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3. Association of Timing of Plasma Transfusion With Adverse Maternal Outcomes in Women With Persistent Postpartum Hemorrhage

Author

Henriquez, D.D.C.A., Caram-Deelder, C., Cessie, S. le, Zwart, J.J., Roosmalen, J.J.M. van, Eikenboom, J.C.J., So-Osman, C., Watering, L.G. van de, Zwaginga, J.J., Koopman-van Gemert, A.W.M.M., Bloemenkamp, K.W.M., Bom, J.G. van der, Bank, C.M.C., Snuif-de Lange, Y.S., Gammeren, A.J. van, Papatsonis, D.N.M., Klinkspoor, H., Kok, M., Boer, B.A. de, Langenveld, J., Leers, M.P.G., Diris, J.H.C., Kok, R.D., Engbers, P., Hanssen, M.J.C.P., Wijngaarden, W.J. van, Schippers, D.H., Stappen, J.J. van der, Hasaart, T.H.M., Kerkhof, D.H. van de, Kok, J.B. de, Unnik, G.A. van, Kortlandt, W., Schuitemaker, N.E., Delemarre, F.M.C., Duijnhoven, H.L.P. van, Duvekot, H.J., Hogenboom, S., Kleiverda, G., Etten-van Hulst, M.J.W. van, Mirani-Oostdijk, K.P., Kampen, C. van, Weinans, M.J.N., Adriaanse, H.J., Huisjes, A.J.M., Frasa, M.A.M., Keuren, J.F.W., Meir, C.A. van, Feitsma, H., Hudig, F., Sikkema, J.M., Baas, M.I., Fouraux, M.A., Hmetz, G.C., Bijvank, B.H.N., Rondeel, H.J.M., Roelofsen, J.M.T., Doesburg-van Kleffens, M., Wit, S.C. de, Versendaal, H., Weerkamp, F., Henskens, Y.M.C., Scheepers, L.H.C.J., Ham, D.P. van der, Smit, J.W., Graaf, F. van der, Porath, M.M., Salm, P.C.M. van der, Wijnen, M. van, Pontesilli, M., Dunne, F.M. van, Ponjee, G.A.E., Post, M.S., Veen, B.S. van der, Brons, J.T.J., Slomp, J., Mare, A. de, Leyte, A., Akker, E.S.A. van den, Wet, H. de, Borden, D.M.R. van der, Bremer, H.A., Tax, G.H.M., Vries, M.J. de, Boer, K. de, Waard, H. de, Keijzer, R.H. de, Burggraaff, J.M., Pouwels, J.G.J., Gemund, N. van, Prinzen, L., Hendriks, H.A., Hermsen, B.B.J., Koehorst, S.G.A., Verhagen, T.E.M., Beek, E. van, Hackeng, C.M., Kabel, P.J., Steures, P., Dooren, I.A. van, Michielse, E.C.H.J., Chon, H., Treskes, M., Visser, H., Oostenveld, E., Peters, D.H.M., Franssen, M.T.M., Meekers, J.H., Woiski, M.D., Pampus, L.C.M. van, Oudijk, M.A., Vooght, K.M.K. de, Cikot, R.L.M., Mostert, L.J., Ceelie, H., Huijssoon, A.M.G., Groot, C.J.M. de, Visser, O., Jonker, N., Koops, A., Hooker, A., Osmanovic, N., Ulenkate, H.J.L.M., Visschers, B., Martens, G.D.M., TeMpOH-Res Grp, Athena Institute, APH - Global Health, APH - Quality of Care, Reproductive Origins of Adult Health and Disease (ROAHD), Faculteit FHML Centraal, RS: CARIM - R1.04 - Clinical thrombosis and haemostasis, MUMC+: DA CDL Algemeen (9), Med Microbiol, Infect Dis & Infect Prev, Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, RS: Carim - B04 Clinical thrombosis and Haemostasis, and Obstetrics & Gynecology more...

Subjects
Adult, medicine.medical_specialty, medicine.medical_treatment, TRACHEAL INTUBATION, Blood Component Transfusion, Time-to-Treatment, Cohort Studies, MULTIPLE IMPUTATION, DOUBLE-BLIND, Plasma, PROPENSITY SCORE ANALYSIS, SDG 3 - Good Health and Well-being, medicine, Coagulopathy, MANAGEMENT, Humans, Original Investigation, FIBRINOGEN CONCENTRATE, COAGULOPATHY, Hysterectomy, business.industry, Obstetrics, Incidence (epidemiology), Research, Incidence, Postpartum Hemorrhage, HOSPITAL CARDIAC-ARREST, Obstetrics and Gynecology, TRANEXAMIC ACID, General Medicine, Odds ratio, Puerperal Disorders, medicine.disease, Uterine atony, Online Only, BALANCE, Propensity score matching, Female, business, Cohort study
Abstract

