaganathan, B, Staff, AC, Smith, GCS, Ganzevoort, W, Laivuori, H, Odibo, AO, Arenas Ramírez, J, Kingdom, J, Daskalakis, G, Farrar, D, Baschat, AA, Seed, PT, Prefumo, F, da Silva Costa, F, Groen, H, Audibert, F, Masse, J, Skråstad, RB, Salvesen, KÅ, Haavaldsen, C, Nagata, C, Rumbold, AR, Heinonen, S, Askie, LM, Smits, LJM, Vinter, CA, Magnus, P, Eero, K, Villa, PM, Jenum, AK, Andersen, LB, Norman, JE, Ohkuchi, A, Eskild, A, Bhattacharya, S, McAuliffe, FM, Galindo, A, Herraiz, I, Carbillon, L, Klipstein-Grobusch, K, Yeo, SA, Browne, JL, Moons, KGM, Riley, RD, Thangaratinam, S, IPPIC Collaborative Network, Snell, KIE, Allotey, J, Smuk, M, Hooper, R, Chan, C, Ahmed, A, Chappell, LC, Von Dadelszen, P, Green, M, Kenny, L, Khalil, A, Khan, KS, Mol, BW, Myers, J, Poston, L, Thilaganathan, B, Staff, AC, Smith, GCS, Ganzevoort, W, Laivuori, H, Odibo, AO, Arenas Ramírez, J, Kingdom, J, Daskalakis, G, Farrar, D, Baschat, AA, Seed, PT, Prefumo, F, da Silva Costa, F, Groen, H, Audibert, F, Masse, J, Skråstad, RB, Salvesen, KÅ, Haavaldsen, C, Nagata, C, Rumbold, AR, Heinonen, S, Askie, LM, Smits, LJM, Vinter, CA, Magnus, P, Eero, K, Villa, PM, Jenum, AK, Andersen, LB, Norman, JE, Ohkuchi, A, Eskild, A, Bhattacharya, S, McAuliffe, FM, Galindo, A, Herraiz, I, Carbillon, L, Klipstein-Grobusch, K, Yeo, SA, Browne, JL, Moons, KGM, Riley, RD, Thangaratinam, S, and IPPIC Collaborative Network
Abstract: BACKGROUND: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk during pregnancy is required to plan management. Although there are many published prediction models for pre-eclampsia, few have been validated in external data. Our objective was to externally validate published prediction models for pre-eclampsia using individual participant data (IPD) from UK studies, to evaluate whether any of the models can accurately predict the condition when used within the UK healthcare setting. METHODS: IPD from 11 UK cohort studies (217,415 pregnant women) within the International Prediction of Pregnancy Complications (IPPIC) pre-eclampsia network contributed to external validation of published prediction models, identified by systematic review. Cohorts that measured all predictor variables in at least one of the identified models and reported pre-eclampsia as an outcome were included for validation. We reported the model predictive performance as discrimination (C-statistic), calibration (calibration plots, calibration slope, calibration-in-the-large), and net benefit. Performance measures were estimated separately in each available study and then, where possible, combined across studies in a random-effects meta-analysis. RESULTS: Of 131 published models, 67 provided the full model equation and 24 could be validated in 11 UK cohorts. Most of the models showed modest discrimination with summary C-statistics between 0.6 and 0.7. The calibration of the predicted compared to observed risk was generally poor for most models with observed calibration slopes less than 1, indicating that predictions were generally too extreme, although confidence intervals were wide. There was large between-study heterogeneity in each model's calibration-in-the-large, suggesting poor calibration of the predicted overall risk across populations. In a subset of models, the net benefit of using the models to inform clinical decisions
Published: 2020

70. Maternal Sildenafil vs Placebo in Pregnant Women With Severe Early-Onset Fetal Growth Restriction A Randomized Clinical Trial

Author: Pels, A, Derks, J, Elvan-Taspinar, A, van Drongelen, J, Boer, M, Duvekot, J.J., van Laar, JAM, Eyck, J, Al-Nasiry, S, Sueters, M, Verhoef-Post, M, Onland, W, van Wassenaer-Leemhuis, A, Naaktgeboren, C, Jakobsen, JC, Gluud, C, Duijnhoven, RG, Lely, T, Gordijn, S, Ganzevoort, W, Pels, A, Derks, J, Elvan-Taspinar, A, van Drongelen, J, Boer, M, Duvekot, J.J., van Laar, JAM, Eyck, J, Al-Nasiry, S, Sueters, M, Verhoef-Post, M, Onland, W, van Wassenaer-Leemhuis, A, Naaktgeboren, C, Jakobsen, JC, Gluud, C, Duijnhoven, RG, Lely, T, Gordijn, S, and Ganzevoort, W
Published: 2020

