Page 31 - 2019-06 presentatie LUMC

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nce perceived as being ‘physiological’. By supervis s and postnatal periods in primary maternity ected) complications/pathology in secondary ma ernity care professionals’ expertise can be applied t
o
r
n
e
α
,
β
-
u
n
sa
e
ndary care are defined in the List of Obstetric In
at
ie
Lijs
t
)–
a
lis
t
b
as
ed
on
sc
ien
ti
fi
c ev
id
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isk s
ele
c
tio
n
,t
he
ind
i
ca
tio
n
s
fo
r re
fe
on the structural similarity
us maternity care professionals. Currently the t ished in 2003, is in use.
Name
2-butenal crotonaldeh
not only important during atal period. In the prenatal
tboebeeffefcfteivcetivine dinetpercetvinegntaindg tions, promoting a healthy postnatal period professional alth of mother and child, to or physical and mental health ffect health and wellbeing. nting and the responsibilities the universal accessibility of in the Netherlands have ous ethnic origins are more
a complete understanding of
thesis is specifically focusing on primary m ementioned primary care midwives as the roximately 77% of the 2444 midwives in the Neth
al
tr(ans-ci
erlands (83.2%) had their first maternity care ch care is provider
e
trans-2-hexe
trans-2-octen
trans-2-cis-6
newborns with complications or a secondary care. Thus these pr gatekeepers to secondary matern is that in the Netherlands, pregn essence perceived as being ‘phy births and postnatal periods in (expected) complications/patholo maternity care professionals’ exp guide the risk selection, the in secondary care are defined in t Indicatie Lijst) – a list based on various maternity care professio
2-propenal (acrolein)
[12]. Between 1999 and 2012, the majority of
ng. E
34.2% gave birth in a primary care setting [13].
ta
rt
ral follow-up visits in which diagnostic, counseli ities are performed. According to the standar nistartiaonosf -M2id-whivesx(KeNnOaV)l, the first prenatal visit e between the 6th and 8th week of pregnancy [14]. 6 prenatal visits should ideally be made, with an ave ssary medical care and the needs and expectatio
without
al
bonds
more
ted
bonds with or additional
citral (mixtu neral and ger
trans-2-trans ienal
and postnatal care. Approximately 77% of the 2444 ondary a care [12]. Between 1999 and 2 mation on the organisation of Netherlands (83.2%) had their f
se
renatal and postnatal care by and 34.2% gave birth in a primary
trans-2-octenal
care system i
i
s
furoa rt
childbirth (natal care) and after bi Prenatal care encompasses sup confirmation during the prenatal several follow-up visits in which activities are performed. Accor Organisation of Midwives (KNOV) made between the 6th and 8th w to 16 prenatal visits should ideally necessary medical care and the
er 1trans-2-cis-6-nonadie
l by only ref nal
stnatal pe ed to be e
he Dutch maternity care sy
t
u
r
a
a ild
l
t
s
ter
ni
ty
c
ar
e
e
d
a
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b
irt
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α,β-unsaturation in p-mentha-1,8(10)-die side chain n-9-al
to α,β-unsaturated aldeh
ein) and 2-butenal (cr p-ment anic materials and theref
t from engines [2, 10]. 2-P al
e [2]. α,β-Unsaturated ald
olyunsaturated fatty acids reaction mechanism, yi ent decomposition of lipi 2-propenal, 4-hydroxy-2- 2,6,6-tr les of food-borne α,β-un
al yEFSAbasedxonath-e1st,ru3c
urated aldehydes also comes from other sources than the diet. Alicyclic
dere grafische uitingen tegen meerprijs
butenal (crotonaldehyde) for example are produced during
1
s and therefore found in all types of smoke including cigarette s [2, 10]. 2-Propenal is pre
sent at 25 – 140
ptrhoveidredmbyoorbestetfriociarnms ed ary care) and academic 1 15]. Lipid peroxi
roperoxides as
tem is risk selection. Risk
ly referring women and veloping complications to
d
e
s
g
e
n
e
r
a
p
ciple behind risk selection
me paosltnoatnaldpeiraiodldarehinyde[ ing low risk pregnancies,
care, and only cases of
ternity care, the various
o its full potential [11]. To
to
dications (Verloskundige d [co1ns4en]sus among the
hird revision of this list,
Structure
aternity care, with the main care providers. lands provide this type of
pregnadnt wombenyin theob eck-up in a primary care
ed
e
h
y
in
ro
fess
io
na
ls
se
r
ve
as
a
n
d
co
nsult
a
t
te
d
labo
ur in pr
imar
y care,
d
e
s
l
i
s
regnancy (prenatal care), are) and
um care).
