Monika Laubach - Academia.edu (original) (raw)
Papers by Monika Laubach
BMC Pregnancy and Childbirth
Background Trial of Labor After Cesarean is an important strategy for reducing the overall rate o... more Background Trial of Labor After Cesarean is an important strategy for reducing the overall rate of cesarean delivery. Offering the option of vaginal delivery to a woman with a history of cesarean section requires the ability to manage a potential uterine rupture quickly and effectively. This requires infrastructure and organization of the maternity unit so that the decision-to-delivery interval is as short as possible when uterine rupture is suspected. We hypothesize that the organizational characteristics of maternity units in Belgium have an impact on their proposal and success rates of trial of labour after cesarean section. Methods We collected data on the organizational characteristics of Belgian maternity units using an online questionnaire. Data on the frequency of cesarean section, trial of labor and vaginal birth after cesarean section were obtained from regional perinatal registries. We analyzed the determinants of the proposal and success of trial of labor after cesarean ...
Unknown eBooks, Sep 18, 2010
Livestock Science, May 1, 2006
The impact of closely controlled energy management during the dry period upon general peripartum ... more The impact of closely controlled energy management during the dry period upon general peripartum metabolism and the subsequent lactation was evaluated in multiparous dairy cows. Eight lactating, pregnant Holstein cows were paired according to current milk production and body condition score and assigned to either the control or the stair-step compensatory nutrition (SSCN) regimen 16 weeks prior to expected calving date. Control cows were fed according to National Research Council [National Research Council., 2001. Nutrient Requirements of Dairy Cattle. 7th rev. ed. Natl. Acad. Sci., Washington, DC.] recommendations and for ad libitum intake during late lactation and the far-off dry period. The SSCN cows were subjected to dietary energy restriction [80% of net energy for lactation requirements (NE L)] during late lactation in order to maintain body weight, followed by realimentation (130% of NE L) during the far-off dry period to induce a compensatory response. A common diet was fed thereafter. The SSCN cows gained less body condition during late lactation and tended to gain more body condition during the far-off dry and transition periods than control cows. There was no difference in dry matter intake during the prepartum transition period and early lactation. Milk yield was not affected by treatment. Serum nonesterified fatty acids (NEFA) were not altered by dietary treatment during late lactation and the dry period; however NEFA were lower in SSCN cows at week 4 of the subsequent lactation. Serum insulin was higher in SSCN cows 8 weeks prior to parturition (end of restriction), tended to be higher at 4 weeks (end of realimentation) before calving, and was also higher at week 12 of early lactation. An SSCN regimen stimulated body condition gain of mature dairy cows during the dry period, did not affect periparturient nutrient metabolism, and led to modest improvements in metabolic parameters later in the subsequent lactation.
Thrombosis Research, Feb 1, 2015
Pharmacy World & Science, 2010
Maternal and Child Health Journal
VBOV Tijdschrift voor Vroedvrouwen, Feb 1, 2021
Tijdschrift voor Vroedvrouwen, Sep 1, 2017
BMC Pregnancy and Childbirth
Background Reducing the length of stay (LOS) after childbirth is a trend, including cost savings,... more Background Reducing the length of stay (LOS) after childbirth is a trend, including cost savings, a more family-centered approach and lower risk for nosocomial infection. Evaluating the impact of reduced LOS is important to improve the outcomes of care, which include maternal satisfaction. The aim of this study was to compare the maternal satisfaction, before and after the reduced LOS. Methods This study was conducted in the University Hospital Brussels, before and after implementing the KOZI&Home program (intervention). This KOZI&Home program consisted of a reduced length of stay of at least one day for both vaginal delivery and caesarean section. It also included three extra antenatal visits with the midwife, preparing for discharge and postnatal home care by an independent midwife. Women completed a questionnaire, including the Maternity Satisfaction Questionnaire (MSQ) and Home Satisfaction Questionnaire (HSQ), respectively at discharge and two weeks postpartum. Satisfaction was...