71. Perinatal morbidity and mortality in early-onset fetal growth restriction: cohort outcomes of the trial of randomized umbilical and fetal flow in Europe (TRUFFLE)

Author: Lees, C., Marlow, N., Arabin, B., Bilardo, C. M., Brezinka, C., Derks, J. B., Duvekot, J., Frusca, T., Diemert, A., Ferrazzi, E., Ganzevoort, W., Hecher, K., Martinelli, P., Ostermayer, E., Papageorghiou, A. T., Schlembach, D., Schneider, K. T. M., Thilaganathan, B., Todros, T., van Wassenaer-Leemhuis, A., Valcamonico, A., Visser, G. H. A., Wolf, H., Scheepers, H. C. J., Spaanderman, M., Calvert, S., Missfelder-Lobos, H., van Eyck, J., Oepkes, D., Fratelli, N., Prefumo, F., Napolitano, R., Chaoui, R., Maso, G., Ogge, G., Oberto, M., and van Charante, Mensing N.
Published: 2013
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72. Pregnancy outcomes in women with Budd–Chiari syndrome or portal vein thrombosis – a multicentre retrospective cohort study.

Author: Wiegers, HMG, Hamulyák, EN, Damhuis, SE, van Duuren, JR, Darwish Murad, S, Scheres, LJJ, Gordijn, SJ, Leentjens, J, Duvekot, JJ, Lauw, MN, Hutten, BA, Middeldorp, S, and Ganzevoort, W
Subjects: BUDD-Chiari syndrome, PREGNANCY outcomes, PORTAL vein, THROMBOSIS, MISCARRIAGE, PORTAL hypertension
Abstract: Objective: To evaluate current practice and outcomes of pregnancy in women previously diagnosed with Budd–Chiari syndrome and/or portal vein thrombosis, with and without concomitant portal hypertension. Design and setting: Multicentre retrospective cohort study between 2008 and 2021. Population: Women who conceived in the predefined period after the diagnosis of Budd–Chiari syndrome and/or portal vein thrombosis. Methods and main outcome measures: We collected data on diagnosis and clinical features. The primary outcomes were maternal mortality and live birth rate. Secondary outcomes included maternal, neonatal and obstetric complications. Results: Forty‐five women (12 Budd–Chiari syndrome, 33 portal vein thrombosis; 76 pregnancies) were included. Underlying prothrombotic disorders were present in 23 of the 45 women (51%). Thirty‐eight women (84%) received low‐molecular‐weight heparin during pregnancy. Of 45 first pregnancies, 11 (24%) ended in pregnancy loss and 34 (76%) resulted in live birth of which 27 were at term (79% of live births and 60% of pregnancies). No maternal deaths were observed; one woman developed pulmonary embolism during pregnancy and two women (4%) had variceal bleeding requiring intervention. Conclusions: The high number of term live births (79%) and lower than expected risk of pregnancy‐related maternal and neonatal morbidity in our cohort suggest that Budd–Chiari syndrome and/or portal vein thrombosis should not be considered as an absolute contraindication for pregnancy. Individualised, nuanced counselling and a multidisciplinary pregnancy surveillance approach are essential in this patient population. Budd–Chiari syndrome and/or portal vein thrombosis should not be considered as an absolute contraindication for pregnancy. Budd–Chiari syndrome and/or portal vein thrombosis should not be considered as an absolute contraindication for pregnancy. Linked article This article is commented on by YY Chung & MA Heneghan pp. 618 in this issue. To view this minicommentary visit https://doi.org/10.1111/1471-0528.17002. [ABSTRACT FROM AUTHOR]
Published: 2022
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73. Prediction of recurrence of hypertensive disorders of pregnancy between 34 and 37 weeks of gestation: a retrospective cohort study

Author: van Oostwaard, M F, Langenveld, J, Bijloo, R, Wong, K M, Scholten, I, Loix, S, Hukkelhoven, C WPM, Vergouwe, Y, Papatsonis, D NM, Mol, B WJ, and Ganzevoort, W
Published: 2012
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74. Recurrence risk and prediction of a delivery under 34 weeks of gestation after a history of a severe hypertensive disorder

Author: Langenveld, J, Buttinger, A, van der Post, J, Wolf, H, Mol, BW, and Ganzevoort, W
Published: 2011
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75. VP37.08: Predicting adverse perinatal outcomes using maternal characteristics, fetal biometry and Doppler ultrasound: a meta‐analysis on individual participant data

Author: Flanagan, M.F., primary, Heidweiller‐Schreurs, C. Vollgraff, additional, Ganzevoort, W., additional, De Boer, M., additional, Vázquez‐Sarandeses, A., additional, Turan, O., additional, Mol, B., additional, and Rolnik, D.L., additional
Published: 2020
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76. Core outcome sets are valuable, but methodological evidence can improve robustness