This cohort study examines the association of timing of receipt of plasma transfusions among women experiencing persistent postpartum hemorrhage with adverse maternal outcomes., Key Points Question Is plasma transfusion within the first 60 minutes of persistent postpartum hemorrhage (PPH) associated with incidence of maternal adverse outcomes? Findings In this cohort study of 114 propensity score–matched women with persistent PPH, plasma transfusion within the first 60 minutes of persistent PPH was not associated with incidence of maternal adverse outcomes compared with no or later plasma transfusion, independent of severity of PPH at the time of plasma transfusion. Meaning These findings do not support the theory that early plasma transfusion in women with persistent PPH is better than no or later plasma transfusion., Importance Early plasma transfusion for women with severe postpartum hemorrhage (PPH) is recommended to prevent coagulopathy. However, there is no comparative, quantitative evidence on the association of early plasma transfusion with maternal outcomes. Objective To compare the incidence of adverse maternal outcomes among women who received plasma during the first 60 minutes of persistent PPH vs women who did not receive plasma for similarly severe persistent PPH. Design, Setting, and Participants This multicenter cohort study used a consecutive sample of women with persistent PPH, defined as PPH refractory to first-line measures to control bleeding, between January 1, 2011, and January 1, 2013. Time-dependent propensity score matching was used to select women who received plasma during the first 60 minutes of persistent PPH and match each of them with a woman who had shown the same severity and received the same treatment of PPH but who had not received plasma at the moment of matching. Transfusions were not guided by coagulation tests. Statistical analysis was performed from June 2018 to June 2019. Exposures Transfusion of plasma during the first 60 minutes of persistent PPH vs no or later plasma transfusion. Main Outcomes and Measures Incidence of adverse maternal outcomes, defined as a composite of death, hysterectomy, or arterial embolization. Results This study included 1216 women (mean [SD] age, 31.6 [5.0] years) with persistent PPH, of whom 932 (76.6%) delivered vaginally and 780 (64.1%) had PPH caused by uterine atony. Seven women (0.6%) died because of PPH, 62 women (5.1%) had a hysterectomy, and 159 women (13.1%) had arterial embolizations. Among women who received plasma during the first 60 minutes of persistent PPH, 114 women could be matched with a comparable woman who had not received plasma at the moment of matching. The incidence of adverse maternal outcomes was similar between the women, with adverse outcomes recorded in 24 women (21.2%) who received early plasma transfusion and 23 women (19.9%) who did not receive early plasma transfusion (odds ratio, 1.09; 95% CI, 0.57-2.09). Results of sensitivity analyses were comparable to the primary results. Conclusions and Relevance In this cohort study, initiation of plasma transfusion during the first 60 minutes of persistent PPH was not associated with adverse maternal outcomes compared with no or later plasma transfusion, independent of severity of PPH. more...

Published
2019
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4. Clinical characteristics of women captured by extending the definition of severe postpartum haemorrhage with ‘refractoriness to treatment’: a cohort study

Author

Henriquez, D.D.C.A., Gillissen, A., Smith, S.M., Cramer, R.A., Akker, T. van den, Zwart, J.J., Roosmalen, J.J.M. van, Bloemenkamp, K.W.M., Bom, J.G. van der, Adriaanse, H.J., Akker, E.S.A. van den, Baas, M.I., Bank, C.M.C., Beek, E. van, Boer, B.A. de, Boer, K. de, Borden, D.M.R. van der, Bremer, H.A., Brons, J.T.J., Burggraaff, J.M., Ceelie, H., Chon, H., Cikot, J.L.M., Delemarre, F.M.C., Diris, J.H.C., Doesburg-van Kleffens, M., Dooren, I.M.A. van, Duijnhoven, J.L.P. van, Dunn, F.M. van, Duvekot, J.J., Engbers, P., Etten-van Hulst, M.J.W. van, Feitsma, H., Fouraux, M.A., Franssen, M.T.M., Frasa, M.A.M., Gammeren, A.J. van, Gemund, N. van, Graaf, F. van der, Groot, C.J.M. de, Hackeng, C.M., Ham, D.P. van der, Hanssen, M.J.C.P., Hasaart, T.H.M., Hendriks, H.A., Henskens, Y.M.C., Hermsen, B.B.J., Hogenboom, S., Hooker, A., Hudig, F., Huijssoon, A.M.G., Huisjes, A.J.M., Jonker, N., Kabel, P.J., Kampen, C. van, Keijzer, M.H. de, Kerkhof, D.H. van de, Keuren, J.F.W., Kleiverda, G., Klinkspoor, J.H., Koehorst, S.G.A., Kok, M., Kok, R.D., Kok, J.B. de, Koops, A., Kortlandt, W., Langenveld, J., Leers, M.P.G., Leyte, A., Mare, A. de, Martens, G.D.M., Meekers, J.H., Meir, C.A. van, Metz, G.C.H., Michielse, E.C.H.J., Mostert, L.J., Bijvank, S.W.H.N., Oostenveld, E., Osmanovic, N., Oudijk, M.A., Mirani-Oostdijk, C.P., Pampus, E.C.M. van, Papatsonis, D.N.M., Peters, R.H.M., Ponjee, G.A.E., Pontesilli, M., Porath, M.M., Post, M.S., Pouwels, J.G.J., Prinzen, L., Roelofsen, J.M.T., Rondeel, J.J.M., Salm, P.C.M. van der, Scheepers, H.C.J., Schippers, D.H., Schuitemaker, N.W.E., Sikkema, J.M., Slomp, J., Smit, J.W., Snuif-de Lange, Y.S., Stappen, J.W.J. van der, Steures, P., Tax, G.H.M., Treskes, M., Ulenkate, H.J.L.M., Unnik, G.A. van, Veen, B.S. van der, Verhagen, T.E.M., Versendaal, J., Visschers, B., Visser, O., Visser, H., Vooght, K.M.K. de, Vries, M.J. de, Waard, H. de, Weerkamp, F., Weinans, M.J.N., Wet, H. de, Wijnen, M. van, Wijngaarden, W.J. van, Wit, A.C. de, Woiski, M.D., TeMpOH-1 Study Grp, Obstetrics & Gynecology, Science Communication, APH - Global Health, Athena Institute, APH - Quality of Care, Reproductive Origins of Adult Health and Disease (ROAHD), Ethics, Law & Medical humanities, Cardiology, ACS - Heart failure & arrhythmias, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), Pediatric surgery, Hematology, Faculteit FHML Centraal, RS: CARIM - R1.04 - Clinical thrombosis and haemostasis, MUMC+: DA CDL Algemeen (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), Obstetrie & Gynaecologie, and RS: Carim - B04 Clinical thrombosis and Haemostasis more...

