scholarly journals Uptake, outcomes, and costs of implementing non-invasive prenatal testing for Down’s syndrome into NHS maternity care: prospective cohort study in eight diverse maternity units

BMJ ◽  
2016 ◽  
pp. i3426 ◽  
Author(s):  
Lyn S Chitty ◽  
David Wright ◽  
Melissa Hill ◽  
Talitha I Verhoef ◽  
Rebecca Daley ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Maternity Care ◽  
Prospective Cohort ◽  
Down's Syndrome ◽  
Prenatal Testing ◽  
Down’S Syndrome ◽  
Non Invasive

scholarly journals Non-invasive assessment of fluid responsiveness to guide fluid therapy in patients with sepsis in the emergency department: a prospective cohort study

2021 ◽  
pp. emermed-2020-209771
Author(s):  
Nienke K Koopmans ◽  
Renate Stolmeijer ◽  
Ben C Sijtsma ◽  
Paul A van Beest ◽  
Christiaan E Boerma ◽  
...  
Keyword(s):  
Cohort Study ◽  
Fluid Responsiveness ◽  
Prospective Cohort Study ◽  
Fluid Therapy ◽  
Prospective Cohort ◽  
Fluid Challenge ◽  
Fluid Bolus ◽  
Non Invasive ◽  
Similar Patient ◽  
Passive Leg Raise

BackgroundLittle is known about optimal fluid therapy for patients with sepsis without shock who present to the ED. In this study, we aimed to quantify the effect of a fluid challenge on non-invasively measured Cardiac Index (CI) in patients presenting with sepsis without shock.MethodsIn a prospective cohort study, CI, stroke volume (SV) and systemic vascular resistance (SVR) were measured non-invasively in 30 patients presenting with sepsis without shock to the ED of a large teaching hospital in the Netherlands between May 2018 and March 2019 using the ClearSight system. After baseline measurements were performed, a passive leg raise (PLR) was done to simulate a fluid bolus. Measurements were then repeated 30, 60, 90 and 120 s after PLR. Finally, a standardised 500 mL NaCl 0.9% intravenous bolus was administered after which final measurements were done. Fluid responsiveness was defined as >15% increase in CI after a standardised fluid challenge.Measurements and main resultsSeven out of 30 (23%) patients demonstrated a >15% increase in CI after PLR and after a 500 mL fluid bolus. Fluid responders had a higher estimated glomerular filtration rate (eGFR) (64 (44–78) vs 37 (23–47), p=0.009) but otherwise similar patient and treatment characteristics as non-responders. Baseline measurements of cardiac output (CO), CI, SV and SVR were unrelated to PLR fluid responsiveness. The change in CI after PLR was strongly positive correlated to the change in CI after a 500 mL NaCl 0.9% fluid bolus (r=0.88, p<0.001).ConclusionThe results of the present study demonstrate that in patients with sepsis in the absence of shock, three out of four patients do not demonstrate a clinically relevant increase in CI after a standardised fluid challenge. Non-invasive CO monitoring in combination with a PLR test has the potential to identify patients who might benefit from fluid resuscitation and may contribute to a better tailored treatment of these patients.

PP350 Study On The Awareness, Willingness To Pay And Satisfaction With Non-Invasive Prenatal Testing Among Pregnant Women

2020 ◽  
Vol 36 (S1) ◽  
pp. 30-30
Author(s):  
Changjia Fan ◽  
Wenru Shang ◽  
Jiayan Huang ◽  
Yang Wan
Keyword(s):  
Willingness To Pay ◽  
Pregnant Women ◽  
Birth Defects ◽  
Financial Burden ◽  
Down's Syndrome ◽  
Prenatal Testing ◽  
Down’S Syndrome ◽  
Anhui Province ◽  
Screening Methods ◽  
Non Invasive

IntroductionBirth defects seriously affect children's survival and quality of life and bring great suffering and financial burden to children and their families. Down's syndrome is one of the most common birth defects. Compared with traditional serological screening methods, non-invasive prenatal testing (NIPT) has higher sensitivity and specificity in the screening of Down's syndrome. In April 2017, the People's Government of Fuyang City, Anhui Province launched a NIPT free screening program. From the perspective of the beneficiary, this research investigated the awareness, willingness to pay and satisfaction of pregnant women in Fuyang City, Anhui Province, to better improve the use of NIPT.MethodsA questionnaire survey was conducted on 1,221 pregnant women who experienced this program in Fuyang City, Anhui Province. Multivariate ordered logistic regression models were established to analyze the factors affecting the satisfaction of NIPT.ResultsA total of 1,217 valid questionnaires were collected. Research indicated 82.5 percent knew about NIPT and 81.9 percent were willing to pay personally when its price was CNY 800 (USD 113.88) per test among pregnant women. The satisfaction of pregnant women with NIPT showed that the waiting time for test results was relatively low (4.5 out of 5 points) compared with other aspects of satisfaction. The higher the education level of the pregnant women, the lower their satisfaction with NIPT.ConclusionsIt is necessary to pay attention to the characteristics of education and to improve the awareness and satisfaction of NIPT among pregnant women. Meanwhile, if it is affordable enough for NIPT services to be provided by the government, this mode should be promoted. In conjunction with the willingness to pay of pregnant women, NIPT payment methods should be developed appropriately.

scholarly journals Respectful maternity care and its relationship with childbirth experience in Iranian women: a prospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Khadije Hajizadeh ◽  
Maryam Vaezi ◽  
Shahla Meedya ◽  
Sakineh Mohammad Alizadeh Charandabi ◽  
Mojgan Mirghafourvand
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Maternity Care ◽  
Prospective Cohort ◽  
Respectful Maternity Care ◽  
Iranian Women ◽  
Childbirth Experience

scholarly journals Microcirculation After Trochanteric Femur Fractures: A Prospective Cohort Study Using Non-invasive Laser-Doppler Spectrophotometry

2019 ◽  
Vol 10 ◽  
Author(s):  
Bergita Ganse ◽  
Franziska Böhle ◽  
Tatjana Pastor ◽  
Boyko Gueorguiev ◽  
Simon Altgassen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Laser Doppler ◽  
Non Invasive ◽  
Femur Fractures

scholarly journals Will the introduction of non-invasive prenatal testing for Down's syndrome undermine informed choice?

2014 ◽  
Vol 18 (5) ◽  
pp. 1658-1671 ◽  
Author(s):  
Caroline Silcock ◽  
Lih-Mei Liao ◽  
Melissa Hill ◽  
Lyn S. Chitty
Keyword(s):  
Down's Syndrome ◽  
Prenatal Testing ◽  
Down’S Syndrome ◽  
Informed Choice ◽  
Non Invasive
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