Author: Beune, IM, primary, Ganzevoort, W, additional, and Gordijn, SJ, additional
Published: 2020
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77. Consensus diagnostic criteria and monitoring of twin anemia–polycythemia sequence: Delphi procedure

Author: Khalil, A., primary, Gordijn, S., additional, Ganzevoort, W., additional, Thilaganathan, B., additional, Johnson, A., additional, Baschat, A. A., additional, Hecher, K., additional, Reed, K., additional, Lewi, L., additional, Deprest, J., additional, Oepkes, D., additional, and Lopriore, E., additional
Published: 2020
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78. A core outcome set for hyperemesis gravidarum research: an international consensus study

Author: Jansen, LAW, primary, Koot, MH, additional, van‘t Hooft, J, additional, Dean, CR, additional, Duffy, JMN, additional, Ganzevoort, W, additional, Gauw, N, additional, Goes, BY, additional, Rodenburg, J, additional, Roseboom, TJ, additional, Painter, RC, additional, and Grooten, IJ, additional
Published: 2020
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79. One-year infant outcome in women with early-onset hypertensive disorders of pregnancy

Author: Rep, A, Ganzevoort, W, Van Wassenaer, A G, Bonsel, G J, Wolf, H, and De Vries, J IP
Published: 2008

80. Reply

Author: Groom, K. M., Ganzevoort, W., Alfirevic, Z., Lim, K., Papageorghiou, A. T., APH - Quality of Care, Amsterdam Reproduction & Development (AR&D), Obstetrics and Gynaecology, and APH - Digital Health
Subjects: Fetal Growth Retardation, Reproductive Medicine, Radiological and Ultrasound Technology, Obstetrics and Gynecology, Humans, Radiology, Nuclear Medicine and imaging, General Medicine, Sildenafil Citrate
Published: 2019

81. Fetal growth and risk assessment: is there an impasse? POINT

Author: Ganzevoort, W, Thilaganathan, B, Baschat, A, and Gordijn, S
Published: 2019

82. Dynamics and incidence patterns of maternal complications in early-onset hypertension of pregnancy

Author: Ganzevoort, W, Rep, A, Bonsel, G J, De Vries, J IP, and Wolf, H
Published: 2007

83. Neurodevelopmental outcomes at five years after early-onset fetal growth restriction: Analyses in a Dutch subgroup participating in a European management trial

Author: Kinderbewegingszorg patientenzorg, Brain, MS Neonatologie, UMC Utrecht, MS Verloskunde, Other research (not in main researchprogram), Pels, A., Knaven, O. C., Wijnberg-Williams, B. J., Eijsermans, M. J.C., Mulder-de Tollenaer, S. M., Aarnoudse-Moens, C. S.H., Koopman-Esseboom, C., van Eyck, J., Derks, J. B., Ganzevoort, W., van Wassenaer-Leemhuis, A. G., Kinderbewegingszorg patientenzorg, Brain, MS Neonatologie, UMC Utrecht, MS Verloskunde, Other research (not in main researchprogram), Pels, A., Knaven, O. C., Wijnberg-Williams, B. J., Eijsermans, M. J.C., Mulder-de Tollenaer, S. M., Aarnoudse-Moens, C. S.H., Koopman-Esseboom, C., van Eyck, J., Derks, J. B., Ganzevoort, W., and van Wassenaer-Leemhuis, A. G.
Published: 2019

84. Understanding patterns of engagement in the citizen humanities: The civil records of Suriname.

Author: Prats López, M., Van Oort, T., Ganzevoort, W., Van Galen, C., and Mourits, R. J.
Subjects: *SCIENCE projects, *DATA entry, *DATABASES, *CITIZEN science, *DATA logging
Abstract: AbstractThis study aims to identify engagement profiles in the citizen humanities and assess whether these profiles match those found in prior studies on crowd-based projects in the natural sciences. To this purpose, we use the log data from the citizen humanities project ‘Historical Database Suriname and the Caribbean’, in which volunteers transcribe the civil records of Suriname, and analyze the differences between engagement in data entry and forum activity. We identify seven engagement profiles, six of which are similar to the profiles found in crowd projects in the natural sciences. However, their pattern of occurrence differs with a more equal distribution of effort. Additionally, we discuss implications for project design and recommend choices that match project goals and foster engagement diversity. [ABSTRACT FROM AUTHOR]
Published: 2024
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85. Longitudinal study of computerized cardiotocography in early fetal growth restriction