Subjects
Male, Blood transfusion, Refractory period, medicine.medical_treatment, 030204 cardiovascular system & hematology, Severity of Illness Index, law.invention, Postpartum haemorrhage, 0302 clinical medicine, law, Pregnancy, Risk Factors, Netherlands, 030219 obstetrics & reproductive medicine, Obstetrics, Incidence, Obstetrics and Gynecology, Prognosis, Intensive care unit, Embolization, Therapeutic, PREVALENCE, Survival Rate, Female, Cohort study, Research Article, Maternal mortality, Adult, medicine.medical_specialty, Reproductive medicine, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], Hysterectomy, lcsh:Gynecology and obstetrics, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, SDG 3 - Good Health and Well-being, medicine, Humans, Blood Transfusion, lcsh:RG1-991, Retrospective Studies, SEVERE MATERNAL MORBIDITY, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Postpartum Hemorrhage, Infant, Newborn, Retrospective cohort study, Definition, Packed red blood cells, business, Maternal morbidity, Follow-Up Studies
Abstract

Background The absence of a uniform and clinically relevant definition of severe postpartum haemorrhage hampers comparative studies and optimization of clinical management. The concept of persistent postpartum haemorrhage, based on refractoriness to initial first-line treatment, was proposed as an alternative to common definitions that are either based on estimations of blood loss or transfused units of packed red blood cells (RBC). We compared characteristics and outcomes of women with severe postpartum haemorrhage captured by these three types of definitions. Methods In this large retrospective cohort study in 61 hospitals in the Netherlands we included 1391 consecutive women with postpartum haemorrhage who received either ≥4 units of RBC or a multicomponent transfusion. Clinical characteristics and outcomes of women with severe postpartum haemorrhage defined as persistent postpartum haemorrhage were compared to definitions based on estimated blood loss or transfused units of RBC within 24 h following birth. Adverse maternal outcome was a composite of maternal mortality, hysterectomy, arterial embolisation and intensive care unit admission. Results One thousand two hundred sixty out of 1391 women (90.6%) with postpartum haemorrhage fulfilled the definition of persistent postpartum haemorrhage. The majority, 820/1260 (65.1%), fulfilled this definition within 1 h following birth, compared to 819/1391 (58.7%) applying the definition of ≥1 L blood loss and 37/845 (4.4%) applying the definition of ≥4 units of RBC. The definition persistent postpartum haemorrhage captured 430/471 adverse maternal outcomes (91.3%), compared to 471/471 (100%) for ≥1 L blood loss and 383/471 (81.3%) for ≥4 units of RBC. Persistent postpartum haemorrhage did not capture all adverse outcomes because of missing data on timing of initial, first-line treatment. Conclusion The definition persistent postpartum haemorrhage identified women with severe postpartum haemorrhage at an early stage of haemorrhage, unlike definitions based on blood transfusion. It also captured a large majority of adverse maternal outcomes, almost as large as the definition of ≥1 L blood loss, which is commonly applied as a definition of postpartum haemorrhage rather than severe haemorrhage. more...

Published
2019
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5. Fluid resuscitation during persistent postpartum haemorrhage and maternal outcome: A nationwide cohort study