women from pregnancy consists of an intake and
ng and health education ds of the Royal Dutch (intake) should ideally be Throughout pregnancy 10 rage of 13, depending on ns of clients. In the first
s risk sele erring 9w
ion
o
f
te
san
μg/cigarette endogenousl
dation,initisure acrol
in the gas y by lipid ated by a l reaction gradation
Pagina afloop Expo 2-Propenal ( α,β-unsaturation combustion o
smoke and ex
Paginarand
with the
ources
d wine [1],
bacco smoke a] n s
Cinna deriva and aroma su
al
d wine [1], 1 mic
bacco smoke ]
anana [1], fig
7]
rape, orange
]isk
Skilled pro childbirth,
Gener
bstituted 2- wi ad
Zwarte balk t.b.v. trapeffect wi
dehydes 2-phenyl-2-alke
al I
roducti
H
fessional car but also during
n
n
-b 3-
ad do T co do wi
n
zijkant boek
eterocyclic
i for pregnFaurnfutralwdeormivaet
o
major initia umber of de
16]. accordance
in f org
ring/side chain haus phase of the smok peroxidation of p free-radical chain products. Subsequ products including
Table 1.1 Examp more comcaptegloerixes made b Description of the
Alphatic
acade
alkyla th or dition
ction. R
en
S retivesCinnamylaldeh
ta stetrici[2ticalkyl
to
double-
ta [2 b [1 g
n
[1
omen caucnumdber[18]
-c
on
ing complications to
period, professional care is generally acknowledg
21-02-15 18:47
adverse pregnancy outcomes, and it is considered
myl
With or addition
the prenatal and po
Furanswith
conjugation in side
no y
n-
n double-
con d
re
other
a
ds alkyla th or dition uble- wo or njuga uble- thout
on
v
e
ydes also comes from other sources than the diet. otonaldehyde) for example are produced during
Alicyclic
Cinnamyl derivatives and other aromatic alkyl substituted aldehydes
Heterocyclic
Others
1.3
General introduction
1
General Introducti
Skilled professional ca
cpheirlidobdi,rtphr,obfeustsioalnsaol cdaur adverse pregnancy outc treating complications, lifestyle and facilitating care is necessary to m
ha-1,8-dien-7-
α,β-unsaturation in side chain
α,β-unsaturation in ring/side chain
more complex
Cinnamyl aldehyde
Furfural derivatives Furfural
ore found inWord
p-mentha-1,8(10)-die n-9-al
p-mentha-1,8-dien-7- al
2,6,6-trimethylcycloh exa-1,3-diene-1- carbaldehyde
trans-cinnamaldehyd e
all types
ropenal is present at 25 – 140 μg/cigarette in the gas
of
ehydes are furthermore formed endogenously by lipid
smo
ke including cigarette
(PUFAs) [2,
elds lipid hydroperoxides as major initial reaction d hydroperoxides generates a number of degradation
15]. Lip
id pe
ro
xidation, initiated by a
graphic
alkenals, and malondialdehyde [16].
imethylcycloh
y
replaced graphic
saturated aldehydes listed in accordance with the
tural similarity [14] -diene-1- e
ehyde acrolein)
Structure
-nonadie
Sources
red wine [1], tabacco smoke [2]
red wine [1], tabacco smoke [2]
banana [1], fig [17]
grape, orange [1]
cucumber [18]
black tea [19]
lime [1]
cassia (bark
oil) [1]
n
namaldehyd
2-phenyl-2-alkenals cassia
(
rk nal
de)
x
5-methyl-2-phenylhe
b
a
nal al
cacao, coffee,
-2 oil) [1]
-e
onaldehy
yl-2-phenylhe
l
re of anial)
-4-hexad
yl-2-pete
foster an environment t meat prodaus cwtsell as social and
[21]
Furthermore, it offers n that come with it [2]. D prenatal and postnat demonstrated that no likely to make inadequa
Research conducted so non-western women’s Filling this gap in knowl conducting this study. interactions between n involved, as this may aff
Furans with conjugation in side chain
Furfurylidene-2-buta nal
Other sulphur 2-(Methylthiomethyl) containing substances -3-phenylpropenal
ADME (absorption, distribution, metabolism and excretion)
a fig [17], α,β-Unsaturated aldehydes are rapidly absorbed, distributead, nmetdabolizesd pandexcreted liniusriene,
re, blueberry[20] faecesandexpiredacir.aWchaenom,alceoWfisftaerera,tswereexpo 14 theaim,researchquest
This introductory chapt population density
ia
d ‘cli in this thesis.
