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https://www.selleckchem.com/products/sitagliptin.html there was no difference in the rates of infectious morbidity between MBP alone, OA alone, or MBP with OA compared to no preparation. CONCLUSIONS Bowel preparation does not protect against SSI or major morbidity following benign or malignant hysterectomy, regardless of surgical approach, and may be safely omitted. BACKGROUND Obstetric healthcare relies on an adequate antepartum risk selection. Most guidelines used for risk stratification, however, do not assess absolute risks. In 2017, a prediction tool was implemented in a Dutch region. This tool combines first trimester prediction models with obstetric care paths tailored to the individual risk profile, enabling risk-based care (RBC). OBJECTIVE To assess impact and cost-effectiveness of RBC compared to care-as-usual (CAU) in a general population. METHODS A before-after study was conducted using two multicenter prospective cohorts. The first cohort (2013-2015) received CAU, the second cohort (2017-2018) received RBC. Health outcomes were 1) a composite of adverse perinatal outcomes and 2) maternal quality adjusted life years (QALYs). Costs were estimated using a healthcare perspective from conception to six weeks after the due date. Mean costs per woman, cost differences between the two groups, as well as incremental cost effectiveness ratios were calculated. Sensitivity analyses were performed to evaluate the robustness of the findings. RESULTS In total 3,425 women were included. In nulliparous women there was a significant reduction of perinatal adverse outcomes among the RBC group (aOR 0.56; 95%CI 0.32-0.94)), but not in multiparous women. Mean costs per pregnant woman were significantly lower for RBC (mean difference -€2,766, 95%CI -€3,700 - -€1,825). No differences in maternal quality of life, adjusted for baseline health, were observed. CONCLUSION In the Netherlands, RBC in nulliparous women was associated with improved perinatal outcomes as compared to CAU

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