Author

Henriquez, D.D.C.A., Bloemenkamp, K.W.M., Loeff, R.M., Zwart, J.J., Roosmalen, J.J.M. van, Zwaginga, J.J., Bom, J.G. van der, Adriaanse, H.J., Akker, E.S.A. van den, Baas, M.I., Bank, C.M.C., Beek, E. van, Boer, B.A. de, Boer, K. de, Borden, D.M.R. van der, Bremer, H.A., Brons, J.T.J., Burggraaff, J.M., Ceelie, H., Chon, H., Cikot, J.L.M., Delemarre, F.M.C., Diris, J.H.C., Doesburg-van Kleffens, M., Dooren, I.M.A. van, Duijnhoven, J.L.P. van, Dunne, F.M. van, Duvekot, J.J., Engbers, P., Hulst, M.J.W.V., Feitsma, H., Fouraux, M.A., Franssen, M.T.M., Frasa, M.A.M., Gammeren, A.J. van, Gemund, N. van, Graaf, F. van der, Groot, C.J.M. de, Hackeng, C.M., Ham, D.P. van der, Hanssen, M.J.C.P., Hasaart, T.H.M., Hendriks, H.A., Henskens, Y.M.C., Hermsen, B.B.J., Hogenboom, S., Hooker, A., Hudig, F., Huijssoon, A.M.G., Huisjes, A.J.M., Jonker, N., Kabel, P.J., Kampen, C. van, Keijzer, M.H. de, Kerkhof, D.H. van de, Keuren, J.F.W., Kleiverda, G., Klinkspoor, J.H., Koehorst, S.G.A., Kok, M., Kok, R.D., Kok, J.B. de, Koops, A., Kortlandt, W., Langenveld, J., Leers, M.P.G., Leyte, A., Mare, A. de, Martens, G.D.M., Meekers, J.H., Meir, C.A. van, Metz, G.C.H., Michielse, E.C.H.J., Mostert, L.J., Bijvank, S.W.H.N., Oostenveld, E., Osmanovic, N., Oudijk, M.A., Mirani-Oostdijk, C.P., Pampus, E.C.M. van, Papatsonis, D.N.M., Peters, R.H.M., Ponjee, G.A.E., Pontesilli, M., Porath, M.M., Post, M.S., Pouwels, J.G.J., Prinzen, L., Roelofsen, J.M.T., Rondeel, J.J.M., Salm, P.C.M. van der, Scheepers, H.C.J., Schippers, D.H., Schuitemaker, N.W.E., Sikkema, J.M., Slomp, J., Smit, J.W., Snuif-de Lange, Y.S., Stappen, J.W.J. van der, Steures, P., Tax, G.H.M., Treskes, M., Ulenkate, H.J.L.M., Unnik, G.A. van, Veen, B.S. van der, Verhagen, T.E.M., Versendaal, J., Visschers, B., Visser, O., Visser, H., Vooght, K.M.K. de, Vries, M.J. de, Waard, H. de, Weerkamp, F., Weinans, M.J.N., Wet, H. de, Wijnen, M. van, Wijngaarden, W.J. van, Wit, A.C. de, Woiski, M.D., TeMpOH-Study Grp, APH - Quality of Care, APH - Global Health, Obstetrics & Gynecology, RS: CARIM - R1.04 - Clinical thrombosis and haemostasis, MUMC+: DA CDL Algemeen (9), Faculteit FHML Centraal, RS: Carim - B04 Clinical thrombosis and Haemostasis, Reproductive Origins of Adult Health and Disease (ROAHD), and Athena Institute more...

Subjects
Adult, medicine.medical_specialty, Resuscitation, Blood transfusion, medicine.medical_treatment, CRYSTALLOIDS, Postpartum haemorrhage, 03 medical and health sciences, RED-BLOOD-CELLS, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Interquartile range, Pregnancy, ERYTHROCYTES, medicine, Humans, Crystalloid solutions, 030212 general & internal medicine, Colloids, THROMBIN GENERATION, Netherlands, Retrospective Studies, COAGULOPATHY, 030219 obstetrics & reproductive medicine, Obstetrics, business.industry, Postpartum Hemorrhage, Obstetrics and Gynecology, Retrospective cohort study, Odds ratio, Confidence interval, Treatment Outcome, Reproductive Medicine, Fluid Therapy, TRAUMA PATIENTS, Female, Packed red blood cells, business, Cohort study
Abstract

Objective: To determine the association between increasing volumes of crystalloids and colloids administered before transfusion of packed red blood cells in women with persistent postpartum haemorrhage and adverse maternal outcomes. Study design: Retrospective cohort study in the Netherlands. Women with persistent postpartum haemorrhage and known clear fluids volume for resuscitation were included. Women who received ≤2 L of clear fluids were the reference group. We determined the effect of every additional litre of clear fluids on total blood loss, severe maternal morbidity and mortality. Results were adjusted for patient and bleeding characteristics. Results: Of the 883 included women, 199 received ≤2 L of clear fluids. Median blood loss for the reference group was 2.9 L (interquartile range 2.2–3.4). Adjusted mean difference in blood loss compared with the reference group was 0.2 L (95% confidence interval −0.1 to 0.5) for women in the >2 to ≤3 L, 0.4 L (0.1–0.7) for the >3 to ≤4 L category, 0.6 L (0.5–0.7) for the >4 to ≤5 L category, and 1.9 L (1.5–2.3) for the >5 to ≤7 L category. Adjusted odds ratios for adverse maternal outcomes were 1.0 (0.7–1.6), 1.2 (0.8–1.9), 1.8 (1.1–3.1) and 4.4 (2.6–7.5) for women in the 2 to ≤3 L category, >3 to ≤4 L, >4 to ≤5 L, and >5 to ≤7 L volume categories respectively. Results were similar in strata of different severities of bleeding. Conclusion: Clear fluids volume >4 L was independently associated with adverse maternal outcome in women with persistent postpartum haemorrhage. more...

Published
2019
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9. Clinical characteristics of women captured by extending the definition of severe postpartum haemorrhage with 'refractoriness to treatment': a cohort study