Author: Wolf, H., Arabin, B., Lees, C.C., Oepkes, D., Prefumo, F., Thilaganathan, B., Todros, T., Visser, G.H.A., Bilardo, C.M., Derks, J.B., Diemert, A., Duvekot, J.J., Ferrazzi, E., Frusca, T., Hecher, K., Marlow, N., Martinelli, P., Ostermayer, E., Papageorghiou, A.T., Scheepers, H.C.J., Schlembach, D., Schneider, K.T.M., Valcamonico, A., Wassenaer-Leemhuis, A. van, Ganzevoort, W., TRUFFLE Grp, Epidemiologie, Psychiatrie en Neuropsychologie, Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, Obstetrics and Gynaecology, ARD - Amsterdam Reproduction and Development, Neonatology, APH - Quality of Care, APH - Digital Health, Obstetrics & Gynecology, Reproductive Origins of Adult Health and Disease (ROAHD), Wolf, H, Arabin, B, Lees, C C, Oepkes, D, Prefumo, F, Thilaganathan, B, Todros, T, Visser, G H A, Bilardo, C M, Derks, J B, Diemert, A, Duvekot, J J, Ferrazzi, E, Frusca, T, Hecher, K, Marlow, N, Martinelli, P, Ostermayer, E, Papageorghiou, A T, Scheepers, H C J, Schlembach, D, Schneider, K T M, Valcamonico, A, van Wassenaer-Leemhuis, A, Ganzevoort, W, and Raimondi, F.
Subjects: Adult, Middle Cerebral Artery, ductus venosu, UNSTRESSED ANTEPARTUM CARDIOTOCOGRAPHY, Longitudinal Studie, Ultrasonography, Prenatal, fetal growth restriction, Fetal Heart, HEART-RATE VARIATION, Pregnancy, short-term variation, MANAGEMENT, Humans, Longitudinal Studies, RATE PATTERNS, Fetal Growth Retardation, fetal monitoring, Infant, Newborn, Pregnancy Outcome, RETARDED FETUSES, Infant, Heart Rate, Fetal, Survival Analysis, ductus venosus, Child, Preschool, Pulsatile Flow, Female, Survival Analysi, cardiotocography, preterm, RETARDATION, Human
Abstract: Objectives: To explore whether, in early fetal growth restriction (FGR), the longitudinal pattern of fetal heart rate (FHR) short-term variation (STV) can be used to identify imminent fetal distress and whether abnormalities of FHR recordings are associated with 2-year infant outcome. Methods: The original TRUFFLE study assessed whether, in early FGR, delivery based on ductus venosus (DV) Doppler pulsatility index (PI), in combination with safety-net criteria of very low STV on cardiotocography (CTG) and/or recurrent FHR decelerations, could improve 2-year infant survival without neurological impairment in comparison with delivery based on CTG monitoring only. This was a secondary analysis of women who delivered before 32 weeks and had consecutive STV data recorded > 3 days before delivery and known infant outcome at 2 years of age. Women who received corticosteroids within 3 days of delivery were excluded. Individual regression line algorithms of all STV values, except the last one before delivery, were calculated. Life tables and Cox regression analysis were used to calculate the daily risk for low STV or very low STV and/or FHR decelerations (below DV group safety-net criteria) and to assess which parameters were associated with this risk. Furthermore, it was assessed whether STV pattern, last STV value or recurrent FHR decelerations were associated with 2-year infant outcome. Results: One hundred and forty-nine women from the original TRUFFLE study met the inclusion criteria. Using the individual STV regression lines, prediction of a last STV below the cut-off used by the CTG monitoring group had sensitivity of 42% and specificity of 91%. For each day after study inclusion, the median risk for low STV (CTG group cut-off) was 4% (interquartile range (IQR), 2-7%) and for very low STV and/or recurrent FHR decelerations (below DV group safety-net criteria) was 5% (IQR, 4-7%). Measures of STV pattern, fetal Doppler (arterial or venous), birth-weight multiples of the median and gestational age did not usefully improve daily risk prediction. There was no association of STV regression coefficients, a low last STV and/or recurrent FHR decelerations with short- or long-term infant outcomes. Conclusion: The TRUFFLE study showed that a strategy of DV monitoring with safety-net criteria of very low STV and/or recurrent FHR decelerations for delivery indication could increase 2-year infant survival without neurological impairment. This post-hoc analysis demonstrates that, in early FGR, the daily risk of abnormal CTG, as defined by the DV group safety-net criteria, is 5%, and that prediction is not possible. This supports the rationale for CTG monitoring more often than daily in these high-risk fetuses. Low STV and/or recurrent FHR decelerations were not associated with adverse infant outcome and it appears safe to delay intervention until such abnormalities occur, as long as DV-PI is within normal range. Copyright (C) 2016 ISUOG. Published by John Wiley & Sons Ltd.
Published: 2017