European Journal of Midwifery, 2019
INTRODUCTION Clinical placements are an integral part of midwifery education and are crucial for ... more INTRODUCTION Clinical placements are an integral part of midwifery education and are crucial for achieving professional competencies. Although students' experiences on placements have been shown to play a meaningful role in their learning, they have received scant attention in the literature. The aim of this paper is to describe the learning experiences of final-year student midwives in labor wards within the Brussels metropolitan region, Belgium. METHODS A qualitative exploratory study was conducted using two focus groups (N=20). Data analysis included: transcription of audio recordings, thematic content analysis with coding into recurrent and common themes, and broader categories. Discussions among researchers were incorporated in all phases of the analysis for integrity and data fit. RESULTS Data analysis identified the following categories as determining student learning experiences in labor wards: 1) managing opportunities, 2) being supported, and 3) dealing with the environment. Overall, respondents were positive and enthusiastic about their learning experiences, although some felt tense and unprepared. Students expressed concerns about differences in learning opportunities between placements and found it challenging to achieve all competencies. Student learning experiences were enhanced when they had placements for longer periods with the same supportive mentors. CONCLUSIONS Factors related to students' functioning, the healthcare professional, midwifery education and hospital environment affected their learning in labor wards. The combination of a more persevered preparation of students and mentors, together with a student-centered organization of placements, is crucial to create a positive learning experience for midwifery students in labor wards.
Surgical Infections, 2009
New England Journal of Medicine, 2013
American Journal of Perinatology, 1998
Nine consecutive multichorionic multiple gestations with early second-trimester (< or =20 ... more Nine consecutive multichorionic multiple gestations with early second-trimester (< or =20 weeks) preterm premature rupture of the membranes (PPROM) of the lower gestational sac were managed expectantly. Mean gestational age at PPROM was 17.5 weeks (13-20 weeks), and the mean PPROM delivery time interval was 6.2 weeks (0-11 weeks). A fetal loss of 63% (12 of 19), and a subsequent neonatal loss of 57% (4 of 7) were observed. Of the four pregnancies evolving beyond 25 weeks, three delivered before 30 weeks. The baby take-home rate was 16% (3 of 19). Histologic evidence of chorioamnionitis was present in 5 of 7 (71%) investigated pregnancies. Three other consecutive twin pregnancies were complicated by PPROM of the precervical gestational sac at 13 to 16 weeks of gestation (mean: 15 weeks). In the absence of clinical chorioamnionitis and amniotic fluid, selective feticide with potassium chloride was performed. Pregnancy was successfully prolonged beyond 33 weeks in two cases. The overall PPROM delivery time interval was 21 weeks (20-22 weeks). No neonatal losses were encountered. The baby take-home rate was 66% (2 of 3). Selective feticide of the fetus with early midtrimester PROM in the absence of maternal signs of infection may improve the former unfavorable pregnancy outcome.
Acta Obstetricia et Gynecologica Scandinavica, 2010
Objective. To find out whether the presence of Ureaplasma species (U. spp.) in combination with a... more Objective. To find out whether the presence of Ureaplasma species (U. spp.) in combination with an alteration of the normal vaginal flora is an independent risk factor for preterm delivery. Design. Prospective observational study. Setting. Department of Obstetrics, University Hospital in Brussels. Population. A total of 1,988 singleton pregnancies were included. Methods. From each woman, a cervical culture for U. spp. was obtained and the vaginal flora evaluated at the first prenatal visit. The presence of known risk factors for preterm delivery was recorded. Preterm birth was defined as delivery < 37 weeks. Results. There were 97 (4.9%) preterm births. In patients delivered before 37 weeks, abnormal vaginal flora was detected in 22.7% and U. spp. in 53.6% of these. The conditions were found together in 17.5%. In patients delivered at term, an abnormal vaginal flora was detected in 14.4% and U. spp. in 41.4% of these women, while they co-existed in 8.2%. Using a logistic regression analysis taking into account known risk factors for preterm birth and the microbiological parameters, preterm delivery was correlated with the presence of U. spp. (odds ratio (OR) 1.64; 95% confidence interval (CI) 1.08-2.48; p = 0.02) and abnormal vaginal flora in combination with U. spp. (OR 2.35; 95% CI 1.35-4.10; p = 0.003). No significant correlation between the presence of abnormal vaginal flora and preterm delivery (p = 0.09) was found. Conclusions. Preterm delivery was significantly correlated with the presence of U. spp. The risk for preterm delivery increased when U. spp. was associated with an abnormal vaginal flora.
