12 results on '"Marcus Rijken"'
Search Results
2. Maternal Hepatitis B Infection Burden, Comorbidity and Pregnancy Outcome in a Low-Income Population on the Myanmar-Thailand Border: A Retrospective Cohort Study
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Marieke Bierhoff, Chaisiri Angkurawaranon, Aung Myat Min, Mary Ellen Gilder, Nay Win Tun, Arunrot Keereevijitt, Aye Kyi Win, Elsi Win, Verena Ilona Carrara, Tobias Brummaier, Cindy S. Chu, Laurence Thielemans, Kanlaya Sriprawat, Borimas Hanboonkunupakarn, Marcus Rijken, François Nosten, Michele van Vugt, and Rose McGready
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Gynecology and obstetrics ,RG1-991 - Abstract
Objectives. Hepatitis B virus (HBV) was believed to have minimal impact on pregnancy outcomes apart from the risk of perinatal transmission. In more recent years, there have been reports of adverse associations, most consistently preterm birth (PTB), but this is in the context of high rates of caesarean section. The aim of this study was to explore the association of HBV on pregnancy outcomes in marginalized, low-income populations on the Myanmar-Thailand border. Methods. HBsAg positive (+) point of care rapid detection tests results were confirmed by immunoassays. Women with a confirmed HBsAg status, HIV- and syphilis-negative at first antenatal care screening, singleton fetus and known pregnancy outcome (Aug-2012 to Dec-2016) were included. Logistic regression analysis was used to evaluate associations between HBV group (controls HBsAg negative, HBsAg+/HBeAg-, or HBsAg+/HBeAg+) and pregnancy outcome and comorbidity. Results. Most women were tested, 15,046/15,114 (99.6%) for HBV. The inclusion criteria were not met for 4,089/15,046 (27.2%) women due mainly to unavailability of pregnancy outcome and nonconfirmation of HBsAg+. In evaluable women 687/11,025 (6.2%) were HBsAg+, with 476/11,025 (4.3%) HBsAg+/HBeAg- and 211/11,025 (1.9%) were HBsAg+/HBeAg+. The caesarean section rate was low at 522/8,963 (5.8%). No significant associations were observed between pregnancy comorbidities or adverse pregnancy outcomes and HBV status. Conclusions. The results highlight the disease burden of HBV in women on the Myanmar-Thailand border and support original reports of a lack of significant associations with HBsAg+ irrespective of HBeAg status, for comorbidity, and pregnancy outcomes in deliveries supervised by skilled birth attendants.
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- 2019
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3. Diagnostic and Management Challenges of Caesarean Scar Ectopic Pregnancy in a Lower Middle Income Country
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Kwaku Asah-Opoku, Nana Essuman Oduro, Alim Swarray-Deen, Kareem Mumuni, Isaac Osei Koranteng, Rita Catherine Senker, Marcus Rijken, and Kobinah Nkyekyer
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Gynecology and obstetrics ,RG1-991 - Abstract
Caesarean scar ectopic pregnancy is defined as the implantation of the blastocyst in a previous Caesarean scar. It is a rare type of ectopic pregnancy. The incidence is however rising due to the increasing rates of Caesarean sections as well as in-vitro fertilization embryo-transfer. It can be diagnosed early by ultrasound. This remains a challenge in lower middle income countries where the availability of high resolution ultrasound and the skill for such sonography may be lacking. Misdiagnosis or a delay in diagnosis often leads to poor treatment outcomes. We present a case of a gravida 3 para 2 + 0 who had laparotomy for a caesarean scar pregnancy and highlight the challenges associated with diagnosis and management of this rare ectopic pregnancy in a lower middle income country.
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- 2019
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4. Malaria burden and artemisinin resistance in the mobile and migrant population on the Thai-Myanmar border, 1999-2011: an observational study.
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Verena I Carrara, Khin Maung Lwin, Aung Pyae Phyo, Elizabeth Ashley, Jacher Wiladphaingern, Kanlaya Sriprawat, Marcus Rijken, Machteld Boel, Rose McGready, Stephane Proux, Cindy Chu, Pratap Singhasivanon, Nicholas White, and François Nosten
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Medicine - Abstract
BackgroundThe Shoklo Malaria Research Unit has been working on the Thai-Myanmar border for 25 y providing early diagnosis and treatment (EDT) of malaria. Transmission of Plasmodium falciparum has declined, but resistance to artesunate has emerged. We expanded malaria activities through EDT and evaluated the impact over a 12-y period.Methods and findingsBetween 1 October 1999 and 30 September 2011, the Shoklo Malaria Research Unit increased the number of cross-border (Myanmar side) health facilities from two to 11 and recorded the number of malaria consultations. Changes in malaria incidence were estimated from a cohort of pregnant women, and prevalence from cross-sectional surveys. In vivo and in vitro antimalarial drug efficacy were monitored. Over this period, the number of malaria cases detected increased initially, but then declined rapidly. In children under 5 y, the percentage of consultations due to malaria declined from 78% (95% CI 76-80) (1,048/1,344 consultations) to 7% (95% CI 6.2-7.1) (767/11,542 consultations), pConclusionsDespite the emergence of resistance to artesunate in P. falciparum, the strategy of EDT with artemisinin-based combination treatments has been associated with a reduction in malaria in the migrant population living on the Thai-Myanmar border. Although limited by its observational nature, this study provides useful data on malaria burden in a strategically crucial geographical area. Alternative fixed combination treatments are needed urgently to replace the failing first-line regimen of mefloquine and artesunate. Please see later in the article for the Editors' Summary.