Author

Henriquez, D., Gillissen, A., Smith, S.M., Cramer, R.A., van den Akker, T., Zwart, J.J. (Joost), van Roosmalen, J.J., Bloemenkamp, KW, Bom, J.G., Adriaanse, H.J., van den Akker, E.S.A., Baas, M.I., Bank, C.M.C., Beek, E. van, de Boer, B.A.G., Boer, K. (Karin), van der Borden, D.M.R., Bremer, H.A. (Henk), Brons, J.T.J., Burggraaff, J.M. (Jan), Ceelie, H., Chon, H., Cikot, J.L.M., Delemarre, F.M.C., Diris, J.H.C., Doesburg-van Kleffens, M., van Dooren, I.M.A., van Duijnhoven, J.L.P., van Dunn, F.M., Duvekot, J.J. (Hans), Engbers, P., van Hulst, M.J.W., Feitsma, H., Fouraux, M.A., Franssen, MT, Frasa, M.A.M., van Gammeren, A.J., Gemund, N. (Nicolette) van, van der Graaf, F., Groot, C.J.M., Hackeng, C.M. (Christian), Ham, D.P. (David) van der, Hanssen, M., Hasaart, T.H.M. (Tom), Hendriks, H.A., Henskens, Y.M.C., Hermsen, B.B.J., Hogenboom, S., Hooker, A., Hudig, F, Huijssoon, A.G. (Annemarie), Huisjes, A.J.M. (Anjoke), Jonker, N., Kabel, P.J., van Kampen, C., de Keijzer, M.H., van de Kerkhof, D.H., Keuren, JFW, Kleiverda, G., Klinkspoor, J.H., Koehorst, S.G.A., Kok, M.O. (Maarten), Kok, R.D., Kok, J.B. (Jacques) de, Koops, A., Kortlandt, W. (Wouter), Langenveld, J. (J.), Leers, MPG, Leyte, A. (Anja), de Mare, A., Martens, G.D.M., Meekers, J.H., Meir, C.A. (Claudia) van, Metz, G.C.H. (Godfried), Michielse, E., Mostert, L.J., Bijvank, S., Oostenveld, E., Osmanovic, N., Oudijk, M.A. (Martijn), Mirani-Oostdijk, C.P., van Pampus, E. C. M., Papatsonis, D.N.M. (Dimitri), Peters, R.H.M., Ponjee, G.A.E. (Gabriëlle), Pontesilli, M., Porath, M. (Martina), Post, M.S., Pouwels, J.G.J., Prinzen, L., Roelofsen, J.M.T., Rondeel, J.J.M., Salm, P.C.M. (Paulien) van der, Scheepers, H.C.J. (Hubertina), Schippers, D.H. (Daniela), Schuitemaker, N.W.E. (Nico), Sikkema, J.M. (J. Marko), Slomp, J. (Jennita), Smit, J.W.A. (Jan), Snuif-de Lange, Y.S., van der Stappen, J.W.J., Steures, P. (Pieternel), Tax, G.H.M., Treskes, M., Ulenkate, H., van Unnik, G.A., van der Veen, B.S., Verhagen, T.E.M., Versendaal, J. (Johan), Visschers, B., Visser, O. (Oane), de Visser, H., De Vooght, KMK, de Vries, M.J., Waard, H. (Harm) de, Weerkamp, F. (Floor), Weinans, M.J.N. (Martin), de Wet, H., Wijnen, M. (Marit), Wijngaarden, W.J. (Wim) van, de Wit, A.C., Woiski, M.D. (Mallory), TeMp, O.H.S.G., Henriquez, D., Gillissen, A., Smith, S.M., Cramer, R.A., van den Akker, T., Zwart, J.J. (Joost), van Roosmalen, J.J., Bloemenkamp, KW, Bom, J.G., Adriaanse, H.J., van den Akker, E.S.A., Baas, M.I., Bank, C.M.C., Beek, E. van, de Boer, B.A.G., Boer, K. (Karin), van der Borden, D.M.R., Bremer, H.A. (Henk), Brons, J.T.J., Burggraaff, J.M. (Jan), Ceelie, H., Chon, H., Cikot, J.L.M., Delemarre, F.M.C., Diris, J.H.C., Doesburg-van Kleffens, M., van Dooren, I.M.A., van Duijnhoven, J.L.P., van Dunn, F.M., Duvekot, J.J. (Hans), Engbers, P., van Hulst, M.J.W., Feitsma, H., Fouraux, M.A., Franssen, MT, Frasa, M.A.M., van Gammeren, A.J., Gemund, N. (Nicolette) van, van der Graaf, F., Groot, C.J.M., Hackeng, C.M. (Christian), Ham, D.P. (David) van der, Hanssen, M., Hasaart, T.H.M. (Tom), Hendriks, H.A., Henskens, Y.M.C., Hermsen, B.B.J., Hogenboom, S., Hooker, A., Hudig, F, Huijssoon, A.G. (Annemarie), Huisjes, A.J.M. (Anjoke), Jonker, N., Kabel, P.J., van Kampen, C., de Keijzer, M.H., van de Kerkhof, D.H., Keuren, JFW, Kleiverda, G., Klinkspoor, J.H., Koehorst, S.G.A., Kok, M.O. (Maarten), Kok, R.D., Kok, J.B. (Jacques) de, Koops, A., Kortlandt, W. (Wouter), Langenveld, J. (J.), Leers, MPG, Leyte, A. (Anja), de Mare, A., Martens, G.D.M., Meekers, J.H., Meir, C.A. (Claudia) van, Metz, G.C.H. (Godfried), Michielse, E., Mostert, L.J., Bijvank, S., Oostenveld, E., Osmanovic, N., Oudijk, M.A. (Martijn), Mirani-Oostdijk, C.P., van Pampus, E. C. M., Papatsonis, D.N.M. (Dimitri), Peters, R.H.M., Ponjee, G.A.E. (Gabriëlle), Pontesilli, M., Porath, M. (Martina), Post, M.S., Pouwels, J.G.J., Prinzen, L., Roelofsen, J.M.T., Rondeel, J.J.M., Salm, P.C.M. (Paulien) van der, Scheepers, H.C.J. (Hubertina), Schippers, D.H. (Daniela), Schuitemaker, N.W.E. (Nico), Sikkema, J.M. (J. Marko), Slomp, J. (Jennita), Smit, J.W.A. (Jan), Snuif-de Lange, Y.S., van der Stappen, J.W.J., Steures, P. (Pieternel), Tax, G.H.M., Treskes, M., Ulenkate, H., van Unnik, G.A., van der Veen, B.S., Verhagen, T.E.M., Versendaal, J. (Johan), Visschers, B., Visser, O. (Oane), de Visser, H., De Vooght, KMK, de Vries, M.J., Waard, H. (Harm) de, Weerkamp, F. (Floor), Weinans, M.J.N. (Martin), de Wet, H., Wijnen, M. (Marit), Wijngaarden, W.J. (Wim) van, de Wit, A.C., Woiski, M.D. (Mallory), and TeMp, O.H.S.G. more...

