Jan MM van Lith

Publications (3)4.61 Total impact

• Article: Cost-effectiveness of cardiotocography plus ST analysis of the fetal electrocardiogram compared with cardiotocography only.

  Sylvia M C Vijgen, Michelle E M H Westerhuis, Brent C Opmeer, Gerard H A Visser, Karl G M Moons, Martina M Porath, Guid S Oei, Herman P Van Geijn, Antoinette C Bolte, Christine Willekes, [......], Giuseppe C M Graziosi, Nico W E Schuitemaker, Jan M M Van Lith, Eline S A Van Den Akker, Addy P Drogtrop, Hendrikus J H M Van Dessel, Robbert J P Rijnders, Herman P Oosterbaan, Ben Willem J Mol, Anneke Kwee
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  ABSTRACT: To assess the cost-effectiveness of addition of ST analysis of the fetal electrocardiogram (ECG; STAN) to cardiotocography (CTG) for fetal surveillance during labor compared with CTG only. Cost-effectiveness analysis based on a randomized clinical trial on ST analysis of the fetal ECG. Obstetric departments of three academic and six general hospitals in The Netherlands. Population. Laboring women with a singleton high-risk pregnancy, a fetus in cephalic presentation, a gestational age >36 weeks and an indication for internal electronic fetal monitoring. A trial-based cost-effectiveness analysis was performed from a health-care provider perspective. Primary health outcome was the incidence of metabolic acidosis measured in the umbilical artery. Direct medical costs were estimated from start of labor to childbirth. Cost-effectiveness was expressed as costs to prevent one case of metabolic acidosis. The incidence of metabolic acidosis was 0.7% in the ST-analysis group and 1.0% in the CTG-only group (relative risk 0.70; 95% confidence interval 0.38-1.28). Per delivery, the mean costs per patient of CTG plus ST analysis (n= 2 827) were €1,345 vs. €1,316 for CTG only (n= 2 840), with a mean difference of €29 (95% confidence interval -€9 to €77) until childbirth. The incremental costs of ST analysis to prevent one case of metabolic acidosis were €9 667. The additional costs of monitoring by ST analysis of the fetal ECG are very limited when compared with monitoring by CTG only and very low compared with the total costs of delivery.
  Acta Obstetricia Et Gynecologica Scandinavica 03/2011; 90(7):772-8. · 1.77 Impact Factor
• Source

  Available from: Angelique J A Kooper

  Article: Multiplex ligation-dependent probe amplification versus karyotyping in prenatal diagnosis: the M.A.K.E. study.

  Elisabeth M A Boormans, Erwin Birnie, Hajo I Wildschut, Heleen G Schuring-Blom, Dick Oepkes, Carla A C van Oppen, Jan G Nijhuis, Merryn V E Macville, Angelique J A Kooper, Karin Huijsdens, Mariëtte V J Hoffer, Attie Go, Johan Creemers, Shama L Bhola, Katia M Bilardo, Ron Suijkerbuijk, Katelijne Bouman, Robert-Jan H Galjaard, Gouke J Bonsel, Jan Mm van Lith
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  ABSTRACT: In the past 30 years karyotyping was the gold standard for prenatal diagnosis of chromosomal aberrations in the fetus. Traditional karyotyping (TKT) has a high accuracy and reliability. However, it is labor intensive, the results take 14-21 days, the costs are high and unwanted findings such as abnormalities with unknown clinical relevance are not uncommon. These disadvantages challenged the practice of karyotyping. Multiplex ligation-dependent probe amplification (MLPA) is a new molecular genetic technique in prenatal diagnosis. Previous preclinical evidence suggests equivalence of MLPA and traditional karyotyping (TKT) regarding test performance. The proposed study is a multicentre diagnostic substitute study among pregnant women, who choose to have amniocentesis for the indication advanced maternal age and/or increased risk following prenatal screening test. In all subjects, both MLPA and karyotyping will be performed on the amniotic fluid sample. The primary outcome is diagnostic accuracy. Secondary outcomes will be maternal quality of life, women's preferences and costs. Analysis will be intention to treat and per protocol analysis. Quality of life analysis will be carried out within the study population. The study aims to include 4500 women. The study results are expected to help decide whether MLPA can replace traditional karyotyping for 'low-risk' pregnancies in terms of diagnostic accuracy, quality of life and women's preferences. This will be the first clinical study to report on all relevant aspects of the potential replacement. The protocol is registered in the clinical trial register number ISRCTN47252164.
  BMC Pregnancy and Childbirth 02/2008; 8:18. · 2.83 Impact Factor
• Chapter: Use of intra‐uterine pressure catheter (IUPC) versus external tocodynamometry (TOCO) during labour for reducing adverse outcomes

  Jannet JH Bakker, Petra F Janssen, Ben Willem J Mol, Dimitri Papatsonis, Jan MM van Lith, Joris AM van der Post