Abstract:
BACKGROUND:Preeclampsia and HELLP syndrome may have serious consequences for both mother and fetus. Women who have suffered from preeclampsia or the HELLP syndrome, have an increased risk of developing preeclampsia in a subsequent pregnancy. However, most women will develop no or only minor complications. In this study, we intend to determine cost-effectiveness of recurrence risk guided care versus care as usual in pregnant women with a history of early-onset preeclampsia. METHODS/DESIGN:We developed a prediction model to estimate the individual risk of recurrence of early-onset preeclampsia and the HELLP syndrome. In a before-after study, pregnant women with preeclampsia or HELLP syndrome in their previous pregnancy receiving care as usual (before introduction of the prediction model) will be compared with women receiving recurrence risk guided care (after introduction of the prediction model). Eligible and pregnant women will be recruited at six university hospitals and seven large non-university tertiary referral hospitals in the Netherlands. The primary outcome measure is the recurrence of early-onset preeclampsia or HELLP syndrome in women allocated to the regular monitoring group. For the economic evaluation, a modelling approach will be used. Costs and effects of recurrence risk guided care with those of care as usual will be compared by means of a decision model. Two incremental cost-effectiveness ratios will be calculated: 1) cost per Quality Adjusted Life Year (mother unit of analysis) and 2) cost per live born child (child unit of analysis). DISCUSSION:This is, to our knowledge, the first study that evaluates prospectively the efficacy of a multivariable prediction rule for recurrent hypertensive disease in pregnancy. Results of this study could either be integrated into the current guideline on Hypertensive Disorders in Pregnancy, or be used to develop a new guideline.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
Delahaije DH,van Kuijk SM,Dirksen CD,Sep SJ,Peeters LL,Spaanderman ME,Bruinse HW,de Wit-Zuurendonk LD,van der Post JA,Duvekot JJ,van Eyck J,van Pampus MG,van der Hoeven MA,Smits LJdoi
10.1186/1471-2393-10-60subject
Has Abstractpub_date
2010-10-11 00:00:00pages
60issn
1471-2393pii
1471-2393-10-60journal_volume
10pub_type
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pub_type: 杂志文章,多中心研究
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,评审
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更新日期:2017-02-20 00:00:00
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更新日期:2017-11-13 00:00:00
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pub_type: 杂志文章
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