Early pregnancy care over time: should we promote an early pregnancy assessment unit?
Open accessAbstract
In this observational study, the effect of the introduction of the first Early Pregnancy Assessment Unit (EPAU) in a university hospital in The Netherlands in 2008 on early pregnancy care is analysed. Derivatives of quality of care were measured before and after the establishment of the EPAU, with the aim of reducing unnecessary care. Care within three time periods was measured: 2006, 2009 and 2012. In 2006, 14% of women who had experienced a miscarriage were admitted to the hospital, whereas in 2009 and 2012 no women were admitted. The surgical management rate for miscarriage decreased from 79% (2006) to 6% (2009) and 28% (2012). Karyotyping of couples who had experienced recurrent miscarriage decreased from 100% (2006) to 17% (2009) and 33% (2012). The surgical management rate for ectopic pregnancy decreased from 50% (2006) to 25% (2009) and 29% (2012). The mean total cost per woman treated in 2006 was €1111 (95% CI €808 to 1426), €436 (95% CI €307 to 590) in 2009 and €633 (95% CI €586 to 788) in 2012. We can therefore conclude that an EPAU results in higher quality and cost-effective care, and has a positive effect on early pregnancy care.
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There is growing evidence that preterm infants born after spontaneous preterm labour have a lower mean birthweight than what would be expected for their gestation.
“There is growing evidence that preterm infants born after spontaneous preterm labour have a lower mean birthweight than what would be expected for their gestation. 104-106”
From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [105]
The Materials and methods and Results passages address care for miscarriage and ectopic pregnancy, not outcomes of spontaneous preterm labour. Searches for the quoted claim and for birthweight, gestational age, and spontaneous preterm labour found no passage in our copy addressing the claimed birthweight difference; no page numbers were provided. (LLM, conf=0.76)
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References 38 · Cited by 32
Research works printed but not linked: 1
- Centre for Disease Control and Prevention, 2012. Ectopic preg- nancy mortality -Florida. In pp. 106-109.
- Authors
- van den Berg, M. M. J., Goddijn, M., Ankum, W. M., van Woerden, E. E., van der Veen, F., van Wely, M., & Hajenius, P. J.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- ORCID
- Hajenius, Petra J.
- Venue
- Reproductive BioMedicine Online
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 31
- Issue
- 2
- Pages
- 192-198
- ISSN
- 1472-6483 (ISSN-L)
- OpenAlex
- W1530667626
- Cited by
- 32
- References
- 38
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 7 · 2021: 6 · 2020: 4 · 2019: 3 · 2018: 3 · 2016: 1
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Reproductive BioMedicine Online (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- early pregnancy care, miscarriage, recurrent pregnancy loss, ectopic pregnancy, karyology, unnecessary care, cost-effectiveness, quality of care, hospitalization
- MeSH terms
- Abortion, Habitual, Female, Humans, Karyotyping, Netherlands, Pregnancy, Pregnancy, Ectopic, Health Care Costs
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