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5. Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands

Author

Verfaille, Viki, de Jonge, Ank, Mokkink, Lidwine, Westerneng, Myrte, van der Horst, Henriëtte, Jellema, Petra, Franx, Arie, Bais, Joke M J, Bonsel, Gouke J., Bosmans, Judith E, van Dillen, Jeroen, van Duijnhoven, Noortje T L, Grobman, William A., Groen, Henk, Hukkelhoven, Chantal W P M, Klomp, Trudy, Kok, Marjolein, de Kroon, Marlou L., Kruijt, Maya, Kwee, Anneke, Ledda, Sabina, Lafeber, Harry N., van Lith, Jan M, Mol, Ben Willem, Molewijk, Bert, Nieuwenhuijze, Marianne, Oei, Guid, Oudejans, Cees, Paarlberg, K. Marieke, Pajkrt, Eva, Papageorghiou, Aris T., Reddy, Uma M., de Reu, Paul A O M, Rijnders, Marlies E. B., de Roon-Immerzeel, Alieke, Scheele, Connie, Scherjon, Sicco A, Snijders, Rosalinde, Teunissen, Pim W., Torij, Hanneke W., Twisk, Jos Wr, Zeeman, Kristel C., Zhang, Jun, and IRIS study group

Subjects
Practice guideline, Prenatal ultrasonography, Uniform approach, Delphi technique, Fetal growth restriction, Obstetrics and Gynaecology, Journal Article, Intrauterine growth restriction, Collaboration
Abstract

Background: Screening for, diagnosis and management of intrauterine growth restriction (IUGR) is often performed in multidisciplinary collaboration. However, variation in screening methods, diagnosis and management of IUGR may lead to confusion. In the Netherlands two monodisciplinary guidelines on IUGR do not fully align. To facilitate effective collaboration between different professionals in perinatal care, we undertook a Delphi study with uniform recommendations as our primary result, focusing on issues that are not aligned or for which specifications are lacking in the current guidelines. Methods: We conducted a Delphi study in three rounds. A purposively sampled selection of 56 panellists participated: 27 representing midwife-led care and 29 obstetrician-led care. Consensus was defined as agreement between the professional groups on the same answer and among at least 70% of the panellists within groups. Results: Per round 51 or 52 (91% - 93%) panellists responded. This has led to consensus on 27 issues, leading to four consensus based recommendations on screening for IUGR in midwife-led care and eight consensus based recommendations on diagnosis and eight on management in obstetrician-led care. The multidisciplinary project group decided on four additional recommendations as no consensus was reached by the panel. No recommendations could be made about induction of labour versus expectant monitoring, nor about the choice for a primary caesarean section. Conclusions: We reached consensus on recommendations for care for IUGR within a multidisciplinary panel. These will be implemented in a study on the effectiveness and cost-effectiveness of routine third trimester ultrasound for monitoring fetal growth. Research is needed to evaluate the effects of implementation of these recommendations on perinatal outcomes. Trial registration:NTR4367.