Abstract

Background: The absence of a uniform and clinically relevant definition of severe postpartum haemorrhage hampers comparative studies and optimization of clinical management. The concept of persistent postpartum haemorrhage, based on refractoriness to initial first-line treatment, was proposed as an alternative to common definitions that are either based on estimations of blood loss or transfused units of packed red blood cells (RBC). We compared characteristics and outcomes of women with severe postpartum haemorrhage captured by these three types of definitions. Methods: In this large retrospective cohort study in 61 hospitals in the Netherlands we included 1391 consecutive women with postpartum haemorrhage who received either ≥4 units of RBC or a multicomponent transfusion. Clinical characteristics and outcomes of women with severe postpartum haemorrhage defined as persistent postpartum haemorrhage were compared to definitions based on estimated blood loss or transfused units of RBC within 24 h following birth. Adverse maternal outcome was a composite of maternal mortality, hysterectomy, arterial embolisation and intensive care unit admission. Results: One thousand two hundred sixty out of 1391 women (90.6%) with postpartum haemorrhage fulfilled the definition of persistent postpartum haemorrhage. The majority, 820/1260 (65.1%), fulfilled this definition within 1 h following birth, compared to 819/1391 (58.7%) applying the definition of ≥1 L blood loss and 37/845 (4.4%) applying the definition of ≥4 units of RBC. The definition persistent postpartum haemorrhage captured 430/471 adverse maternal outcomes (91.3%), compared to 471/471 (100%) for ≥1 L blood loss and 383/471 (81.3%) for ≥4 units of RBC. Persiste more...

Published
2019
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10. Clinical characteristics of women captured by extending the definition of severe postpartum haemorrhage with 'refractoriness to treatment': a cohort study