86. Severe fetal growth restriction at 26–32 weeks : key messages from the TRUFFLE study

Author: Bilardo, Cm, Hecher, K, Visser, Gha, Papageorghiou, At, Marlow, N, Thilaganathan, B, Van Wassenaer-Leemhuis, A, Todros, T, Marsal, K, Frusca, T, Arabin, B, Brezinka, C, Derks, Jb, Diemert, A, Duvekot, Jj, Ferrazzi, E, Ganzevoort, W, Martinelli, P, Ostermayer, E, Schlembach, D, Valensise, H, Thornton, J, Wolf, H, Lees, C, Calda, P, Gordjin, S, Gyselaers, W, Klaritsch, P, Lobmaier, S, Manz, M, Napolitano, R, Prefumo, F, Schild, R, Stampalija, T, von Holsbeke, C, von Kaisenberg, C, Bilardo, C. M., Hecher, K., Visser, G. H. A., Papageorghiou, A. T., Marlow, N., Thilaganathan, B., Van Wassenaer-Leemhuis, A., Todros, T., Marsal, K., Frusca, T., Arabin, B., Brezinka, C., Derks, J. B., Diemert, A., Duvekot, J. J., Ferrazzi, E., Ganzevoort, W., Martinelli, P., Ostermayer, E., Schlembach, D., Valensise, H., Thornton, J., Wolf, H., Lees, C., Calda, P., Gordjin, S., Gyselaers, W., Klaritsch, P., Lobmaier, S., Manz, M., Napolitano, R., Prefumo, F., Schild, R., Stampalija, T., von Holsbeke, C., and von Kaisenberg, C.
Subjects: Fetal Growth Retardation, Radiological and Ultrasound Technology, Obstetrics and Gynecology, Gestational Age, Fetal, Heart Rate, Fetal, Humans, Heart Rate, Reproductive Medicine, Radiology, Nuclear Medicine and Imaging, Settore MED/40, Human
Abstract: What was the TRUFFLE study? The Trial of Randomized Umbilical and Fetal Flow in Europe (TRUFFLE) was a prospective, multicenter, unblinded, randomized trial that ran between 1 January 2005 and 1 October 2010 in 20 European centers 1 . It studied singleton pregnancies at 26–32 weeks of gestation with a diagnosis of fetal growth restriction (FGR), defined as abdominal circumference < 10th percentile and high umbilical artery Doppler pulsatility index (PI) (> 95th percentile). In order to assess whether changes in the fetal ductus venosus (DV) Doppler waveform or short-term variation (STV) on cardiotocography (CTG) should be used as a trigger for delivery in these pregnancies, the 503 included women were randomly allocated to one of three ‘timing-of-delivery’ plans (with 1 : 1 : 1 randomization).
Published: 2017

87. The impact of pre‐eclampsia definitions on the identification of adverse outcome risk in hypertensive pregnancy – analyses from the CHIPS trial (Control of Hypertension in Pregnancy Study).

Author: Magee, LA, Singer, J, Lee, T, Rey, E, Asztalos, E, Hutton, E, Helewa, M, Logan, AG, Ganzevoort, W, Welch, R, Thornton, JG, Woo Kinshella, ML, Green, M, Tsigas, E, and Dadelszen, P
Subjects: HYPERTENSION in pregnancy, PREECLAMPSIA, PREGNANCY outcomes, HYPERTENSION, BLOOD pressure, PRECONCEPTION care
Abstract: Objective: To examine the association between pre‐eclampsia definition and pregnancy outcome. Design: Secondary analysis of Control of Hypertension in Pregnancy Study (CHIPS) trial data. Setting: International multicentre randomised controlled trial (RCT). Population: In all, 987 women with non‐severe non‐proteinuric pregnancy hypertension. Methods: We evaluated the association between pre‐eclampsia definitions and adverse pregnancy outcomes, stratified by hypertension type and blood pressure control. Main outcome measures: Main CHIPS trial outcomes: primary (perinatal loss or high‐level neonatal care for >48 hours), secondary (serious maternal complications), birthweight <10th centile, severe maternal hypertension, delivery at <34 or <37 weeks, and maternal hospitalisation before birth. Results: Of 979/987 women with informative data, 280 (28.6%) progressed to pre‐eclampsia defined restrictively by new proteinuria, and 471 (48.1%) to pre‐eclampsia defined broadly as proteinuria or one/more maternal symptoms, signs or abnormal laboratory tests. The broad (versus restrictive) definition had significantly higher sensitivities (range 62–79% versus 36–50%), lower specificities (range 53–65% versus 72–82%), and similar or higher diagnostic odds ratios and 'true‐positive' to 'false‐positive' ratios. Stratified analyses showed similar results. Addition of available fetoplacental manifestations (stillbirth or birthweight <10th centile) to the broad pre‐eclampsia definition improved sensitivity (74–87%). Conclusions: A broad (versus restrictive) pre‐eclampsia definition better identifies women who develop adverse pregnancy outcomes. These findings should be replicated in a prospective study within routine healthcare to ensure that the anticipated increase in surveillance and intervention in a larger number of women with pre‐eclampsia is associated with improved outcomes, reasonable costs and congruence with women's values. A broad (versus restrictive) pre‐eclampsia definition better identifies the risk of adverse pregnancy outcomes. A broad (versus restrictive) pre‐eclampsia definition better identifies the risk of adverse pregnancy outcomes. This article includes Author Insights, a video abstract available at https://vimeo.com/rcog/authorinsights16602 [ABSTRACT FROM AUTHOR]
Published: 2021
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88. P11.10: A core outcome set for studies investigating the management of selective fetal growth restriction in twins