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- 2013
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5. Complex Interactions between soil-transmitted helminths and malaria in pregnant women on the Thai-Burmese border.
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Machteld Boel, Verena I Carrara, Marcus Rijken, Stephane Proux, Mathieu Nacher, Mupawjay Pimanpanarak, Moo Koo Paw, Oh Moo, Hser Gay, Wendi Bailey, Pratap Singhasivanon, Nicholas J White, François Nosten, and Rose McGready
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Deworming is recommended by the WHO in girls and pregnant and lactating women to reduce anaemia in areas where hookworm and anaemia are common. There is conflicting evidence on the harm and the benefits of intestinal geohelminth infections on the incidence and severity of malaria, and consequently on the risks and benefits of deworming in malaria affected populations. We examined the association between geohelminths and malaria in pregnancy on the Thai-Burmese border.Routine antenatal care (ANC) included active detection of malaria (weekly blood smear) and anaemia (second weekly haematocrit) and systematic reporting of birth outcomes. In 1996 stool samples were collected in cross sectional surveys from women attending the ANCs. This was repeated in 2007 when malaria incidence had reduced considerably. The relationship between geohelminth infection and the progress and outcome of pregnancy was assessed.Stool sample examination (339 in 1996, 490 in 2007) detected a high prevalence of geohelminths 70% (578/829), including hookworm (42.8% (355)), A. lumbricoides (34.4% (285)) and T.trichuria (31.4% (250)) alone or in combination. A lower proportion of women (829) had mild (21.8% (181)) or severe (0.2% (2)) anaemia, or malaria 22.4% (186) (P.vivax monoinfection 53.3% (101/186)). A. lumbricoides infection was associated with a significantly decreased risk of malaria (any species) (AOR: 0.43, 95% CI: 0.23-0.84) and P.vivax malaria (AOR: 0.29, 95% CI: 0.11-0.79) whereas hookworm infection was associated with an increased risk of malaria (any species) (AOR: 1.66, 95% CI: 1.06-2.60) and anaemia (AOR: 2.41, 95% CI: 1.18-4.93). Hookworm was also associated with low birth weight (AOR: 1.81, 95% CI: 1.02-3.23).A. lumbricoides and hookworm appear to have contrary associations with malaria in pregnancy.
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- 2010
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6. Modified Delphi study of ultrasound signs associated with placenta accreta spectrum
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E, Jauniaux, F, D'Antonio, A, Bhide, F, Prefumo, R M, Silver, A M, Hussein, S A, Shainker, F, Chantraine, Z, Alfirevic, Alfred, Abuhamad, Rozi Aditya, Aryananda, Giuseppe, Calì, Conrado M, Countinho, Andrea, Dall'Asta, Maria, de Carvalho Afonso, Veronica M, Deniega, Brett, Einerson, Karin A, Fox, Matus, Halaj, Petra, Hanulikova, Anne, Kennedy, John C, Kingdom, Christoph, Lees, Ky, Leung, Wing-Cheong, Leung, Zengping, Liu, Wolfgang, Henrich, Ron, Maymon, Mina G, Mhallem, Olivier, Morel, Martha, Rac, Marcus, Rijken, Jin-Chung, Shih, Vedran, Stefanovic, Karin, Sundberg, Paula, Woodward, Huixia, Yang, Nurit, Zosmer, Lisa C, Zuckerwise, Obstetrics and Gynaecology, 04 Woman - Child, and ARD - Amsterdam Reproduction and Development
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placenta accreta spectrum ,ultrasound imaging ,Reproductive Medicine ,Radiological and Ultrasound Technology ,systematic review ,placenta previa accreta ,Delphi survey ,Obstetrics and Gynecology ,Radiology, Nuclear Medicine and imaging ,General Medicine - Abstract
Objective: To determine, by expert consensus through a modified Delphi process, the role of standardized and new ultrasound signs in the prenatal evaluation of patients at high risk of placenta accreta spectrum (PAS). Methods: A systematic review of articles providing information on ultrasound imaging signs or markers associated with PAS was performed before the development of questionnaires for the first round of the Delphi process. Only peer-reviewed original research studies in the English language describing one or more new ultrasound sign(s) for the prenatal evaluation of PAS were included. A three-round consensus-building Delphi method was then conducted under the guidance of a steering group, which included nine experts who invited an international panel of experts in obstetric ultrasound imaging in the evaluation of patients at high risk for PAS. Consensus was defined as agreement of ≥ 70% between participants. Results: The systematic review identified 15 articles describing eight new ultrasound signs for the prenatal evaluation