Author

Henriquez, D, Gillissen, A, Smith, SM, Cramer, RA, van den Akker, T, Zwart, JJ, van Roosmalen, JJ, Bloemenkamp, KW, Bom, JG, Adriaanse, HJ, Akker, ESA, Baas, MI, Bank, CMC, Beek, E, de Boer, BAG, Boer, K, van der Borden, DMR, Bremer, HA, Brons, JTJ, Burggraaff, JM, Ceelie, H, Chon, H, Cikot, JLM, Delemarre, FMC, Diris, JHC, Doesburg-van Kleffens, M, van Dooren, IMA, van Duijnhoven, JLP, van Dunn, FM, Duvekot, J.J., Engbers, P, Hulst, MJW, Feitsma, H, Fouraux, MA, Franssen, MT, Frasa, MAM, van Gammeren, AJ, Gemund, N, Graaf, F, Groot, CJM, Hackeng, CM, van der Ham, DP, Hanssen, M, Hasaart, THM, Hendriks, HA, Henskens, YMC, Hermsen, BBJ, Hogenboom, S, Hooker, A, Hudig, F, Huijssoon, AMG, Huisjes, AJM, Jonker, N, Kabel, PJ, van Kampen, C, de Keijzer, MH, van de Kerkhof, DH, Keuren, JFW, Kleiverda, G, Klinkspoor, JH, Koehorst, SGA, Kok, M, Kok, RD, de Kok, JB, Koops, A, Kortlandt, W, Langenveld, J, Leers, MPG, Leyte, A, de Mare, A, Martens, GDM, Meekers, JH, van Meir, CA, Metz, GCH, Michielse, E, Mostert, LJ, Bijvank, S, Oostenveld, E, Osmanovic, N, Oudijk, MA, Mirani-Oostdijk, CP, van Pampus, E C M, Papatsonis, DNM, Peters, RHM, Ponjee, GA, Pontesilli, M, Porath, MM, Post, MS, Pouwels, JGJ, Prinzen, L, Roelofsen, JMT, Rondeel, JJM, van der Salm, PCM, Scheepers, HCJ, Schippers, DH, Schuitemaker, NWE, Sikkema, JM, Slomp, J, Smit, JWA, Snuif-de Lange, YS, van der Stappen, JWJ, Steures, P, Tax, GHM, Treskes, M, Ulenkate, H, van Unnik, GA, van der Veen, BS, Verhagen, TEM, Versendaal, J, Visschers, B, Visser, O, Visser, H, De Vooght, KMK, Vries, MJ, Waard, H, Weerkamp, F, Weinans, MJN, de Wet, H, Wijnen, M (Mandy), van Wijngaarden, WJ, de Wit, AC, Woiski, MD, TeMp, OHSG, Henriquez, D, Gillissen, A, Smith, SM, Cramer, RA, van den Akker, T, Zwart, JJ, van Roosmalen, JJ, Bloemenkamp, KW, Bom, JG, Adriaanse, HJ, Akker, ESA, Baas, MI, Bank, CMC, Beek, E, de Boer, BAG, Boer, K, van der Borden, DMR, Bremer, HA, Brons, JTJ, Burggraaff, JM, Ceelie, H, Chon, H, Cikot, JLM, Delemarre, FMC, Diris, JHC, Doesburg-van Kleffens, M, van Dooren, IMA, van Duijnhoven, JLP, van Dunn, FM, Duvekot, J.J., Engbers, P, Hulst, MJW, Feitsma, H, Fouraux, MA, Franssen, MT, Frasa, MAM, van Gammeren, AJ, Gemund, N, Graaf, F, Groot, CJM, Hackeng, CM, van der Ham, DP, Hanssen, M, Hasaart, THM, Hendriks, HA, Henskens, YMC, Hermsen, BBJ, Hogenboom, S, Hooker, A, Hudig, F, Huijssoon, AMG, Huisjes, AJM, Jonker, N, Kabel, PJ, van Kampen, C, de Keijzer, MH, van de Kerkhof, DH, Keuren, JFW, Kleiverda, G, Klinkspoor, JH, Koehorst, SGA, Kok, M, Kok, RD, de Kok, JB, Koops, A, Kortlandt, W, Langenveld, J, Leers, MPG, Leyte, A, de Mare, A, Martens, GDM, Meekers, JH, van Meir, CA, Metz, GCH, Michielse, E, Mostert, LJ, Bijvank, S, Oostenveld, E, Osmanovic, N, Oudijk, MA, Mirani-Oostdijk, CP, van Pampus, E C M, Papatsonis, DNM, Peters, RHM, Ponjee, GA, Pontesilli, M, Porath, MM, Post, MS, Pouwels, JGJ, Prinzen, L, Roelofsen, JMT, Rondeel, JJM, van der Salm, PCM, Scheepers, HCJ, Schippers, DH, Schuitemaker, NWE, Sikkema, JM, Slomp, J, Smit, JWA, Snuif-de Lange, YS, van der Stappen, JWJ, Steures, P, Tax, GHM, Treskes, M, Ulenkate, H, van Unnik, GA, van der Veen, BS, Verhagen, TEM, Versendaal, J, Visschers, B, Visser, O, Visser, H, De Vooght, KMK, Vries, MJ, Waard, H, Weerkamp, F, Weinans, MJN, de Wet, H, Wijnen, M (Mandy), van Wijngaarden, WJ, de Wit, AC, Woiski, MD, and TeMp, OHSG more...

Published
2019

12. Sarcoglycanopathies in Dutch patients with autosomal recessive limb girdle muscular dystrophy

Author

Ginjaar, H.B., primary, vd Kooi, A., additional, Ceelie, H., additional, Kneppers, A.L.J., additional, Barth, P.G., additional, Busch, H.F.M., additional, Wokke, J.H.J., additional, Kerkhoff, H., additional, Broere, D., additional, Anderson, L.V.B., additional, Bönnemann, C.G., additional, Jeanpierre, M., additional, Bakker, E., additional, de Visser, M., additional, and v Ommen, G.J.B., additional more...

Published
1997
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14. Type of D-dimer assay determines the diagnostic yield of computed tomography in patients suspected for pulmonary embolism.

Author

Assmann JLJC, van Gammeren AJ, Sprenger RA, de Wit S, Ceelie H, Leebeek FWG, and Schellings MWM

Abstract

Background: Pulmonary embolism (PE) is a life-threatening condition with high morbidity and mortality. The diagnosis of PE is challenging due to nonspecific symptoms, making reliable diagnostic tools essential. This study addresses the clinical impact of interassay variability in D-dimer measurements on the utilization and diagnostic yield of computed tomography pulmonary angiography (CTPA)., Objectives: To investigate the effect of different D-dimer assays on the decision to perform CTPA and the subsequent diagnostic yield in patients with suspected PE., Methods: This retrospective, multicenter cohort study analyzed data from 3 teaching hospitals in the southwest region of the Netherlands, covering the years 2018, 2019, 2022, and 2023. The study included data from 40,096 clinically requested D-dimer results and 11,372 CTPA records of patients with suspected PE. The D-dimer assays used were the Roche Tina-quant and Siemens INNOVANCE., Results: The study found significant differences in CTPA utilization and diagnostic yield based on the D-dimer assay used. In 2018 to 2019, hospitals using the Roche Tina-quant assay ordered 21% fewer CTPA scans and had a 9% higher positivity rate compared with those using the Siemens INNOVANCE assay., Conclusion: The findings highlight the necessity for assay-specific cutoff values or, ideally, the standardization of the D-dimer assay to optimize the accuracy and efficiency of PE diagnosis. This study demonstrates that the choice of D-dimer assay significantly influences the clinical management of suspected PE, affecting both the number of CTPA scans performed and the positivity rate of these scans. Implementing assay-specific cutoff values or standardization of the D-dimer assay could reduce unnecessary CTPA scans, minimize patient exposure to radiation, and lower healthcare costs. These results advocate enhanced collaboration between clinicians and laboratory specialists to accurately interpret D-dimer results within the context of the specific assay used. Future research should validate these findings in prospective studies and explore standardized protocols that account for interassay variability., (© 2024 The Authors.) more...