Author: Khalil, A., primary, Sileo, F., additional, Gordijn, S., additional, Townsend, R., additional, Duffy, J.M., additional, Perry, H., additional, Ganzevoort, W., additional, Thilaganathan, B., additional, Papageorghiou, A.T., additional, Lopriore, E., additional, Baschat, A.A., additional, Oepkes, D., additional, Reed, K., additional, Hecher, K., additional, and Gratacós, E., additional
Published: 2019
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89. OP12.07: Consensus diagnostic criteria and management of twin anemia polycythaemia sequence: a Delphi procedure

Author: Khalil, A., primary, Lopriore, E., additional, Ganzevoort, W., additional, Thilaganathan, B., additional, Johnson, A., additional, Hecher, K., additional, Baschat, A.A., additional, Reed, K., additional, Lewi, L., additional, Deprest, J., additional, Oepkes, D., additional, and Gordijn, S., additional
Published: 2019
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90. Neurodevelopmental Outcomes at Five Years After Early-Onset Fetal Growth Restriction: Analyses in a Dutch Subgroup Participating in a European Management Trial

Author: Pels, A., primary, Knaven, O. C., additional, Wijnberg-Williams, B. J., additional, Eijsermans, M. J. C., additional, Mulder-de Tollenaer, S. M., additional, Aarnoudse-Moens, C. S. H., additional, Koopman-Esseboom, C., additional, van Eyck, J., additional, Derks, J. B., additional, Ganzevoort, W., additional, and van Wassenaer-Leemhuis, A. G., additional
Published: 2019
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91. Temporal variation in definition of fetal growth restriction in the literature

Author: Beune, I. M., primary, Pels, A., additional, Gordijn, S. J., additional, and Ganzevoort, W., additional
Published: 2019
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92. Essential variables for reporting research studies on fetal growth restriction: a Delphi consensus

Author: Khalil, A., primary, Gordijn, S. J., additional, Beune, I. M., additional, Wynia, K., additional, Ganzevoort, W., additional, Figueras, F., additional, Kingdom, J., additional, Marlow, N., additional, Papageorghiou, A. T., additional, Sebire, N., additional, Zeitlin, J., additional, and Baschat, A. A., additional
Published: 2019
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93. Variation in outcome reporting in randomized controlled trials of interventions for prevention and treatment of fetal growth restriction

Author: Townsend, R., primary, Sileo, F., additional, Stocker, L., additional, Kumbay, H., additional, Healy, P., additional, Gordijn, S., additional, Ganzevoort, W., additional, Beune, I., additional, Baschat, A., additional, Kenny, L., additional, Bloomfield, F., additional, Daly, M., additional, Devane, D., additional, Papageorghiou, A., additional, and Khalil, A., additional
Published: 2019
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94. Consensus definition and essential reporting parameters of selective fetal growth restriction in twin pregnancy: a Delphi procedure

Author: Khalil, A., primary, Beune, I., additional, Hecher, K., additional, Wynia, K., additional, Ganzevoort, W., additional, Reed, K., additional, Lewi, L., additional, Oepkes, D., additional, Gratacos, E., additional, Thilaganathan, B., additional, and Gordijn, S. J., additional
Published: 2019
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95. Chronic hypertension in pregnancy : an unique opportunity

Author: Groenhof, T K J, Ganzevoort, W, Lely, A T, Groenhof, T K J, Ganzevoort, W, and Lely, A T
Published: 2018

96. Chronic hypertension in pregnancy: an unique opportunity

Author: Cardiovasculaire Epi Team 5, MS Verloskunde, Child Health, Circulatory Health, Groenhof, T K J, Ganzevoort, W, Lely, A T, Cardiovasculaire Epi Team 5, MS Verloskunde, Child Health, Circulatory Health, Groenhof, T K J, Ganzevoort, W, and Lely, A T
Published: 2018

