The Perinatal Database of the Netherlands

Elferink-Stinkens, P.M.; Hemel, O.J.S. Van; Brand, Ronald; Merkus, J.M.W.M.

doi:10.1016/s0301-2115(00)00295-5

Cited by 14 publications

(8 citation statements)

References 18 publications

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“…Detailed descriptions of PRN are provided elsewhere. 6 Briefly, PRN is composed of three databases-primary midwifery care, hospital-based obstetric care and paediatric care-and the three databases are linked through a validated method. 7 We used all data from 2007 to 2010.…”

Section: Methodsmentioning

confidence: 99%

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Caesarean section rates in subgroups of women and perinatal outcomes

Zhang

Geerts

Hukkelhoven

et al. 2015

BJOG

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Objectives To identify factors that are associated with a relatively low caesarean section (CS) rate by examining the CS rate in various subgroups in the Netherlands.Design Cross-sectional analysis.Settings the Netherlands. Methods A modified classification system for CS was used to categorise all women into ten groups. Labour management, mode of delivery, maternal and neonatal morbidity and mortality were assessed according to these ten groups.Main outcome measures Caesarean section, labour induction, instrumental delivery, postpartum haemorrhage, perineal laceration, duration of second stage of labour, Apgar score, fetal and neonatal mortality.Results Total CS rate was 15.6%. Term, nulliparous and parous women with a singleton pregnancy of a fetus in cephalic position and spontaneous onset of labour had CS rates of 9.6 and 1.9% and instrumental birth rates of 19.4 and 2.4%, respectively; 17.3% of births were induced. Among women with a previous CS and term, singleton pregnancies with a fetus in cephalic presentation, 71% had trial of labour, of which 75% had a successful vaginal birth. Of women with multiple gestation, 43% had CS. Women with CS due to 'failure to progress' in the second stage of labour had a median duration of second-stage pushing of almost 2 hours in nulliparas and >90 minutes in parous women.Conclusions Several obstetric practice patterns may have contributed to the relatively low overall CS rate in the Netherlands: a relatively low CS rate in term, singleton pregnancies of a fetus in cephalic position and spontaneous onset of labour, relatively low rate of labour induction, a high rate of a trial of labour after a previous CS, the use of vacuum and forceps, and a high proportion of women being taken care of by midwives.Keywords Caesarean section, classification, labour, maternal, the Netherlands.Tweetable abstract The Netherlands has several practice patterns that may have contributed to its relatively low CS rate.

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Section: Methodsmentioning

confidence: 99%

“…Underreporting of late neonatal death was a serious concern in the database. 6 A more recent study 12 showed that 7.1% of late perinatal deaths were not reported in the PRN. Although only 48-68% of paediatric practices participated in PRN, 100% of academic paediatric practices are included (www.perinatreg.nl).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Caesarean section rates in subgroups of women and perinatal outcomes

Zhang

Geerts

Hukkelhoven

et al. 2015

BJOG

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“…This includes both deliveries under the supervision of midwives and general practitioners (low risk: primary care) and deliveries under the responsibility of gynaecologists (high risk: secondary care). Because only a few secondary care departments with a small number of deliveries do not participate, the registry covers almost 100% of secondary care deliveries 5 . All infants in breech position are born under secondary care.…”

Section: Methodsmentioning

confidence: 99%

The effect of the Term Breech Trial on medical intervention behaviour and neonatal outcome in The Netherlands: an analysis of 35,453 term breech infants

Rietberg

Elferink-Stinkens

Visser

2005

BJOG

246

118

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Objective To examine the effects of the Term Breech Trial on the medical behaviour of Dutch obstetricians and on neonatal outcomes. Design Retrospective observational study.Setting The Netherlands.Population Infants born at term in breech presentation in the Netherlands between 1998 and 2002, with birthweights 4000 g (n ¼ 33,024) and >4000 g (n ¼ 2429), respectively. Multiple pregnancies, antenatal death and major congenital malformations were excluded. Methods Data derived from the Dutch Perinatal Database were used to compare modes of delivery and neonatal outcome of infants born in breech position in the 33 months preceding publication of the Term Breech Trial and in the 25 months thereafter. Main outcome measures Incidence of planned and emergency caesarean section, vaginal breech delivery, perinatal death, 5-minute Apgar score and birth trauma. Results Within two months after publication of the Term Breech Trial, the overall caesarean rate increased from 50% to 80% and has remained stable thereafter. In the group of infants 4000 g, this was associated with a significant decrease of perinatal mortality from 0.35% to 0.18%, a decrease of the incidence of a 5-minute Apgar score <7 from 2.4% to 1.1% and a decrease of birth trauma from 0.29% to 0.08%. In the (small) group of infants >4000 g, a similar trend was observed. Conclusions The Term Breech Trial has resulted in an exceptionally rapid change in medical behaviour by Dutch obstetricians. This change was followed by improved neonatal outcome.

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“…The sample size was calculated based on estimations contained in previous reports on the future of Dutch obstetric practice 28 and based on data of the Perinatal Database of the Netherlands (LVR). 29 Both the reports are based on detailed data regarding pregnancy, birth and infant condition from 95% of Dutch midwives and obstetricians. For an expected difference favouring sweeping of 10%, i.e.…”

Section: Methodsmentioning

confidence: 99%

Membrane sweeping and prevention of post‐term pregnancy in low‐risk pregnancies: a randomised controlled trial

Miranda

Bom

Bonsel³

et al. 2006

BJOG

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Objective To evaluate the effectiveness of membrane sweeping at 41 weeks for the prevention of post-term pregnancy.Design A multicentre randomised controlled trial.Setting Fifty-one primary care midwifery practices in the Netherlands.Population A total of 742 low-risk pregnant women at 41 weeks of gestation.Methods Participants were randomly assigned to serial sweeping of the membranes (every 48 hours until labour commenced up to 42 weeks of gestation) or no intervention.Main outcome measures Post-term pregnancy ( ‡42 weeks). Subgroup analyses were performed on nulliparous and parous women. Secondary outcomes included adverse effects. NNT 6 [95% CI 4-6]). Adverse effects were similar in both the groups except for uncomplicated bleeding, which was reported more frequently in the sweeping group. Other obstetric outcomes and indicators of neonatal morbidity were similar in both groups. There were two perinatal deaths in each group.Conclusions Membrane sweeping at 41 weeks can substantially reduce the proportion of women with post-term pregnancy.

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The Perinatal Database of the Netherlands

Cited by 14 publications

References 18 publications

Caesarean section rates in subgroups of women and perinatal outcomes

Caesarean section rates in subgroups of women and perinatal outcomes

The effect of the Term Breech Trial on medical intervention behaviour and neonatal outcome in The Netherlands: an analysis of 35,453 term breech infants

Membrane sweeping and prevention of post‐term pregnancy in low‐risk pregnancies: a randomised controlled trial

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