Types of cardiovascular disease and its mortality.

*<p>more than one subcategory possible. PPCM: peripartum cardiomyopathy; CM: cardiomyopathy; CHD: congenital heart disease; ACS: acute coronary syndrome; SVT: supraventricular tachycardia; VT: ventricular tachycardia; SADS: Sudden Arrhythmic Death Syndrome.</p

Characteristics of women with severe maternal morbidity caused by cardiovascular disease.

*<p>not including pregnancy-induced hypertension or (pre) eclampsia,</p>∧<p>more than one option possible. (PP)CM: (peripartum) cardiomyopathy, VALVE: valvular disease, IHD: ischaemic heart disease, ARR: arrhythmias, AD: aortic dissection, MISC: miscellaneous.</p

Comparison of possible risk factors for developing severe maternal morbidity and mortality caused by cardiovascular disease between cases and the general pregnant population.

<p>n/a = data not available. RR = relative risk (95% confidence interval) <b>significant</b>.</p>*<p>includes hypertension, diabetes, cardiac disease and coagulation disorders. National reference values from.</p>**<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0056494#pone.0056494-Statistics1" target="_blank">[11]</a> Statistics Netherlands (exact study period) and.</p>***<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0056494#pone.0056494-LVRLandelijke1" target="_blank">[12]</a> The Netherlands Perinatal Registry (LVR-2, 2005).</p

Obstetric history and mode of delivery in women with severe maternal morbidity caused by cardiovascular disease.

<p>(PP)CM: (peripartum) cardiomyopathy, VALVE: valvular disease, IHD: ischaemic heart disease, ARR: arrhythmias, AD: aortic dissection, MISC: miscelaneous.</p

Balloon catheter for induction of labor in women with one previous cesarean and an unfavorable cervix

Introduction When women with a previous cesarean section and an unfavorable cervix have an indication for delivery, the choice is to induce labor or to perform a cesarean section. This study aims to assess the effectiveness and safety of a balloon catheter as a method of induction of labor in women with one previous cesarean section and an unfavorable cervix compared with an elective repeat cesarean section. Material and methods We performed a prospective cohort study in 51 hospitals in the Netherlands on term women with one previous cesarean section, a live singleton fetus in cephalic position, an unfavorable cervix and an indication for delivery. We recorded obstetric, maternal and neonatal characteristics. We compared the outcome of women who were induced with a balloon catheter with the outcome of women who delivered by elective repeat cesarean section. Main outcomes were maternal and neonatal morbidity. Mode of delivery was a secondary outcome for women who were induced. Adjusted odds ratios (aOR) were calculated using logistic regression, adjusted for potential confounders. Results Analysis was performed on 993 women who were induced and 321 women who had a repeat cesarean section (August 2011 until September 2012). Among the women who were induced, 560 (56.4%) delivered vaginally and 11 (1.1%) sustained a uterine rupture. Composite adverse maternal outcome (uterine rupture, severe postpartum hemorrhage or postpartum infection) occurred in 73 (7.4%) in the balloon and 14 (4.5%) women in the repeat cesarean section group (aOR 1.58, 95% confidence interval [CI] 0.85-2.96). Composite adverse neonatal outcome (Apgar score p

Defining definitions: a Delphi study to develop a core outcome set for conditions of severe maternal morbidity

Objective: Develop a core outcome set of international consensus definitions for severe maternal morbidities. Design: Electronic Delphi study. Setting: International. Population: Eight expert panels. Methods: All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions. From these suggestions, a steering committee distilled critical components: eclampsia: 23, amniotic fluid embolism: 15, pregnancy-related hysterectomy: 11, severe primary postpartum haemorrhage: 19, uterine rupture: 20, abnormally invasive placentation: 12, spontaneous haemoperitoneum in pregnancy: 16, and cardiac arrest in pregnancy: 10. These components were assessed by the expert panel using a 5-point Likert scale, following which a framework for an encompassing definition was constructed. Possible definitions were evaluated in rounds until a rate of agreement of more than 70% was reached. Expert commentaries were used in each round to improve definitions. Main outcome measures: Definitions with a rate of agreement of more than 70%. Results: The invitation to participate in one or more of eight Delphi processes was accepted by 103 experts from 13 high-income countries. Consensus definitions were developed for all of the conditions. Conclusion: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. These should be used in national registrations and international studies, and should be taken up by the Core Outcomes in Women's and Newborn Health initiative. Tweetable abstract: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.</p