97. The missing pillar : Eudemonic values in the justification of nature conservation

Author: van den Born, Riyan J.G., Arts, B., Admiraal, J.G.A., Beringer, A., Knights, P., Molinario, E., Horvat, K.P., Porras-Gomez, C., Smrekar, A., Soethe, N., Vivero-Pol, J.L., Ganzevoort, W., Bonaiuto, M., Knippenberg, L., De Groot, W.T., van den Born, Riyan J.G., Arts, B., Admiraal, J.G.A., Beringer, A., Knights, P., Molinario, E., Horvat, K.P., Porras-Gomez, C., Smrekar, A., Soethe, N., Vivero-Pol, J.L., Ganzevoort, W., Bonaiuto, M., Knippenberg, L., and De Groot, W.T.
Abstract: The public justification for nature conservation currently rests on two pillars: hedonic (instrumental) values, and moral values. Yet, these representations appear to do little motivational work in practice; biodiversity continues to decline, and biodiversity policies face a wide implementation gap. In seven EU countries, we studied why people act for nature beyond professional obligations. We explore the motivations of 105 committed actors for nature in detail using life-history interviews, and trace these back to their childhood. Results show that the key concept for understanding committed action for nature is meaningfulness. People act for nature because nature is meaningful to them, connected to a life that makes sense and a difference in the world. These eudemonic values (expressing the meaningful life) constitute a crucial third pillar in the justification of nature conservation. Important policy implications are explored, e.g. with respect to public discourse and the encounter with nature in childhood.
Published: 2018

98. Groene Vrijwilligers : Wie zijn ze, wat doen ze en wat drijft hen?

Author: Ganzevoort, W., Born, R. van den, Ganzevoort, W., and Born, R. van den
Abstract: Groene vrijwilligers spelen een belangrijke rol in bescherming van, onderzoek naar en educatie over de natuur. In Nederland zijn veel mensen actief als groene vrijwilliger, zowel binnen projecten vanuit organisaties als door deelname aan groene burgerinitiatieven. Voor zowel de overheid als alle organisaties die werken met groene vrijwilligers is het van belang inzicht te krijgen in het profiel van d e groene vrijwilliger, wat hen motiveert, en waar zij tegenaan lopen. Met deze kennis kan de ondersteuning en waardering van groene vrijwilligers beter aansluiten bij hun drijfveren, wensen en behoeften. In opdracht van het Ministerie van Economische Zaken zijn de volgende vragen onderzocht: 1. Wat is de sociaal - demografische achtergrond van de groene vrijwilligers? 2. Wat voor groen vrijwilligerswerk doen zij, en hoe is dit georganiseerd? 3. Wat motiveert hen om groen vrijwilligerswerk te doen? 4. Welke kansen zien zij voor groen vrijwilligerswerk, en welke belemmeringen ervaren ze? De onderzoekers hebben een online enquête opgesteld die onder groene vrijwilligers is verspreid via organisaties als het IVN en LandschappenNL, en via groene burgerinitiatieven. Van de 3 775 respondenten zijn de achtergrond, activiteiten, motivaties en ervaringen in kaart gebracht
Published: 2018

