Download het volledig rapport (302 p.) - KCE

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<strong>KCE</strong> reports vol. 6A Prenatale zorg 206 3. Cardiotocography What is the effect of cardiotocography on perinatal outcomes, methods of delivery and hospital admissions? Study Ref Population Intervention Outcomes Results Comment Pattison and McCowan, 2001 4 [573] 4 RCTs, 1588 high or intermediate risk pregnancies Antenatal cardiotocography vs. control for fetal assessment Perinatal outcomes Methods of delivery Hospital admissions Perinatal deaths: 3 RCTs, n = 127, Peto OR 2.85, 95% CI 0.99 to 7.12 Neonatal admissions: 2 RCTs, n = 883, Peto OR 1.11, 95% CI 0.80 to 1.54 Elective caesarean section: 3 RCTs, n = 1047, Peto OR 1.01, 95% CI 0.68 to 1.51 Emergency caesarean section: 3 RCTs, n = 1049, Peto OR 1.27 95% CI 0.83 to 1.92 Induction of labour: 3 RCTs, n = 1049, Peto OR 1.09 95% CI 0.85 to 1.40 Hospital admissions: 1 RCT, n = 300, Peto OR 0.37 95% CI 0.17 to 0.83 s Study type EL SR 1a
<strong>KCE</strong> reports vol. 6A Prenatale zorg 207 4. Screening for DownÊs syndrome What is the incidence of DownÊs syndrome and what is the odds at different maternal age-levels? Study Ref Population Intervention Outcomes Results Comments Study ONS, 2000 Morris et al., 2002 4 [303] 4 [311] All children in England and Wales All antenatal or postnatally diagnosed and confirmed cases (via a karyotype) of DownÊs syndrome in England and Wales from 1989 to 1998 Notification of DownÊs syndrome Collection of reports from all regional cytogenetic laboratories of cases found to have a DownÊs syndrome karyotype Incidence of DownÊs syndrome per 10,000 live and still births Observed odds of maternal age specific risk of DownÊs syndrome 1986: 6.7 1988 6. 1. 1990: 5.9 1992: 5.7 1994: 4.7 1996: 5.5 1998: 6.2 Odds at age 20 years: 1:1441 Odds at age 25 years: 1:1383 Odds at age 30 years: 1:959 Odds at age 35 years: 1:338 Odds at age 40 years: 1:84 Odds at age 45 years: 1:32 Report of child health statistics An estimated 6% of births with DownÊs syndrome are missed by the National Down Syndrome Cytogenetic Register, therefore, the number of births was increased by 6% to allow for those not included What is the sensitivity, specificity, detection rate or false positive rate of different screening methods? Study Ref Population Intervention Outcomes Results Comments Study Smith- Bindman et al., 2001 4 [315] 56 studies, 130,365 unaffected fetuses and 1930 cases of DownÊs syndrome Systematic review; Articles that assessed second trimester (15 to 24 weeks) ultrasound markers (choroid plexus cyst, nuchal fold thickening, echogenic Sensitivity and specificity of each ultrasonographic marker and associated fetal loss per case diagnosed Nuchal fold (95% CI): Sensitivity 0.04 (0.02 to 0.10) Specificity 0.99 (0.99 to 0.99) Fetal loss 0.6 EL type SV 3 SV 3 type EL SR 2b & 3
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KCE reports 1. Effectiviteit en kos
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