of PAS. A total of 35 external experts were approached, of whom 31 agreed and participated in the first round. Thirty external experts (97%) and seven experts from the steering group completed all three Delphi rounds. A consensus was reached that a prior history of at least one Cesarean delivery, myomectomy or PAS should be an indication for detailed PAS ultrasound assessment. The panelists also reached a consensus that seven of the 11 conventional signs of PAS should be included in the examination of high-risk patients and the routine mid-gestation scan report: (1) loss of the ‘clear zone’, (2) myometrial thinning, (3) bladder-wall interruption, (4) placental bulge, (5) uterovesical hypervascularity, (6) placental lacunae and (7) bridging vessels. A consensus was not reached for any of the eight new signs identified by the systematic review. With respect to other ultrasound features that are not specific to PAS but increase the probability of PAS at birth, the panelists reached a consensus for the finding of anterior placenta previa or placenta previa with cervical involvement. The experts were also asked to determine which PAS signs should be quantified and consensus was reached only for the quantification of placental lacunae using an existing score. For predicting surgical outcome in patients with a high probability of PAS at delivery, a consensus was obtained for loss of the clear zone, bladder-wall interruption, presence of placental lacunae and presence of placenta previa involving the cervix. Conclusions: We have confirmed the continued importance of seven established standardized ultrasound signs of PAS, highlighted the role of transvaginal ultrasound in evaluating the placental position and anatomy of the cervix, and identified new ultrasound signs that may become useful in the future prenatal evaluation and management of patients at high risk for PAS at birth.
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- 2023
7. Maternal perception of fetal movements: views, knowledge and practices of women and health providers in a low-resource setting
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Katinka Weller, Natasha Housseine, Rashid Khamis, Tarek Meguid, GJ Hofmeyr, Joyce Browne, and Marcus Rijken
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Objective To assess the perception, knowledge, and practices regarding maternal perception of fetal movements (FMs) among women and their healthcare providers in a low-resource setting. Design Qualitative study. Setting The maternity unit of Mnazi Mmoja Hospital, Zanzibar, Tanzania. Population Pregnant and postpartum women, and health providers. Methods Semi-structured interviews, questionnaires and focus group discussions were conducted with 45 Zanzibar women (18 antenatal, 28 postpartum) and 28 health providers. Main outcome measures Descriptive and thematic analyses were conducted to systematically extract subthemes within four main themes 1) knowledge/awareness, 2) behavior/practice, 3) barriers, and 4) improvements. Results Within the main themes it was found that 1) Women were instinctively aware of (ab)normal FM-patterns and healthcare providers had adequate knowledge about FMs. 2) Women often did not know how to monitor FMs or when to report concerns. There was inadequate assessment and management of (ab)normal FMs. 3) Women did not feel free to express concerns. Healthcare providers considered FM-awareness among women as low and unreliable; lack of staff, time and space for FM-education, and no protocol for FM-management. 4) Women and health providers recognized the need for education on assessment and management of (ab)normal FMs. Conclusion Women expressed FMs in an adequate way and perceived abnormalities of these movements better than assumed by health providers. There is a need for more evidence on the effect of improving knowledge and awareness of FMs in order to construct evidence-based guidelines for low resource settings.
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- 2022
8. Fetal movement trials: where is the evidence in settings with high-burden of stillbirths?
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Natasha Housseine, Joyce Browne, nanna maaloe, Sam Ali, brenda dmello, Muzdalifat Abeid, Tarek Meguid, Marcus Rijken, and Hussein Kidanto
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- 2022
9. Obstetric emergencies
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Marcus Rijken, Rose McGready, and Tarek Meguid
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Respectful Maternal Care, Antenatal care, Early pregnancy bleeding?, Hypertensive emergencies?, Pregnancy-related infection?, Obstetric haemorrhage?, Intrapartum emergencies?
