Download het volledig rapport (302 p.) - KCE

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<strong>KCE</strong> reports vol. 6A Prenatale zorg 194 What is the effect of external cephalic version on perinatal outcomes and mode of delivery? what is the effectiveness of external cephalic version? Study Ref Population Intervention Outcomes Results Comments Study type EL Hofmeyr and 28 6 randomized External cephalic Caesarean OR: 0.52 [0.39- SR 1a Kulier 2004 controlled version attempt section 0.71] studies of term at term, with or external version without the use Perinatal OR: 0.44 [0.07, of tocolysis, mortality 2.92] 303 intervention compared with & no ECV attempt Hofmeyr and Gyte, 2004 Collaris and Oei, 2004 306 control 30 6 randomized controlled studies of term external version 317 intervention & 300 control 90 Systematic review of 44 studies 737 patients from 1990 to 2002 Routine betamimetic tocolysis for external cephalic version at term compared with ECV attempted without tocolysis Systematic review of observational studies Failed external cephalic version - Persistent anomalies of CTG - Mortality 0.74 [0.64, 0.87] SR 1a 0.37% 0.16% safe procedure SR of OB 3
<strong>KCE</strong> reports vol. 6A Prenatale zorg 195 1. d. Screening for placenta praevia What is the sensitivity and specificity of a transvaginal/ transabdominal ultrasound scan and does transvaginal ultrasound cause vaginal bleeding? Study Ref Population Intervention Outcomes Results Comments Study type EL Leerentveld et 4 [549] 100 women with In group with Sensitivity and Sensitivity: 87.5%, CS 3 al., 1990 second or third suspected specificity of 95% CI 61.7 to trimester placenta praevia transvaginal 98.4 haemorrhage, (n=15) placental suspected transvaginal scan localisation Specificity: 98.8%, placenta praevia, performed at 31 95%CI 93.4 to fetal weeks (median). Cases of vaginal 100 malpresentation In the rest of the bleeding or nonengaged women (n=85) No cases of presenting part transvaginal vaginal bleeding from 1988 to ultrasound and no woman 1990 performed at 29 who presented weeks (median) with vaginal haemorrhage Findings at (n=76) displayed delivery used as aggravated gold standard bleeding after sonography Oppenheimer et 4 [550] 36 pregnant Eligible women Cases of vaginal No case of CS 3 al., 2001 women with a identified by bleeding from vaginal bleeding placenta lying transvaginal transvaginal within 30mm of ultrasound and ultrasound Procedure also the internal repeated every 4 reported to be cervical os or weeks until well tolerated by overlapping it at leading edge all women or after 26 migrated beyond weeks 30 mm or delivery Sherman et al., 4 [551] 38 women with Group 1 (n = Diagnosis of Group 1, on Method of RCT 1b 1991 suspected 20): abdominal placenta praevia initial randomisation
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NATIONALE RICHTLIJN PRENATALE ZORG:
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KCE reports 1. Effectiviteit en kos
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