Richtlijn Sterilisatie van de vrouw - NVOG

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ReferentieType studieKenmerken(studie/patiënten)Interventie (I)Uitkomstmaten enfollow-up duurResultatenBeoordelingkwaliteit studiemean age of 31years (0.133 SE Filshie Clipand 0.129 SE Tubal Ring) and had givenbirth to an overall average of 3.7 children.BMI (mean/ average/ 95% CI)Other relevant demographics…Identification ofconfounders andcorrection in analysis: (+/?/-)Financial support: the U.S.Agency for InternationalDevelopment (USAID)three cases of Filshie Clip expulsions, two of which occurred after theplanned follow-up period. None of these women requiredhospitalization, but one woman subsequently underwent a diagnosticlaparoscopy. This woman reported an asymptomaticexpulsion of a Filshie clip from the rectum 18 months after thesterilization procedure.92
ReferentieType studieKenmerken(studie/patiënten)Interventie (I)Uitkomstmaten enfollow-up duurResultatenBeoordelingkwaliteit studieUbeda,2004Prospectiveobservational Cohortstudy.July 2002-july 2003:UniversityClinic, SpainNotcomparitiveInclusion criteria:Exclusion criteria:Age : 38 (26-46 yrs)BMI (mean/ average/ 95% CI)71% in proliferative phase26% OC3% IUD removed before last periodnullip: 11%, P1: 22%, 67% MPHysteroscopic sterilizationEssureBettocchi techniqueDiazepam 5 mgr and Naproxen550 mgr 500 mgr3 months X ray. HSG onindicationOutcomes (primary/ secondary) andassesment of outcomes:Follow-up: one day post proceduretelephone3 months control- proceduretime: 9 min ( 1-35 min)no intraoperative complicationsno postoperative complication for pain, sign bleeding, or feverone symptomatic bradycardia during procedureStudy groups clearly defined: (+)Selectionbias*: (+)Adequate assesment of exposure *:(+/?/-)Adequate assesment of outcomes*:(-)Assesor of the effect adequatelyblinded*: (-)N = 85Sufficient length of follow-up*: (+)Selective loss tofollow-up*: (-)Identification ofconfounders andcorrection in analysis: (-)Financial support:NonePatient satisfaction immidate post procedure: good/excellent: 95%3 months: positive advise to relative/family: 100%3 months X ray: 75/81: all correct placementsVancaillie, 2008Prospective.Single-armmulticenter,internationalstudy.NoncomparativeInclusion criteria: 18 -45 yrs, health seekingsterilizationNov 2002 – May 2005Exclusion criteria: major medical conditions,use of cortisone or cytostatics, PID, uterineabnormalities,Hysteroscopic sterilizationwitha AdianaProliferative phaseDivers painprotocol3 -6 months HSGPrim. Outcome: pregnancy rate after12 monthsSec. Outcome: placementrateSatisfaction, comfort (VAS)No long term complication, no change in menstual pattern- withdrew 75, excluded: 50- procedure time: 11:54 min (SD 7.08)- glycine volume use : 1226mL, loss: 182 mL40.2% little or no discomfort; 9.2% very uncomfortablebilateral placement: 95% ( 7 patients in two attempts) : 611safety:Study groups clearly defined: (+)Selectionbias*: (+)Adequate assesment of exposure *:(+)Adequate assesment of outcomes*:(+)Phase I : n = 150Phase I + II: 770 (US: 627, OUS: 143)Assesor of the effect adequatelyblinded*: (-)Sufficient length of follow-up*: (+)Selective loss tofollow-up*: (-)93
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Conclusies ........................
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Onderbouwing en overwegingen ......
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Gezien de risico’s van een laparo
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Hysteroscopische sterilisaties moet
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Afbakening en uitgangsvragenDe huid
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In eerste instantie werd gezocht na
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Tabel 2. Niveau van bewijskracht va
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Implementatie en indicatorontwikkel
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HOOFDSTUK 1AchtergrondinformatieInl
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altijd werd aangenomen en dat de le
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Peterson, H. B., Xia, Z., Hughes, J
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Veiligheid2.1 Wat is meest optimale
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Bipolaire coagulatie versus Filshie
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hebben geantwoord, waarbij een succ
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Klinische relevantie: kritiek / bel
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Ringen 5,9 (3,3 - 8,5) 10,0 (6,4 -
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Van alle in Nederland beschikbare s
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LiteratuurAranda, C., Broutin, A.,
Page 41 and 42: HOOFDSTUK 3Keuze van sterilisatieme
Page 43 and 44: mislukken van de sterilisatie.In de
Page 45 and 46: Uterus myomatosus en andere uterusa
Page 47 and 48: Niveau 3En zijn aanwijzingen dat ee
Page 49 and 50: HOOFDSTUK 4CounselingUitgangsvraag4
Page 51 and 52: Kans op spijtDe meeste vrouwen neme
Page 53 and 54: - Algemene voorgeschiedenis- Kans o
Page 55 and 56: terwijl soms ook de hulp van een ma
Page 57 and 58: een open verbinding - fistel - onts
Page 59 and 60: Stel de zwangerschapstermijn vast e
Page 61 and 62: HOOFDSTUK 6KwaliteitscriteriaUitgan
Page 63 and 64: InleidingAls na een sterilisatie ee
Page 65 and 66: BevestigingstestBij alle laparoscop
Page 67 and 68: Bij analyse van zwangerschappen na
Page 69 and 70: BIJLAGE 1 ZoekverantwoordingDeze ri
Page 71 and 72: ReferentieType studieKenmerken(stud
Page 91: ReferentieType studieKenmerken(stud
Page 97 and 98: ReferenceType studyCharacteristicsI
Page 117 and 118: * Uitkomst: de uitkomst en gebruikt
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Richtlijn Sterilisatie van de vrouw - NVOG

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