Published
2017

7. Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands

Author

UMC Utrecht, DV&B-MT-Medisch, Brain, Circulatory Health, Child Health, Geboortecentrum voorzitterschap, Other research (not in main researchprogram), MS Verloskunde, Verfaille, Viki, de Jonge, Ank, Mokkink, Lidwine, Westerneng, Myrte, van der Horst, Henriëtte, Jellema, Petra, Franx, Arie, Bais, Joke M J, Bonsel, Gouke J., Bosmans, Judith E, van Dillen, Jeroen, van Duijnhoven, Noortje T L, Grobman, William A., Groen, Henk, Hukkelhoven, Chantal W P M, Klomp, Trudy, Kok, Marjolein, de Kroon, Marlou L., Kruijt, Maya, Kwee, Anneke, Ledda, Sabina, Lafeber, Harry N., van Lith, Jan M, Mol, Ben Willem, Molewijk, Bert, Nieuwenhuijze, Marianne, Oei, Guid, Oudejans, Cees, Paarlberg, K. Marieke, Pajkrt, Eva, Papageorghiou, Aris T., Reddy, Uma M., de Reu, Paul A O M, Rijnders, Marlies E. B., de Roon-Immerzeel, Alieke, Scheele, Connie, Scherjon, Sicco A, Snijders, Rosalinde, Teunissen, Pim W., Torij, Hanneke W., Twisk, Jos Wr, Zeeman, Kristel C., Zhang, Jun, IRIS study group, UMC Utrecht, DV&B-MT-Medisch, Brain, Circulatory Health, Child Health, Geboortecentrum voorzitterschap, Other research (not in main researchprogram), MS Verloskunde, Verfaille, Viki, de Jonge, Ank, Mokkink, Lidwine, Westerneng, Myrte, van der Horst, Henriëtte, Jellema, Petra, Franx, Arie, Bais, Joke M J, Bonsel, Gouke J., Bosmans, Judith E, van Dillen, Jeroen, van Duijnhoven, Noortje T L, Grobman, William A., Groen, Henk, Hukkelhoven, Chantal W P M, Klomp, Trudy, Kok, Marjolein, de Kroon, Marlou L., Kruijt, Maya, Kwee, Anneke, Ledda, Sabina, Lafeber, Harry N., van Lith, Jan M, Mol, Ben Willem, Molewijk, Bert, Nieuwenhuijze, Marianne, Oei, Guid, Oudejans, Cees, Paarlberg, K. Marieke, Pajkrt, Eva, Papageorghiou, Aris T., Reddy, Uma M., de Reu, Paul A O M, Rijnders, Marlies E. B., de Roon-Immerzeel, Alieke, Scheele, Connie, Scherjon, Sicco A, Snijders, Rosalinde, Teunissen, Pim W., Torij, Hanneke W., Twisk, Jos Wr, Zeeman, Kristel C., Zhang, Jun, and IRIS study group

Published
2017

9. Effectiveness and cost-effectiveness of routine third trimester ultrasound screening for intrauterine growth restriction : Study protocol of a nationwide stepped wedge cluster-randomized trial in The Netherlands (The IRIS Study)

Author

Henrichs, Jens, Verfaille, Viki, Viester, Laura, Westerneng, Myrte, Molewijk, Bert, Franx, Arie, van der Horst, Henriette, Bosmans, Judith E., de Jonge, Ank, Jellema, Petra, van Baar, Anneloes L., Bais, Joke, Bonsel, Gouke J., van Dillen, Jeroen, van Duijnhoven, Noortje T L, Grobman, William A., Groen, Henk, Hukkelhoven, Chantal W P M, Klomp, Trudy, Kok, Marjolein, de Kroon, Marlou L., Kruijt, Maya, Kwee, Anneke, Ledda, Sabina, Lafeber, Harry N., van Lith, Jan M., Mol, Ben Willem, Nieuwenhuijze, Marianne, Oei, Guid, Oudejans, Cees, Marieke Paarlberg, K., Pajkrt, Eva, Papageorghiou, Aris T., Reddy, Uma M., De Reu, Paul A O M, Rijnders, Marlies, de Roon-Immerzeel, Alieke, Scheele, Connie, Scherjon, Sicco A., Snijders, Rosalinde, Spaanderman, Marc E., Teunissen, Pim W., Torij, Hanneke W., Vrijkotte, Tanja G., Twisk, Jos, Zeeman, Kristel C., Zhang, Jun, {collab} The IRIS Study Group, The IRIS Study Group, Henrichs, Jens, Verfaille, Viki, Viester, Laura, Westerneng, Myrte, Molewijk, Bert, Franx, Arie, van der Horst, Henriette, Bosmans, Judith E., de Jonge, Ank, Jellema, Petra, van Baar, Anneloes L., Bais, Joke, Bonsel, Gouke J., van Dillen, Jeroen, van Duijnhoven, Noortje T L, Grobman, William A., Groen, Henk, Hukkelhoven, Chantal W P M, Klomp, Trudy, Kok, Marjolein, de Kroon, Marlou L., Kruijt, Maya, Kwee, Anneke, Ledda, Sabina, Lafeber, Harry N., van Lith, Jan M., Mol, Ben Willem, Nieuwenhuijze, Marianne, Oei, Guid, Oudejans, Cees, Marieke Paarlberg, K., Pajkrt, Eva, Papageorghiou, Aris T., Reddy, Uma M., De Reu, Paul A O M, Rijnders, Marlies, de Roon-Immerzeel, Alieke, Scheele, Connie, Scherjon, Sicco A., Snijders, Rosalinde, Spaanderman, Marc E., Teunissen, Pim W., Torij, Hanneke W., Vrijkotte, Tanja G., Twisk, Jos, Zeeman, Kristel C., Zhang, Jun, and {collab} The IRIS Study Group, The IRIS Study Group