BMC Pregnancy and Childbirth
Background Trial of Labor After Cesarean is an important strategy for reducing the overall rate o... more Background Trial of Labor After Cesarean is an important strategy for reducing the overall rate of cesarean delivery. Offering the option of vaginal delivery to a woman with a history of cesarean section requires the ability to manage a potential uterine rupture quickly and effectively. This requires infrastructure and organization of the maternity unit so that the decision-to-delivery interval is as short as possible when uterine rupture is suspected. We hypothesize that the organizational characteristics of maternity units in Belgium have an impact on their proposal and success rates of trial of labour after cesarean section. Methods We collected data on the organizational characteristics of Belgian maternity units using an online questionnaire. Data on the frequency of cesarean section, trial of labor and vaginal birth after cesarean section were obtained from regional perinatal registries. We analyzed the determinants of the proposal and success of trial of labor after cesarean ...
Unknown eBooks, Sep 18, 2010
Livestock Science, May 1, 2006
The impact of closely controlled energy management during the dry period upon general peripartum ... more The impact of closely controlled energy management during the dry period upon general peripartum metabolism and the subsequent lactation was evaluated in multiparous dairy cows. Eight lactating, pregnant Holstein cows were paired according to current milk production and body condition score and assigned to either the control or the stair-step compensatory nutrition (SSCN) regimen 16 weeks prior to expected calving date. Control cows were fed according to National Research Council [National Research Council., 2001. Nutrient Requirements of Dairy Cattle. 7th rev. ed. Natl. Acad. Sci., Washington, DC.] recommendations and for ad libitum intake during late lactation and the far-off dry period. The SSCN cows were subjected to dietary energy restriction [80% of net energy for lactation requirements (NE L)] during late lactation in order to maintain body weight, followed by realimentation (130% of NE L) during the far-off dry period to induce a compensatory response. A common diet was fed thereafter. The SSCN cows gained less body condition during late lactation and tended to gain more body condition during the far-off dry and transition periods than control cows. There was no difference in dry matter intake during the prepartum transition period and early lactation. Milk yield was not affected by treatment. Serum nonesterified fatty acids (NEFA) were not altered by dietary treatment during late lactation and the dry period; however NEFA were lower in SSCN cows at week 4 of the subsequent lactation. Serum insulin was higher in SSCN cows 8 weeks prior to parturition (end of restriction), tended to be higher at 4 weeks (end of realimentation) before calving, and was also higher at week 12 of early lactation. An SSCN regimen stimulated body condition gain of mature dairy cows during the dry period, did not affect periparturient nutrient metabolism, and led to modest improvements in metabolic parameters later in the subsequent lactation.
Thrombosis Research, Feb 1, 2015
Pharmacy World & Science, 2010
Maternal and Child Health Journal
VBOV Tijdschrift voor Vroedvrouwen, Feb 1, 2021
Tijdschrift voor Vroedvrouwen, Sep 1, 2017
BMC Pregnancy and Childbirth
Background Reducing the length of stay (LOS) after childbirth is a trend, including cost savings,... more Background Reducing the length of stay (LOS) after childbirth is a trend, including cost savings, a more family-centered approach and lower risk for nosocomial infection. Evaluating the impact of reduced LOS is important to improve the outcomes of care, which include maternal satisfaction. The aim of this study was to compare the maternal satisfaction, before and after the reduced LOS. Methods This study was conducted in the University Hospital Brussels, before and after implementing the KOZI&Home program (intervention). This KOZI&Home program consisted of a reduced length of stay of at least one day for both vaginal delivery and caesarean section. It also included three extra antenatal visits with the midwife, preparing for discharge and postnatal home care by an independent midwife. Women completed a questionnaire, including the Maternity Satisfaction Questionnaire (MSQ) and Home Satisfaction Questionnaire (HSQ), respectively at discharge and two weeks postpartum. Satisfaction was...
