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Biomedical subjects

H Kragt

Publications and source records attributed to H Kragt.

11 recordsLinked to original sources
PubMed1998

Cervicovaginal fetal fibronectin concentrations: predictive value of impending birth in postterm pregnancies.

OBJECTIVE: To determine the predictive value of cervicovaginal fetal fibronectin (fFN) concentrations > or =50 ng/ml for spontaneous onset of labour within 3 days in pregnancies of 41 weeks gestation or more. STUDY DESIGN: In the Department of Obstetrics, Leiden University Medical Centre, and of the Diaconessen Hospital, Voorburg (The Netherlands), 126 cervicovaginal secretions of fFN, from 80 consenting women between 287 and 304 days gestation were collected. Pregnant women underwent sterile speculum examinations for cervicovaginal sampling from the 41st week onwards. The fFN concentration in these samples was determined with a quantitative solid-phase enzyme-linked immunosorbent assay. Concentrations of <50 ng fFN per ml were characterised as negative test results, meaning that spontaneous delivery would not take place within 3 days, and those of > or =50 fFN ng/ml were taken as positive test results. Sensitivity and specificity of the fFN test were calculated for predicting spontaneous birth. Parametric and nonparametric tests were used for evaluating differences and correlations. RESULTS: Spontaneous delivery took place after 2.5+/-2.5(SD) days with fFN values > or =50 ng/ml and after 4.7+/-3.6 days with fFN concentrations <50 ng/ml (P<0.001). Sensitivity and specificity of the fFN test predicting spontaneous onset of labour within 3 days, were 0.71 [95% confidence interval (CI) 0.58-0.86] and 0.64 (95% CI 0.48-0.78). If fFN > or =50 ng/ml then a spontaneous onset of labour is more likely to occur within 3 days (odds ratio 4.5 (95% CI 1.8-11.3). CONCLUSIONS: The fFN test does not predict accurately enough whether or not birth will take place within 3 days of sampling. Nevertheless, the higher odds for spontaneous delivery within a few days when the test is positive may be of use in planning adjusted induction of labour.

Cervix Uteri↗
PubMed1992

Importance of trends in the interpretation of an overall odds ratio in the meta-analysis of clinical trials.

This paper contains a proposition related to the publication of meta-analyses of clinical trials. We consider the situation where the results of a number of trials are summarized by a common or typical odds ratio. We show that stating such an odds ratio as the summary of evidence from a number of trials can be misleading if certain systematic differences between trials exist. In such cases the author should state not just one odds ratio but also its dependence on the relevant characteristics of the trials. In particular, we propose that those reporting a meta-analysis state in advance a (limited) number of variables to be considered for potential interaction with the exposure (risk factor or treatment) of interest. The list might include centre size and the odds in the placebo or control group if such an effect is a priori clinically plausible. The trials should be ordered according to each of these variables and a trend test for the odds ratio should be computed. Apart from a 'genuine' effect, an appreciable interaction could also be indicative of the (multiplicative) odds ratio being an inappropriate measure for the particular meta-analysis. Without any consideration as to the possibility of interaction, the meta-analysis should be considered incomplete. If such an interaction exists, the odds ratio should be stated as a function of the interacting variable, either as a formula or (preferably) in a table stating the odds ratio for a number of different values of the interacting variable, and not as a single summary statistic.

Clinical Trials as Topic↗
PubMed1990

How accurate is a woman's diagnosis of threatened preterm delivery?

During a 1-year period all women entering hospital with signs or symptoms that could herald preterm delivery were studied. The primary complaints of these 178 women were contractions in 70, watery discharge in 59, bloody discharge in 33, and abdominal pain in 16. These complaints were considered as confirmed threats of preterm delivery if the woman was delivered or received tocolysis within 48 h (n = 63; 35%); they were labelled as an unconfirmed threat if the woman was allowed to return home without further action within 48 h (n = 45; 25%). Overall, 75% of the women were correct in their estimation that something was wrong in that they either gave birth or were admitted for greater than 48 h for diagnostic or therapeutic measures. Parity had only a small influence on women's predictive ability. It is concluded that efforts to increase women's awareness of the significance of various symptoms are not likely to contribute much to improvement in the early diagnosis of preterm labour. Greater effect can be anticipated from the development of methods to differentiate between contractions that will or will not lead to early delivery.

Adolescent↗
PubMed1989

Limb body wall malformation complex: an embryologic etiology?

Four human fetuses with the limb body wall malformation complex, also known as the amniotic band syndrome, were examined. Besides malformations of the body wall and the limb(s), anomalies of the internal organs were found in three fetuses, suggesting a disturbance of normal morphogenesis before the fifth week of development. When analyzing the observed data in relation to their etiology, no support was found for either the amniotic band or the vascular disruption theory. New insights into morphogenesis suggest that the limb body wall malformation complex results from a malfunction in the ectodermal placodes and that it can be considered to be an embryonic dysplasia.

Abdominal Muscles↗
PubMed1985

Neurological morbidity in newborn twins.

Forty-six twins were compared with an equal number of singletons, matched for gestational age, birthweight and mode of delivery. The neurological findings in the neonatal period were similar in the matched groups, but twins were significantly more often deviant than a large unselected sample of singletons. It is concluded that both in twins and in singletons growth retardation, preterm birth and birth trauma are important causes of neonatal neurological abnormality, but that twins are not more susceptible to the effects of these variables than singletons.

Delivery, Obstetric↗