Published
2016

12. Effectiveness and cost-effectiveness of routine third trimester ultrasound screening for intrauterine growth restriction

Author

Henrichs, Jens, Verfaille, Viki, Viester, Laura, Westerneng, Myrte, Molewijk, Bert, Franx, Arie, van der Horst, Henriette, Bosmans, Judith E., de Jonge, Ank, Jellema, Petra, van Baar, Anneloes L., Bais, Joke, Bonsel, Gouke J., van Dillen, Jeroen, van Duijnhoven, Noortje T L, Grobman, William A., Groen, Henk, Hukkelhoven, Chantal W P M, Klomp, Trudy, Kok, Marjolein, de Kroon, Marlou L., Kruijt, Maya, Kwee, Anneke, Ledda, Sabina, Lafeber, Harry N., van Lith, Jan M., Mol, Ben Willem, Nieuwenhuijze, Marianne, Oei, Guid, Oudejans, Cees, Marieke Paarlberg, K., Pajkrt, Eva, Papageorghiou, Aris T., Reddy, Uma M., De Reu, Paul A O M, Rijnders, Marlies, de Roon-Immerzeel, Alieke, Scheele, Connie, Scherjon, Sicco A., Snijders, Rosalinde, Spaanderman, Marc E., Teunissen, Pim W., Torij, Hanneke W., Vrijkotte, Tanja G., Twisk, Jos, Zeeman, Kristel C., Zhang, Jun, {collab} The IRIS Study Group, The IRIS Study Group, Midwifery Science, EMGO - Quality of care, Ethics, Law & Medical humanities, General practice, Development and Treatment of Psychosocial Problems, Leerstoel Baar, Health Economics and Health Technology Assessment, EMGO+ - Mental Health, Value, Affordability and Sustainability (VALUE), Reproductive Origins of Adult Health and Disease (ROAHD), Public Health Research (PHR), Other departments, ARD - Amsterdam Reproduction and Development, Obstetrics and Gynaecology, APH - Amsterdam Public Health, Public and occupational health, and Papageorghiou, A

Subjects
Pediatrics, Cost effectiveness, Cost-Benefit Analysis, law.invention, Study Protocol, 0302 clinical medicine, Pregnancy Outcome/economics, Randomized controlled trial, Clinical Protocols, law, Pregnancy, Obstetrics and Gynaecology, Prenatal, Cluster Analysis, 030212 general & internal medicine, Cluster randomised controlled trial, Non-U.S. Gov't, Qualitative Research, Netherlands, Ultrasonography, 030219 obstetrics & reproductive medicine, Fetal Growth Retardation, Obstetrics, Prenatal/economics, Research Support, Non-U.S. Gov't, Pregnancy Outcome, Obstetrics and Gynecology, Fetal Growth Retardation/diagnostic imaging, Randomized Controlled Trial, Apgar score, Female, Pregnancy Trimester, Quality-Adjusted Life Years, Adult, medicine.medical_specialty, Pregnancy Trimester, Third, Third trimester ultrasonography, Research Support, Midwifery, Ultrasonography, Prenatal/economics, Ultrasonography, Prenatal, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, SDG 3 - Good Health and Well-being, medicine, Journal Article, Humans, Fundal height, Third, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Perinatal outcome, medicine.disease, Intrauterine growth retardation, Quality-adjusted life year, Bronchopulmonary dysplasia, Quality of Life, business
Abstract