European Journal of Midwifery, 2019
INTRODUCTION Clinical placements are an integral part of midwifery education and are crucial for ... more INTRODUCTION Clinical placements are an integral part of midwifery education and are crucial for achieving professional competencies. Although students' experiences on placements have been shown to play a meaningful role in their learning, they have received scant attention in the literature. The aim of this paper is to describe the learning experiences of final-year student midwives in labor wards within the Brussels metropolitan region, Belgium. METHODS A qualitative exploratory study was conducted using two focus groups (N=20). Data analysis included: transcription of audio recordings, thematic content analysis with coding into recurrent and common themes, and broader categories. Discussions among researchers were incorporated in all phases of the analysis for integrity and data fit. RESULTS Data analysis identified the following categories as determining student learning experiences in labor wards: 1) managing opportunities, 2) being supported, and 3) dealing with the environment. Overall, respondents were positive and enthusiastic about their learning experiences, although some felt tense and unprepared. Students expressed concerns about differences in learning opportunities between placements and found it challenging to achieve all competencies. Student learning experiences were enhanced when they had placements for longer periods with the same supportive mentors. CONCLUSIONS Factors related to students' functioning, the healthcare professional, midwifery education and hospital environment affected their learning in labor wards. The combination of a more persevered preparation of students and mentors, together with a student-centered organization of placements, is crucial to create a positive learning experience for midwifery students in labor wards.
Surgical Infections, 2009
New England Journal of Medicine, 2013
American Journal of Perinatology, 1998
Nine consecutive multichorionic multiple gestations with early second-trimester (< or =20 ... more Nine consecutive multichorionic multiple gestations with early second-trimester (< or =20 weeks) preterm premature rupture of the membranes (PPROM) of the lower gestational sac were managed expectantly. Mean gestational age at PPROM was 17.5 weeks (13-20 weeks), and the mean PPROM delivery time interval was 6.2 weeks (0-11 weeks). A fetal loss of 63% (12 of 19), and a subsequent neonatal loss of 57% (4 of 7) were observed. Of the four pregnancies evolving beyond 25 weeks, three delivered before 30 weeks. The baby take-home rate was 16% (3 of 19). Histologic evidence of chorioamnionitis was present in 5 of 7 (71%) investigated pregnancies. Three other consecutive twin pregnancies were complicated by PPROM of the precervical gestational sac at 13 to 16 weeks of gestation (mean: 15 weeks). In the absence of clinical chorioamnionitis and amniotic fluid, selective feticide with potassium chloride was performed. Pregnancy was successfully prolonged beyond 33 weeks in two cases. The overall PPROM delivery time interval was 21 weeks (20-22 weeks). No neonatal losses were encountered. The baby take-home rate was 66% (2 of 3). Selective feticide of the fetus with early midtrimester PROM in the absence of maternal signs of infection may improve the former unfavorable pregnancy outcome.
Acta Obstetricia et Gynecologica Scandinavica, 2010
Objective. To find out whether the presence of Ureaplasma species (U. spp.) in combination with a... more Objective. To find out whether the presence of Ureaplasma species (U. spp.) in combination with an alteration of the normal vaginal flora is an independent risk factor for preterm delivery. Design. Prospective observational study. Setting. Department of Obstetrics, University Hospital in Brussels. Population. A total of 1,988 singleton pregnancies were included. Methods. From each woman, a cervical culture for U. spp. was obtained and the vaginal flora evaluated at the first prenatal visit. The presence of known risk factors for preterm delivery was recorded. Preterm birth was defined as delivery < 37 weeks. Results. There were 97 (4.9%) preterm births. In patients delivered before 37 weeks, abnormal vaginal flora was detected in 22.7% and U. spp. in 53.6% of these. The conditions were found together in 17.5%. In patients delivered at term, an abnormal vaginal flora was detected in 14.4% and U. spp. in 41.4% of these women, while they co-existed in 8.2%. Using a logistic regression analysis taking into account known risk factors for preterm birth and the microbiological parameters, preterm delivery was correlated with the presence of U. spp. (odds ratio (OR) 1.64; 95% confidence interval (CI) 1.08-2.48; p = 0.02) and abnormal vaginal flora in combination with U. spp. (OR 2.35; 95% CI 1.35-4.10; p = 0.003). No significant correlation between the presence of abnormal vaginal flora and preterm delivery (p = 0.09) was found. Conclusions. Preterm delivery was significantly correlated with the presence of U. spp. The risk for preterm delivery increased when U. spp. was associated with an abnormal vaginal flora.