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- 2022
10. Management of Unexpected Placenta Accreta Spectrum Cases in Resource Poor Settings in Colombia and Indonesia: Potential Role for Telemedicine
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rozi aryananda, Albaro José Nieto-Calvache, Johannes J. Duvekot, Aditiawarman Aditiawarman, and Marcus Rijken
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- 2022
11. Clinical algorithms for identification and management of delay in the progression of first and second stage of labour
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J Pasquale, M Chamillard, V Diaz, C Gialdini, M Bonet, OT Oladapo, E Abalos, for the WHO Intrapartum Care Algorithms Working Group, Livia Ciabati, Lariza Laura De Oliveira, Joyce Browne, Marcus Rijken, Sue Fawcus, Justus Hofmeyr, Tippawan Liabsuetrakul, Çağri GÜLÜMSER, Anna Blennerhassett, David Lissauer, Shireen Meher, Fernando Althabe, Mercedes Bonet, A Metin Gülmezoglu, and Olufemi Oladapo
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second stage of labour ,prolonged labour ,delay ,protracted ,Abnormal ,dystocia ,Obstetrics and Gynecology ,duration ,length ,active first stage ,labour - Abstract
Aim: To develop clinical algorithms for the assessment and management of slow progress of labour. Population: Low-risk singleton, term, pregnant women in labour. Setting: Institutional births in low- and middle-income countries. Search strategy: We systematically reviewed the literature on normal labour progression, and guidance on clinical management of abnormally slow progression from 1 December 2015 to 1 October 2020 from relevant international guidelines, Cochrane reviews and primary research studies in PubMed by searching for international and national guidance documents, electronic databases and published systematic reviews using relevant keywords. Case scenarios: We developed two clinical algorithms: one for abnormally slow labour progression and arrest during first stage and one for the second stage. The algorithms provide definitions of suspected and confirmed slow progress of labour or arrest, initial assessment and ongoing monitoring, differential diagnosis, and management of the abnormalities, as well as links to other algorithms for labour management. Conclusions: Identifying abnormal progress of labour is often challenging. These algorithms may help healthcare providers identify abnormal labour progress and institute prompt management or referral where needed but also reduce misdiagnosis and unnecessary use of interventions to accelerate labour. Tweetable abstract: Evidence-based clinical algorithms may help and standardize early identification and management of abnormally slow labour progress or arrest.
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- 2022
12. Defining definitions: a Delphi study to develop a core outcome set for conditions of severe maternal morbidity
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Serena Donati, Marcus Rijken, William Parsonage, David Ellwood, Elizabeth Sullivan, Lone Krebs, Michael Peek, Shilpanjali Jesudason, Elena Kuklina, Caroline Daelemans, Lucy Mackillop, Amsterdam Reproduction & Development (AR&D), Obstetrics and gynaecology, and ACS - Atherosclerosis & ischemic syndromes
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Embolism, Amniotic Fluid ,medicine.medical_specialty ,Consensus ,Placenta Diseases ,Delphi Technique ,Quality Assurance, Health Care ,International studies ,International Cooperation ,Population ,education ,Pregnancy Complications, Cardiovascular ,Delphi method ,Hysterectomy ,Severity of Illness Index ,Likert scale ,03 medical and health sciences ,Amniotic fluid embolism ,0302 clinical medicine ,Obstetrics and gynaecology ,Uterine Rupture ,Pregnancy ,Outcome Assessment, Health Care ,medicine ,Humans ,Eclampsia ,computer.programming_language ,education.field_of_study ,030219 obstetrics & reproductive medicine ,business.industry ,Obstetrics ,Developed Countries ,Postpartum Hemorrhage ,Obstetrics and Gynecology ,medicine.disease ,Heart Arrest ,Pregnancy Complications ,Family medicine ,Hemoperitoneum ,Female ,business ,computer ,Delphi - Abstract
Objective Develop a core outcome set of international consensus definitions for severe maternal morbidities. Design Electronic Delphi study. Setting International. Population Eight expert panels. Methods All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions. From these suggestions, a steering committee distilled critical components: eclampsia: 23, amniotic fluid embolism: 15, pregnancy-related hysterectomy: 11, severe primary postpartum haemorrhage: 19, uterine rupture: 20, abnormally invasive placentation: 12, spontaneous haemoperitoneum in pregnancy: 16, and cardiac arrest in pregnancy: 10. These components were assessed by the expert panel using a 5-point Likert scale, following which a framework for an encompassing definition was constructed. Possible definitions were evaluated in rounds until a rate of agreement of more than 70% was reached. Expert commentaries were used in each round to improve definitions. Main outcome measures Definitions with a rate of agreement of more than 70%. Results The invitation to participate in one or more of eight Delphi processes was accepted by 103 experts from 13 high-income countries. Consensus definitions were developed for all of the conditions. Conclusion Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. These should be used in national registrations and international studies, and should be taken up by the Core Outcomes in Women's and Newborn Health initiative. Tweetable abstract Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.
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- 2017
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