99. Recurrence of hypertensive disorders of pregnancy: An individual patient data metaanalysis

Author: Van Oostwaard, M, Langenveld, J, Schuit, E, Papatsonis, D, Brown, M, Byaruhanga, R, Bhattacharya, S, Campbell, D, Chappell, L, Chiaffarino, F, Crippa, I, Facchinetti, F, Ferrazzani, S, Ferrazzi, E, Figueiró Filho, E, Gaugler Senden, I, Haavaldsen, C, Lykke, J, Mbah, A, Oliveira, V, Poston, L, Redman, C, Salim, R, Thilaganathan, B, Vergani, P, Zhang, J, Steegers, E, Mol, B, Ganzevoort, W, VERGANI, PATRIZIA, Ganzevoort, W., Van Oostwaard, M, Langenveld, J, Schuit, E, Papatsonis, D, Brown, M, Byaruhanga, R, Bhattacharya, S, Campbell, D, Chappell, L, Chiaffarino, F, Crippa, I, Facchinetti, F, Ferrazzani, S, Ferrazzi, E, Figueiró Filho, E, Gaugler Senden, I, Haavaldsen, C, Lykke, J, Mbah, A, Oliveira, V, Poston, L, Redman, C, Salim, R, Thilaganathan, B, Vergani, P, Zhang, J, Steegers, E, Mol, B, Ganzevoort, W, VERGANI, PATRIZIA, and Ganzevoort, W.
Abstract: Objective We performed an individual participant data (IPD) metaanalysis to calculate the recurrence risk of hypertensive disorders of pregnancy (HDP) and recurrence of individual hypertensive syndromes. Study Design We performed an electronic literature search for cohort studies that reported on women experiencing HDP and who had a subsequent pregnancy. The principal investigators were contacted and informed of our study; we requested their original study data. The data were merged to form one combined database. The results will be presented as percentages with 95% confidence interval (CI) and odds ratios with 95% CI. Results Of 94 eligible cohort studies, we obtained IPD of 22 studies, including a total of 99,415 women. Pooled data of 64 studies that used published data (IPD where available) showed a recurrence rate of 18.1% (n = 152,213; 95% CI, 17.9-18.3%). In the 22 studies that are included in our IPD, the recurrence rate of a HDP was 20.7% (95% CI, 20.4-20.9%). Recurrence manifested as preeclampsia in 13.8% of the studies (95% CI,13.6-14.1%), gestational hypertension in 8.6% of the studies (95% CI, 8.4-8.8%) and hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome in 0.2% of the studies (95% CI, 0.16-0.25%). The delivery of a small-for-gestational-age child accompanied the recurrent HDP in 3.4% of the studies (95% CI, 3.2-3.6%). Concomitant HELLP syndrome or delivery of a small-for-gestational-age child increased the risk of recurrence of HDP. Recurrence increased with decreasing gestational age at delivery in the index pregnancy. If the HDP recurred, in general it was milder, regarding maximum diastolic blood pressure, proteinuria, the use of oral antihypertensive and anticonvulsive medication, the delivery of a small-for-gestational-age child, premature delivery, and perinatal death. Normotensive women experienced chronic hypertension after pregnancy more often after experiencing recurrence (odds ratio, 3.7; 95% CI, 2.3-6.1). Conclusion Amon
Published: 2015

100. Cerebroplacental ratio in predicting adverse perinatal outcome: a meta-analysis of individual participant data.

Author: Vollgraff Heidweiller‐Schreurs, CA, Osch, IR, Heymans, MW, Ganzevoort, W, Schoonmade, LJ, Bax, CJ, Mol, BWJ, Groot, CJM, Bossuyt, PMM, Boer, MA, Khalil, Asma, Thilaganathan, Basky, Turan, Ozhan M, Crimmins, Sarah, Harman, Chris, Shannon, Alisson M, Kumar, Sailesh, Dicker, Patrick, Malone, Fergal, and Tully, Elizabeth C
Subjects: UMBILICAL arteries, PREGNANCY outcomes, MISSING data (Statistics), RECEIVER operating characteristic curves, GESTATIONAL age, RESEARCH, PHYSICS, PREDICTIVE tests, META-analysis, RESEARCH methodology, SYSTEMATIC reviews, MEDICAL cooperation, EVALUATION research, CEREBRAL arteries, COMPARATIVE studies, DOPPLER ultrasonography, PREGNANCY complications, FETAL ultrasonic imaging
Abstract: Objective: To investigate if cerebroplacental ratio (CPR) adds to the predictive value of umbilical artery pulsatility index (UA PI) alone - standard of practice - for adverse perinatal outcome in singleton pregnancies.Design and Setting: Meta-analysis based on individual participant data (IPD).Population or Sample: Ten centres provided 17 data sets for 21 661 participants, 18 731 of which could be included. Sample sizes per data set ranged from 207 to 9215 individuals. Patient populations varied from uncomplicated to complicated pregnancies.Methods: In a collaborative, pooled analysis, we compared the prognostic value of combining CPR with UA PI, versus UA PI only and CPR only, with a one-stage IPD approach. After multiple imputation of missing values, we used multilevel multivariable logistic regression to develop prediction models. We evaluated the classification performance of all models with receiver operating characteristics analysis. We performed subgroup analyses according to gestational age, birthweight centile and estimated fetal weight centile.Main Outcome Measures: Composite adverse perinatal outcome, defined as perinatal death, caesarean section for fetal distress or neonatal unit admission.Results: Adverse outcomes occurred in 3423 (18%) participants. The model with UA PI alone resulted in an area under the curve (AUC) of 0.775 (95% CI 0.709-0.828) and with CPR alone in an AUC of 0.778 (95% CI 0.715-0.831). Addition of CPR to the UA PI model resulted in an increase in the AUC of 0.003 points (0.778, 95% CI 0.714-0.831). These results were consistent across all subgroups.Conclusions: Cerebroplacental ratio added no predictive value for adverse perinatal outcome beyond UA PI, when assessing singleton pregnancies, irrespective of gestational age or fetal size.Tweetable Abstract: Doppler measurement of cerebroplacental ratio in clinical practice has limited added predictive value to umbilical artery alone. [ABSTRACT FROM AUTHOR]
Published: 2021
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