Ben Willem Mol

Accuracy of serum uric acid determination in predicting pre-eclampsia: a systematic review.

Background. Pre‐eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early prediction of pre‐eclampsia may be used to target high‐risk women for effective preventative treatments. Hyperuricemia is associated with pre‐eclampsia and it has been tested in early pregnancy for its ability to predict the later onset of the disease.

Effect of Interpregnancy Interval on Adverse Perinatal Outcomes in Southern China: A Retrospective Cohort Study, 2000-2015.

BACKGROUND In January 2016, a universal two-child policy was introduced in China. The association of interpregnancy interval (IPI) with perinatal outcomes has not previously been assessed among Chinese population. We investigated the effect of IPI after live birth on the risks of preterm delivery, and small, and large for gestational age births in China. METHODS We conducted a cohort study among 227 352 Chinese women with their first and second delivery during 2000 to 2015. IPI was calculated as months from first live delivery to conception of the second pregnancy. Poisson regression models with robust variance were fit to evaluate associations of IPI with risk of adverse perinatal outcomes, adjusted for potential confounders. RESULTS Compared to IPI of 24- <30 months, IPI <18 months was associated with higher risks of preterm birth (PTB) and small for gestational age (SGA). For IPI <6 months, the adjusted relative risks (RR) for PTB and SGA were 2.04 (95% confidence interval [CI] 1.83, 2.27) and 1.43 (95% CI 1.31, 1.57), respectively. Women with IPI ≥60 months had higher risks of PTB and large for gestational age (LGA). For IPI ≥120 months, the adjusted RRs for PTB and LGA were 1.67 (95% CI 1.43, 1.94) and 1.10 (95% CI 0.97, 1.26). CONCLUSIONS Women with IPI <18 months after live birth had higher risk of PTB and SGA, and IPI ≥60 months was associated with higher risk of PTB and LGA. These findings may provide information to Chinese couples about the appropriate interpregnancy interval for a second pregnancy.

Comparison of hysterectomy techniques and cost–benefit analysis

The first description of the removal of gangrenous and inverted uteri goes back to the third century ad. 1 However, it was not until 1813 when a German surgeon Conrad Langenbeck described the first intentional complete vaginal hysterectomy in which the patient survived. In those days the operative mortality rate was close to 90%. The first reports of abdominal hysterectomies were accidental hysterectomies at the time of ovariectomy, mostly with conservation of the cervix. The first abdominal hysterectomy where the patient survived was reported by an American surgeon, Walter Burnham, in the American Lancet in 1854. 2 Another American surgeon, Harry Reich, reported the first laparoscopic-assisted vaginal hysterectomy in 1989. 3 Hysterectomy is now the most frequently performed major gynecologic operation, with millions of procedures annually performed throughout the world. 4 Abdominal hysterectomy has traditionally been the surgical approach for gynecologic malignancy, in cases where pelvic pathology such as endometriosis or adhesions is suspected and in the presence of a large uterus. Abdominal hysterectomy remains the ‘fallback option’ if the uterus cannot be removed by another approach. The vaginal approach was originally used for prolapse, but has become more widely used for abnormal uterine bleeding when the uterus is of fairly normal size with or without a small degree of descent. Compared to abdominal hysterectomy, successful vaginal hysterectomy is considered as less invasive and can be performed under spinal anesthesia, whereas abdominal and laparoscopic hysterectomy will mostly require general anesthesia.

Use of intra‐uterine pressure catheter (IUPC) versus external tocodynamometry (TOCO) during labour for reducing adverse outcomes

Jannet JH Bakker, Petra F Janssen, Ben Willem J Mol, Dimitri Papatsonis, Jan MM van Lith, Joris AM van der Post