Contains fulltext : 172417.pdf (Publisher’s version ) (Open Access) BACKGROUND: Intrauterine growth retardation (IUGR) is a major risk factor for perinatal mortality and morbidity. Thus, there is a compelling need to introduce sensitive measures to detect IUGR fetuses. Routine third trimester ultrasonography is increasingly used to detect IUGR. However, we lack evidence for its clinical effectiveness and cost-effectiveness and information on ethical considerations of additional third trimester ultrasonography. This nationwide stepped wedge cluster-randomized trial examines the (cost-)effectiveness of routine third trimester ultrasonography in reducing severe adverse perinatal outcome through subsequent protocolized management. METHODS: For this trial, 15,000 women with a singleton pregnancy receiving care in 60 participating primary care midwifery practices will be included at 22 weeks of gestation. In the intervention (n = 7,500) and control group (n = 7,500) fetal growth will be monitored by serial fundal height assessments. All practices will start offering the control condition (ultrasonography based on medical indication). Every three months, 20 practices will be randomized to the intervention condition, i.e. apart from ultrasonography if indicated, two routine ultrasound examinations will be performed (at 28-30 weeks and 34-36 weeks). If IUGR is suspected, both groups will receive subsequent clinical management as described in the IRIS study protocol that will be developed before the start of the trial. The primary dichotomous clinical composite outcome is 'severe adverse perinatal outcome' up to 7 days after birth, including: perinatal death; Apgar score

Published
2016

13. Modulation of CYP1A1 by PKC Inhibitors and TPA Pre-Treatments in MH1C1 Rat Hepatoma Cells Exposed to 3 -Methylcholanthrene

Author

De Pascale, Clara, primary, Domenicotti, Cinzia, additional, Nitti, Mariapaola, additional, Marengo, Barbara, additional, Catalano, Mariafrancesca, additional, Scanarotti, Chiara, additional, Sanguineti, Roberta, additional, Siri, Maura, additional, Ledda, Sabina, additional, Penco, Susanna, additional, and Bassi, Anna M., additional

Published
2009
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16. Role of the kinase activation loop on protein kinase C theta activity and intracellular localisation.

Author

Sparatore B, Passalacqua M, Pedrazzi M, Ledda S, Patrone M, Gaggero D, Pontremoli S, and Melloni E

Subjects
Animals, Catalysis, Cell Fractionation, Cell Line, Tumor, Enzyme Activation, Golgi Apparatus, Mice, Microscopy, Fluorescence, Phosphorylation, Protein Kinase C-theta, Protein Structure, Tertiary, Protein Transport, Threonine metabolism, Isoenzymes metabolism, Protein Kinase C metabolism
Abstract

Multiple protein kinase C (PKC) theta species, identified in an erythroleukaemia cell line, have been characterised in terms of their molecular properties and intracellular distribution. PKCthetas localised in the detergent-soluble cell fraction have an Mr of 76 kDa (theta-76) and contain Thr538 or pThr538 in the kinase activation loop. In contrast, PKCthetas localised in the Golgi complex have an Mr of 85 kDa (theta-85) and, although unphosphorylated at Thr538, are catalytically active. Strikingly, only theta-76 species which are unphosphorylated at Thr538 can undergo autocatalytic conversion to theta-85. Moreover, a Thr538-->Ala PKCtheta mutant is constitutively localised in the Golgi complex, confirming that changes in the phosphorylation state of this residue play a pivotal role in the overall control of catalytic properties and localisation of this kinase.

Published
2003
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