Published
2024
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16. The alternative Thomas-plot: A new tool for effective anemia diagnostics.

Author

de Leur K, Pouw NMC, Lopez J, Waals-Prinzen L, Ceelie H, and van der Zwan-van Beek EM

Subjects
Humans, Iron metabolism, Ferritins, Hemoglobins analysis, Transferrin, Receptors, Transferrin, Chronic Disease, Anemia diagnosis, Anemia, Iron-Deficiency diagnosis
Abstract

Introduction: The Thomas-plot has proven to be a helpful tool to discriminate between different types of anemia. This plot combines the reticulocyte hemoglobin content (Ret-He) with the soluble transferrin receptor (sTfR)/log ferritin (fer) ratio. In this study, we designed an alternative Thomas-plot in which Ret-He is combined with the transferrin (Tf)/log ferritin ratio. We validated both Thomas-plots in a population of anemic patients and compared the performance to the current laboratory diagnostics of anemia., Methods: A total of 536 anemic patients were included. The first 188 patients were used to generate ROC curves to define the optimal cut-off values for both Thomas-plots. With the following 348 patients included we studied the performance of the alternative and classical Thomas-plots compared to current anemia diagnostics., Results: Cut-off values were defined (Ret-He: 31.2 pg, sTfR/log(fer): 0.91, and Tf/log(fer): 1.71). With both Thomas-plots the amount of e causa ignota (ECI) cases dropped from 39% to 27%. A more in depth analysis on the iron status of anemia of chronic disease (ACD) patients and a subdivision between latent and classical iron deficiencies could be made with the help of both plots. A shift from classical iron deficiency anemia (IDA) cases according to the classical Thomas-plot toward functional IDA according to the alternative Thomas-plot was observed., Conclusion: The alternative Thomas-plot is an effective tool that gives a more in depth view on the iron status of anemic patients. In addition, it is easier to implement due to the use of transferrin rather than the soluble transferrin receptor., (© 2022 John Wiley & Sons Ltd.) more...

Published
2023
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17. Interlaboratory Reproducibility of Blood Morphology Using the Digital Microscope.

Author

Riedl JA, Stouten K, Ceelie H, Boonstra J, Levin MD, and van Gelder W

Subjects
Humans, Image Cytometry instrumentation, Image Processing, Computer-Assisted, Microscopy instrumentation, Reproducibility of Results, Blood Cells classification, Blood Cells cytology, Image Cytometry methods, Microscopy methods
Abstract

Differential counting of peripheral blood cells is an important diagnostic tool. However, manual morphological analysis using the microscope is time-consuming and requires highly trained personnel. The digital microscope is capable of performing an automated peripheral blood cell differential, which is as reliable as manual classification by experienced laboratory technicians. To date, information concerning the interlaboratory variation and quality of cell classification by independently operated digital microscopy systems is limited. We compared four independently operated digital microscope systems for their ability in classifying the five main peripheral blood cell classes and detection of blast cells in 200 randomly selected samples. Set against the averaged results, the R(2) values for neutrophils ranged between 0.90 and 0.96, for lymphocytes between 0.83 and 0.94, for monocytes between 0.77 and 0.82, for eosinophils between 0.70 and 0.78, and for blast cells between 0.94 and 0.99. The R(2) values for the basophils were between 0.28 and 0.34. This study shows that independently operated digital microscopy systems yield reproducible preclassification results when determining the percentages of neutrophils, eosinophils, lymphocytes, monocytes, and blast cells in a peripheral blood smear. Detection of basophils was hampered by the low incidence of this cell class in the samples., (© 2015 Society for Laboratory Automation and Screening.) more...

Published
2015
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18. Determination of anti-endomysium IgA antibodies in the diagnosis of celiac disease: comparison of a novel ELISA-based assay with conventional immunofluorescence.

Author

Poland DC, Ceelie H, Dinkelaar RB, and Beijer C

Subjects
Antibodies, Anti-Idiotypic immunology, Celiac Disease blood, Humans, Immunoglobulin A immunology, Muscle Fibers, Skeletal immunology, Nephelometry and Turbidimetry methods, Sensitivity and Specificity, Antibodies, Anti-Idiotypic blood, Celiac Disease immunology, Enzyme-Linked Immunosorbent Assay methods, Fluorescent Antibody Technique methods, Immunoglobulin A blood, Reticulin immunology
Abstract

Aim: To evaluate the novel anti-endomysium (anti-EMA) detection based on ELISA., Methods: Anti-EMA IgA was measured by a novel ELISA in 196 patients with gastrointestinal symptoms and suspected mal-absorption. Data were compared with those obtained by the conventional IF test., Results: A good concordance of 98% was found between these two assays. In sera of 161 patients (82%) both assays tested negative whereas in sera of 31 patients (16%) both assays tested positive for the presence of anti-EMA antibodies. Discrepancies between EMA-ELISA and EMA-immunofluorescence (IF) were found in only 4 patients (2%)., Conclusion: This ELISA can replace IF for the detection of anti-EMA antibodies and provide clinicians with an excellent tool to screen for celiac disease in patients with gastrointestinal complaints. more...

Published
2006
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