Download het volledig rapport (302 p.) - KCE

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<strong>KCE</strong> reports vol. 6A Prenatale zorg 212 Study Ref Population Intervention Outcomes Results Comments Study type Urine tested for ITA, total) hCG, and beta-core fragment, total Detection rate for fixed FPR maternal age in the 2nd hCG and free beta-hCG of 5%: Serum integrated test 92% trimester Quadruple test 92% Double test based on Triple test 90% AFP, free beta-(or total) Double test 86% Fetal losses/100,000 women screened (i.e. 173 cases diagnosed) (n): Integrated test 9 Serum integrated test 19 Combined test 44 Quadruple test 45 Triple test 67 Double test 94 NT 144 hCG, and maternal age in the 2nd trimester 71 DownÊs syndrome pregnancies were terminated, 4 miscarried after amniocentesis and 26 resulted in a live birth What is the sampling failure and total pregnancy loss of CVS and amniocentesis? Study Ref Population Intervention Outcomes Results Comments Study Alfirevic et al., 1998 4 [323] 3 RCTs, 9067 women 1st trimester CVS vs. 2nd trimester amniocentesis Sampling failure Total pregnancy loss Failure (1 RCT, n = 3201): Peto OR 2.86, 95% CI 1.93 to 4.24 EL EL type SR 1a
<strong>KCE</strong> reports vol. 6A Prenatale zorg 213 Study Ref Population Intervention Outcomes Results Pregnancy loss (3 RCTs, n = 9067): Peto OR 1.33, 95% CI 1.17 to 1.52 Comments Study type EL Alfirevic, 4 [324] 3 RCTs, 1832 Amniocentesis vs. Sampling failure Failure (3 RCTs, n = 1832): SR 1a 2000 women transabdominal CVS at 9 0.4% vs. 2%, RR 0.23, 95% CI to 14 weeks gestation Total pregnancy loss 0.08 to 0.65 RCOG Guideline No. 8, 2000 4 [307] N/A Amniocentesis vs. no amniocentesis at 16 to 18 weeks (n = 4606 women) Early amniocentesis (before 14 weeks, n = 2183) vs. amniocentesis at 15 weeks or later (n = 2185) Excess loss rate for amniocentesis vs. no amniocentesis For early amniocentesis vs. late amniocentesis: Rates of fetal loss and fetal talipes following amniocentesis Procedure analysis Pregnancy loss (3 RCTs, n = 1832): 6.2% vs. 5%, RR 1.24, 95% CI 0.85 to 1.81 Excess miscarriage rate in amniocentesis group: 1% Early vs. late amniocentesis: Total fetal loss, 7.6% vs. 5.9%, p = 0.012 Fetal talipes, 1.3% vs. 0.1%, p = 0.0001 Procedure reported difficult, 10.1% vs. 4.0%, p < 0.0001 Amniotic fluid leakage at < 22 weeks, 3.5% vs. 1.7%, p = 0.0007 Multiple needle insertion, 5.4% vs. 2.1%, p < 0.0001 First attempt success, 96.9% vs. 99.6%, p < 0.0001 SR 1b
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NATIONALE RICHTLIJN PRENATALE ZORG:
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Nationale richtlijn prenatale zorg:
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KCE reports vol. 6A Prenatale zorg
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KCE reports 1. Effectiviteit en kos
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