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https://hdl.handle.net/2440/88514
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dc.contributor.author | Koopmans, C. | - |
dc.contributor.author | Bijlenga, D. | - |
dc.contributor.author | Groen, H. | - |
dc.contributor.author | Vijgen, S. | - |
dc.contributor.author | Aarnoudse, J. | - |
dc.contributor.author | Bekedam, D. | - |
dc.contributor.author | van den Berg, P. | - |
dc.contributor.author | de Boer, K. | - |
dc.contributor.author | Burggraaff, J. | - |
dc.contributor.author | Bloemenkamp, K. | - |
dc.contributor.author | Drogtrop, A. | - |
dc.contributor.author | Franx, A. | - |
dc.contributor.author | de Groot, C. | - |
dc.contributor.author | Huisjes, A. | - |
dc.contributor.author | Kwee, A. | - |
dc.contributor.author | van Loon, A. | - |
dc.contributor.author | Lub, A. | - |
dc.contributor.author | Papatsonis, D. | - |
dc.contributor.author | van der Post, J. | - |
dc.contributor.author | Roumen, F. | - |
dc.contributor.author | et al. | - |
dc.date.issued | 2009 | - |
dc.identifier.citation | The Lancet, 2009; 374(9694):979-988 | - |
dc.identifier.issn | 0140-6736 | - |
dc.identifier.issn | 1474-547X | - |
dc.identifier.uri | http://hdl.handle.net/2440/88514 | - |
dc.description.abstract | BACKGROUND: Robust evidence to direct management of pregnant women with mild hypertensive disease at term is scarce. We investigated whether induction of labour in women with a singleton pregnancy complicated by gestational hypertension or mild pre-eclampsia reduces severe maternal morbidity. METHODS: We undertook a multicentre, parallel, open-label randomised controlled trial in six academic and 32 non-academic hospitals in the Netherlands between October, 2005, and March, 2008. We enrolled patients with a singleton pregnancy at 36-41 weeks' gestation, and who had gestational hypertension or mild pre-eclampsia. Participants were randomly allocated in a 1:1 ratio by block randomisation with a web-based application system to receive either induction of labour or expectant monitoring. Masking of intervention allocation was not possible. The primary outcome was a composite measure of poor maternal outcome--maternal mortality, maternal morbidity (eclampsia, HELLP syndrome, pulmonary oedema, thromboembolic disease, and placental abruption), progression to severe hypertension or proteinuria, and major post-partum haemorrhage (>1000 mL blood loss). Analysis was by intention to treat and treatment effect is presented as relative risk. This study is registered, number ISRCTN08132825. FINDINGS: 756 patients were allocated to receive induction of labour (n=377 patients) or expectant monitoring (n=379). 397 patients refused randomisation but authorised use of their medical records. Of women who were randomised, 117 (31%) allocated to induction of labour developed poor maternal outcome compared with 166 (44%) allocated to expectant monitoring (relative risk 0.71, 95% CI 0.59-0.86, p<0.0001). No cases of maternal or neonatal death or eclampsia were recorded. INTERPRETATION: Induction of labour is associated with improved maternal outcome and should be advised for women with mild hypertensive disease beyond 37 weeks' gestation. | - |
dc.description.statementofresponsibility | Corine M Koopmans ... Ben WJ Mol ... et al. for the HYPITAT study group | - |
dc.language.iso | en | - |
dc.publisher | Elsevier | - |
dc.rights | Copyright © 2009 Elsevier Ltd. All rights reserved. | - |
dc.source.uri | http://dx.doi.org/10.1016/s0140-6736(09)60736-4 | - |
dc.subject | HYPITAT study group | - |
dc.subject | Humans | - |
dc.subject | Pulmonary Edema | - |
dc.subject | Hypertension, Pregnancy-Induced | - |
dc.subject | Eclampsia | - |
dc.subject | HELLP Syndrome | - |
dc.subject | Pre-Eclampsia | - |
dc.subject | Abruptio Placentae | - |
dc.subject | Postpartum Hemorrhage | - |
dc.subject | Thromboembolism | - |
dc.subject | Fetal Monitoring | - |
dc.subject | Pregnancy Outcome | - |
dc.subject | Labor, Induced | - |
dc.subject | Severity of Illness Index | - |
dc.subject | Maternal Mortality | - |
dc.subject | Logistic Models | - |
dc.subject | Statistics, Nonparametric | - |
dc.subject | Gestational Age | - |
dc.subject | Pregnancy | - |
dc.subject | Patient Selection | - |
dc.subject | Adult | - |
dc.subject | Netherlands | - |
dc.subject | Female | - |
dc.title | Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT): a multicentre, open-label randomised controlled trial | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1016/S0140-6736(09)60736-4 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Mol, B. [0000-0001-8337-550X] | - |
Appears in Collections: | Aurora harvest 2 Paediatrics publications |
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