Guid S Oei

Publications (3)6.38 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: Objective. 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. Design. Cost-effectiveness analysis based on a randomized clinical trial on ST analysis of the fetal ECG. Setting. 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 >36weeks and an indication for internal electronic fetal monitoring. Methods. A trial-based cost-effectiveness analysis was performed from a health-care provider perspective. Main Outcome Measures. 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. Results. 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. Conclusions. 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 06/2011; 90(7):772 - 778. · 1.77 Impact Factor
• 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
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  Available from: Simone M Kuppens

  Article: Maternal thyroid function and the outcome of external cephalic version: a prospective cohort study.

  Simone M Kuppens, Libbe Kooistra, Tom H Hasaart, Riet W van der Donk, Huib L Vader, Guid S Oei, Victor J Pop
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  ABSTRACT: To investigate the relation between maternal thyroid function and the outcome of external cephalic version (ECV) in breech presentation. Prospective cohort study in 141 women (≥ 35 weeks gestation) with a singleton fetus in breech. Blood samples for assessing thyroid function were taken prior to ECV. Main outcome measure was the relation between maternal thyroid function and ECV outcome indicated by post ECV ultrasound. ECV success rate was 77/141 (55%), 41/48 (85%) in multipara and 36/93 (39%) in primipara. Women with a failed ECV attempt had significantly higher TSH concentrations than women with a successful ECV (p < 0.001). Multiple logistic regression showed that TSH (OR: 0.52, 95% CI: 0.30-0.90), nulliparity (OR: 0.11, 95% CI: 0.03-0.36), frank breech (OR: 0.30, 95% CI: 0.10-0.93) and placenta anterior (OR: 0.31, 95% CI: 0.11-0.85) were independently related to ECV success. Higher TSH levels increase the risk of ECV failure. ClinicalTrials.gov: NCT00516555.
  BMC Pregnancy and Childbirth 01/2011; 11:10. · 2.83 Impact Factor