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Papers by Hilmar Bijma

Research paper thumbnail of Twenty years of experience in advanced ultrasound scanning for fetal anomalies in Rotterdam

Nederlands tijdschrift voor geneeskunde

At the Rotterdam Fetal Medicine Unit over a period of 20 years, scanning for foetal anomalies has... more At the Rotterdam Fetal Medicine Unit over a period of 20 years, scanning for foetal anomalies has been performed in more than 24,000 pregnancies at risk of a foetal congenital anomaly. In pregnancies where there was prior knowledge of increased risk of a foetal anomaly (group I), the incidence of foetal pathology was 2-5%. In pregnancies in which a foetal anomaly was suspected on clinical or sonographic grounds (group II), the incidence of foetal pathology was 32-57%. For reasons of good-image quality, group I pregnancies were nearly always referred for a foetal-anomaly scan at 18-21 weeks of gestation. Group II pregnancies were often referred after 24 weeks of gestation, which is the upper legal limit for termination of pregnancy in the Netherlands. The detection rate was 94.7% (2000 and 2001). An abnormal chromosome pattern was established in 18% of all affected pregnancies, the great majority of these patterns (83%) being numerical. Approximately 18% of affected pregnancies were ...

Research paper thumbnail of Decision-Making after Ultrasound Diagnosis of Fetal Abnormality

Reproductive Health Matters, 2008

Research paper thumbnail of Ultrasound diagnosis of fetal anomalies: an analysis of perinatal management of 318 consecutive pregnancies in a multidisciplinary setting

Prenatal Diagnosis, 2004

Objectives The objectives of this study are to analyse the perinatal management decisions made in... more Objectives The objectives of this study are to analyse the perinatal management decisions made in a multidisciplinary setting following the prenatal diagnosis of fetal anomalies and to evaluate to what extent, in clinical practice, decisions about obstetric management are attuned to those about neonatal management.

Research paper thumbnail of Obstetricians' agreement on fetal prognosis after ultrasound diagnosis of fetal anomalies

Research paper thumbnail of Survival after non-aggressive obstetric management in cases of severe fetal anomalies: a retrospective study

BJOG: An International Journal of Obstetrics and Gynaecology, 2005

Objective Obstetricians may choose to refrain from interventions aimed at sustaining fetal life (... more Objective Obstetricians may choose to refrain from interventions aimed at sustaining fetal life (i.e., nonaggressive obstetric management) when the fetus has an extremely poor prognosis. However, if the infant is then born alive, crucial neonatal management decisions then have to be made. We sought empirical data concerning such perinatal end-of-life decisions. Firstly, to describe survival during delivery and after birth following non-aggressive obstetric management, and secondly, to describe neonatal management in infants born alive after non-aggressive obstetric management. Design Retrospective descriptive study.

Research paper thumbnail of Impact of decision-making in a multidisciplinary perinatal team

Prenatal Diagnosis, 2007

(1) To describe the characteristics of decision-making about management of unborn infants with se... more (1) To describe the characteristics of decision-making about management of unborn infants with serious anomalies by a multidisciplinary perinatal team. (2) To evaluate the impact of multidisciplinary team discussions on the degree to which decisions about the management of unborn infants with serious anomalies are supported. (3) To evaluate the impact of the team discussions on the arguments used by physicians for their preferences concerning management. Prospective analysis of 78 cases discussed within the multidisciplinary perinatal team of a tertiary centre by means of an anonymous one-page questionnaire with structured questions pertaining to the opinion of the responder on medical management of each case. We did not find systematic differences between specialties prior to the discussion of cases. However, discussion with the multidisciplinary perinatal team improved decision-making about management of unborn infants with serious anomalies by enhancing the degree of support for the decisions taken. The discussions of the team did not change the physicians' arguments mentioned for their preferences. Multidisciplinary team discussions improve decision-making about management of unborn infants with serious congenital anomalies.

Research paper thumbnail of Twenty years of experience in advanced ultrasound scanning for fetal anomalies in Rotterdam

Nederlands tijdschrift voor geneeskunde

At the Rotterdam Fetal Medicine Unit over a period of 20 years, scanning for foetal anomalies has... more At the Rotterdam Fetal Medicine Unit over a period of 20 years, scanning for foetal anomalies has been performed in more than 24,000 pregnancies at risk of a foetal congenital anomaly. In pregnancies where there was prior knowledge of increased risk of a foetal anomaly (group I), the incidence of foetal pathology was 2-5%. In pregnancies in which a foetal anomaly was suspected on clinical or sonographic grounds (group II), the incidence of foetal pathology was 32-57%. For reasons of good-image quality, group I pregnancies were nearly always referred for a foetal-anomaly scan at 18-21 weeks of gestation. Group II pregnancies were often referred after 24 weeks of gestation, which is the upper legal limit for termination of pregnancy in the Netherlands. The detection rate was 94.7% (2000 and 2001). An abnormal chromosome pattern was established in 18% of all affected pregnancies, the great majority of these patterns (83%) being numerical. Approximately 18% of affected pregnancies were ...

Research paper thumbnail of Decision-Making after Ultrasound Diagnosis of Fetal Abnormality

Reproductive Health Matters, 2008

Research paper thumbnail of Ultrasound diagnosis of fetal anomalies: an analysis of perinatal management of 318 consecutive pregnancies in a multidisciplinary setting

Prenatal Diagnosis, 2004

Objectives The objectives of this study are to analyse the perinatal management decisions made in... more Objectives The objectives of this study are to analyse the perinatal management decisions made in a multidisciplinary setting following the prenatal diagnosis of fetal anomalies and to evaluate to what extent, in clinical practice, decisions about obstetric management are attuned to those about neonatal management.

Research paper thumbnail of Obstetricians' agreement on fetal prognosis after ultrasound diagnosis of fetal anomalies

Research paper thumbnail of Survival after non-aggressive obstetric management in cases of severe fetal anomalies: a retrospective study

BJOG: An International Journal of Obstetrics and Gynaecology, 2005

Objective Obstetricians may choose to refrain from interventions aimed at sustaining fetal life (... more Objective Obstetricians may choose to refrain from interventions aimed at sustaining fetal life (i.e., nonaggressive obstetric management) when the fetus has an extremely poor prognosis. However, if the infant is then born alive, crucial neonatal management decisions then have to be made. We sought empirical data concerning such perinatal end-of-life decisions. Firstly, to describe survival during delivery and after birth following non-aggressive obstetric management, and secondly, to describe neonatal management in infants born alive after non-aggressive obstetric management. Design Retrospective descriptive study.

Research paper thumbnail of Impact of decision-making in a multidisciplinary perinatal team

Prenatal Diagnosis, 2007

(1) To describe the characteristics of decision-making about management of unborn infants with se... more (1) To describe the characteristics of decision-making about management of unborn infants with serious anomalies by a multidisciplinary perinatal team. (2) To evaluate the impact of multidisciplinary team discussions on the degree to which decisions about the management of unborn infants with serious anomalies are supported. (3) To evaluate the impact of the team discussions on the arguments used by physicians for their preferences concerning management. Prospective analysis of 78 cases discussed within the multidisciplinary perinatal team of a tertiary centre by means of an anonymous one-page questionnaire with structured questions pertaining to the opinion of the responder on medical management of each case. We did not find systematic differences between specialties prior to the discussion of cases. However, discussion with the multidisciplinary perinatal team improved decision-making about management of unborn infants with serious anomalies by enhancing the degree of support for the decisions taken. The discussions of the team did not change the physicians' arguments mentioned for their preferences. Multidisciplinary team discussions improve decision-making about management of unborn infants with serious congenital anomalies.

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