ty c non-western women in
Or
ma
among non-western wo
terni
the no
lnly important during
riod. In the prenatal
-4-octad
ffective in preventing
lidene-2-buta
ctive in detecting and
10
l
trans-2-nonenal or trans-2-pentenal by gavage [22], both aldehydes entered the systemicary ca
circulation from the mgasteroaintesptinraol (dGIu) tcratcst, and were metabolized to yield C-3 mercapturic
acids within 24 hours. Only trace amount of trans-2-nonenal or trans-2-pentenal were foundIninthe Netherlands, mat primary, secondary and
faeces [22]. In anoth[er2st1ud]y, male and female Sprague-Dawley rats were exposed to 2.5 or 15
midwives, autonomous mg/kg bw 14C labelled 2-propenal by gavage [23]. Urine was the major excretion rocuatre on their own acc active in midwifery car
sed
to
100 m
g/
C
el
led
kg
bw
of
hospitals (tert
One of the basic pil 811
selection is condu
ab
g
anis
ati
on of
ma
te
on
re for pregnant women is ring the prenatal and postn e is generally acknowledged omes, and it is considered to providing timely interven informed choice [1]. In the aintain and promote the he hat offers help and support f cultural issues that can a ew parents support for pare espite these advantages and al care, previous studies n-western women from vari te use of these services [3-7].
far, has not been able to give prenatal and postnatal care edge and understanding pr
The second rationale w on-western women and the ect the utilisation of prenatal
[er9prov]ide.s bacSkgroeundcinfor
n-
men and the utilisation of p
ions
wes
ntheiNcethaerlalnd’s. In amdditio
a
heo
re
tical fr
, perin amew
ter nd t
n pop
ula
tion
rrnitey ca)re in[th1e N0ethe]rl.an ernity care is organised in a tertiary care [8]. Primary car qualified medical professio ountability, and a small nu e. Latter are mainly engag
lars of t
cted at
Non-western wo
PDF o
1 grafische
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population density [9]. Secondar and specialised ‘clinical’ midwiv hospitals (tertiary care) [10].
Os e n l e e c o t i f o n t h e i s b a c s o i n c d p u i l c l a t e r s d o a f t t h p e r i D m u
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an
d
tert
ia
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ca
u
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ital
s
a
t
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(PUFAs) [2,
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(te
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ary c
ar
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[
10
].
t
d
a
l
d
e
h
y
specialised ‘clinical’ midwives in general (second
d
e
s
a
r
e
f
re
is
chanism, yields lipid hyd
of the basic pillars of the Dutch maternity care sys
een
ction is conducted at primary care level by on
borns with complications or an increased risk for de
i
t
i
o
n
o
f
l
i
p
i
d
h
y
n
keepers to secondary maternity care. The basic prin
d
a
ry
c
are.
T
hu
s lan
t
he
s pr
ep
rim
a cy
d
r
o
p
e
r
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i
ry ,c
m
nal
ted aldehydes 2-methylcrot
ary2m-bidwuitferyncalre includes care provided during p
l (secondary c birth(natalcare)andafterbirth(postnatal/postpartlsutilisationintheNetherlands.publishedin2003,isinuse.
without de
5-meth
al double trans-2-meth
nal ovided the main rationale for
x-2-ena
as gaining insight into the This thesis is specifically focu
nFou ien al
a
tal a
nd m
ate
rna
l mort
ality
tting. E
ven
tuall
y, 5
4.3% o
ft
he
nd tertiary care is
n, information is given about
ork of the research presented Primary midwifery care includes idwives in general (secon
is2-kmefthoylcrrotdonealdvehey lop de
Furfury to bnealeffe
primary care level by o
s
secondary care. Thus these primary maternity car gatekeepers to secondary maternity care. The basic pri
nity care professionals serve as
timely
3
2429
Boerlei
der.indd 9
trans-2-methyl-2-pete
lifestyle and facilitating informed chOotihceer s[u1lp]h.uIrn the po2s-(tMneatthaylthpioemreiothdyl)professional black tea [19]
treating
complications,
providing
chain
interventions, promoting a
healthy
newborns with complications or an increa
e
d
risk for d
nal containing substances -3-phenylpropenal
asic principle behind risk selection care is necessary to maintain and promote the health of mother and child, to
Others
32620 Reiko Kiwamoto.indd 11
17-03-15 15:34
s
trans-2-trans
jug
a bonds
ted
ds
model consisting of so called e is provided by primary care nals providing full maternity mber of general practitioners ed in rural areas with a low
men in maternity care in the Netherlands Chapter 1
D
fi
o r
sp p
u
l
u
d s
4t
h
b d
o
v
h y
a
y e
b
th and the postnatal period are in foster an environment that offers help and support for physical and mental health
g
m p
n e
DF opmaak standaard
175,-
PDF op
n is that in the Netherlands, pregnancy, childbirth and th