Practice Variation in the Management of First Trimester Miscarriage in The Netherlands: A Nationwide Survey
Objectives. To survey practice variation in the management of first trimester miscarriage in The Netherlands. Methods. We sent an online questionnaire to gynecologists in eight academic, 37 nonacademic teaching, and 47 nonteaching hospitals. Main outcome measures were availability of a local protoco...
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| Format: | Article |
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Wiley
2014-01-01
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| Series: | Obstetrics and Gynecology International |
| Online Access: | http://dx.doi.org/10.1155/2014/387860 |
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| author | Marianne A. C. Verschoor Marike Lemmers Malu Z. Wekker Judith A. F. Huirne Mariëtte Goddijn Ben Willem J. Mol Willem M. Ankum |
| author_facet | Marianne A. C. Verschoor Marike Lemmers Malu Z. Wekker Judith A. F. Huirne Mariëtte Goddijn Ben Willem J. Mol Willem M. Ankum |
| author_sort | Marianne A. C. Verschoor |
| collection | DOAJ |
| description | Objectives. To survey practice variation in the management of first trimester miscarriage in The Netherlands. Methods. We sent an online questionnaire to gynecologists in eight academic, 37 nonacademic teaching, and 47 nonteaching hospitals. Main outcome measures were availability of a local protocol; estimated number of patients treated with curettage, misoprostol, or expectant management; misoprostol regimen; and estimated number of curettages performed after initial misoprostol treatment. Outcomes were compared to the results of a previous nationwide survey. Results. The response rate was 100%. A miscarriage protocol was present in all academic hospitals, 68% of nonacademic teaching hospitals, and 38% of nonteaching hospitals (P=0.008). Misoprostol was first-choice treatment for 41% of patients in academic hospitals versus 34% and 27% in teaching-and nonteaching hospitals (P=0.045). There were 23 different misoprostol regimens. Curettage was first-choice treatment in 29% of patients in academic hospitals versus 46% and 50% in nonacademic teaching or nonteaching hospitals (P=0.007). In 30% of patients, initial misoprostol treatment was followed by curettage. Conclusions. Although the percentage of gynaecologists who are aware of the availability of misoprostol for miscarriage treatment has doubled to almost 100% since 2005, practice variation is still large. This practice variation underlines the need for a national guideline. |
| format | Article |
| id | doaj-art-d44a79b0393645ee976d276dcbff9249 |
| institution | OA Journals |
| issn | 1687-9589 1687-9597 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Obstetrics and Gynecology International |
| spelling | doaj-art-d44a79b0393645ee976d276dcbff92492025-08-20T02:19:45ZengWileyObstetrics and Gynecology International1687-95891687-95972014-01-01201410.1155/2014/387860387860Practice Variation in the Management of First Trimester Miscarriage in The Netherlands: A Nationwide SurveyMarianne A. C. Verschoor0Marike Lemmers1Malu Z. Wekker2Judith A. F. Huirne3Mariëtte Goddijn4Ben Willem J. Mol5Willem M. Ankum6Department of Obstetrics and Gynecology, Academic Medical Center, P.O. Box 22770, 1100 DE Amsterdam, The NetherlandsDepartment of Obstetrics and Gynecology, Academic Medical Center, P.O. Box 22770, 1100 DE Amsterdam, The NetherlandsDepartment of Obstetrics and Gynecology, Academic Medical Center, P.O. Box 22770, 1100 DE Amsterdam, The NetherlandsDepartment of Obstetrics and Gynaecology, VUmc, P.O. Box 7057, 1007 MB Amsterdam, The NetherlandsDepartment of Obstetrics and Gynecology, Academic Medical Center, P.O. Box 22770, 1100 DE Amsterdam, The NetherlandsDepartment of Obstetrics and Gynecology, Academic Medical Center, P.O. Box 22770, 1100 DE Amsterdam, The NetherlandsDepartment of Obstetrics and Gynecology, Academic Medical Center, P.O. Box 22770, 1100 DE Amsterdam, The NetherlandsObjectives. To survey practice variation in the management of first trimester miscarriage in The Netherlands. Methods. We sent an online questionnaire to gynecologists in eight academic, 37 nonacademic teaching, and 47 nonteaching hospitals. Main outcome measures were availability of a local protocol; estimated number of patients treated with curettage, misoprostol, or expectant management; misoprostol regimen; and estimated number of curettages performed after initial misoprostol treatment. Outcomes were compared to the results of a previous nationwide survey. Results. The response rate was 100%. A miscarriage protocol was present in all academic hospitals, 68% of nonacademic teaching hospitals, and 38% of nonteaching hospitals (P=0.008). Misoprostol was first-choice treatment for 41% of patients in academic hospitals versus 34% and 27% in teaching-and nonteaching hospitals (P=0.045). There were 23 different misoprostol regimens. Curettage was first-choice treatment in 29% of patients in academic hospitals versus 46% and 50% in nonacademic teaching or nonteaching hospitals (P=0.007). In 30% of patients, initial misoprostol treatment was followed by curettage. Conclusions. Although the percentage of gynaecologists who are aware of the availability of misoprostol for miscarriage treatment has doubled to almost 100% since 2005, practice variation is still large. This practice variation underlines the need for a national guideline.http://dx.doi.org/10.1155/2014/387860 |
| spellingShingle | Marianne A. C. Verschoor Marike Lemmers Malu Z. Wekker Judith A. F. Huirne Mariëtte Goddijn Ben Willem J. Mol Willem M. Ankum Practice Variation in the Management of First Trimester Miscarriage in The Netherlands: A Nationwide Survey Obstetrics and Gynecology International |
| title | Practice Variation in the Management of First Trimester Miscarriage in The Netherlands: A Nationwide Survey |
| title_full | Practice Variation in the Management of First Trimester Miscarriage in The Netherlands: A Nationwide Survey |
| title_fullStr | Practice Variation in the Management of First Trimester Miscarriage in The Netherlands: A Nationwide Survey |
| title_full_unstemmed | Practice Variation in the Management of First Trimester Miscarriage in The Netherlands: A Nationwide Survey |
| title_short | Practice Variation in the Management of First Trimester Miscarriage in The Netherlands: A Nationwide Survey |
| title_sort | practice variation in the management of first trimester miscarriage in the netherlands a nationwide survey |
| url | http://dx.doi.org/10.1155/2014/387860 |
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