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Emergency peripartum hysterectomy: results from the prospective Nordic Obstetric Surveillance Study (NOSS)

Jakobsson, Maija; Tapper, Anna-Maija; Colmorn, Lotte Berdiin; Lindqvist, Pelle G.; Klungsoyr, Kari; Krebs, Lone; Bordahl, Per E.; Gottvall, Karin; Källén, Karin LU and Bjarnadottir, Ragnheiour I., et al. (2015) In Acta Obstetricia et Gynecologica Scandinavica 94(7). p.745-754
Abstract
Objective: To assess the prevalence and risk factors of emergency peripartum hysterectomy. Design:Nordic collaborative study. Population605362 deliveries across the five Nordic countries. Methods: We collected data prospectively from patients undergoing emergency peripartum hysterectomy within 7days of delivery from medical birth registers and hospital discharge registers. Control populations consisted of all other women delivering on the same units during the same time period. Main outcome measures: Emergency peripartum hysterectomy rate. Results: The total number of emergency peripartum hysterectomies reached 211, yielding an incidence rate of 3.5/10000 (95% confidence interval 3.0-4.0) births. Finland had the highest prevalence (5.1)... (More)
Objective: To assess the prevalence and risk factors of emergency peripartum hysterectomy. Design:Nordic collaborative study. Population605362 deliveries across the five Nordic countries. Methods: We collected data prospectively from patients undergoing emergency peripartum hysterectomy within 7days of delivery from medical birth registers and hospital discharge registers. Control populations consisted of all other women delivering on the same units during the same time period. Main outcome measures: Emergency peripartum hysterectomy rate. Results: The total number of emergency peripartum hysterectomies reached 211, yielding an incidence rate of 3.5/10000 (95% confidence interval 3.0-4.0) births. Finland had the highest prevalence (5.1) and Norway the lowest (2.9). Primary indications included an abnormally invasive placenta (n=91, 43.1%), atonic bleeding (n=69, 32.7%), uterine rupture (n=31, 14.7%), other bleeding disorders (n=12, 5.7%), and other indications (n=8, 3.8%). The delivery mode was cesarean section in nearly 80% of cases. Previous cesarean section was reported in 45% of women. Both preterm and post-term birth increased the risk for emergency peripartum hysterectomy. The number of stillbirths was substantially high (70/1000), but the case fatality rate stood at 0.47% (one death, maternal mortality rate 0.17/100000 deliveries). Conclusions: A combination of prospective data collected from clinicians and information gathered from register-based databases can yield valuable data, improving the registration accuracy for rare, near-miss cases. However, proper and uniform clinical guidelines for the use of well-defined international diagnostic codes are still needed. (Less)
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keywords
Abnormally invasive placenta, cesarean section, emergency peripartum, hysterectomy, postpartum hemorrhage, near-miss complication
in
Acta Obstetricia et Gynecologica Scandinavica
volume
94
issue
7
pages
745 - 754
publisher
Wiley-Blackwell
external identifiers
  • wos:000355868600011
  • scopus:84930415633
ISSN
1600-0412
DOI
10.1111/aogs.12644
language
English
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yes
id
6d2e39eb-7ec9-4a14-9474-ac720c22802c (old id 7602018)
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2015-08-03 10:08:40
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2017-08-27 04:43:31
@article{6d2e39eb-7ec9-4a14-9474-ac720c22802c,
  abstract     = {Objective: To assess the prevalence and risk factors of emergency peripartum hysterectomy. Design:Nordic collaborative study. Population605362 deliveries across the five Nordic countries. Methods: We collected data prospectively from patients undergoing emergency peripartum hysterectomy within 7days of delivery from medical birth registers and hospital discharge registers. Control populations consisted of all other women delivering on the same units during the same time period. Main outcome measures: Emergency peripartum hysterectomy rate. Results: The total number of emergency peripartum hysterectomies reached 211, yielding an incidence rate of 3.5/10000 (95% confidence interval 3.0-4.0) births. Finland had the highest prevalence (5.1) and Norway the lowest (2.9). Primary indications included an abnormally invasive placenta (n=91, 43.1%), atonic bleeding (n=69, 32.7%), uterine rupture (n=31, 14.7%), other bleeding disorders (n=12, 5.7%), and other indications (n=8, 3.8%). The delivery mode was cesarean section in nearly 80% of cases. Previous cesarean section was reported in 45% of women. Both preterm and post-term birth increased the risk for emergency peripartum hysterectomy. The number of stillbirths was substantially high (70/1000), but the case fatality rate stood at 0.47% (one death, maternal mortality rate 0.17/100000 deliveries). Conclusions: A combination of prospective data collected from clinicians and information gathered from register-based databases can yield valuable data, improving the registration accuracy for rare, near-miss cases. However, proper and uniform clinical guidelines for the use of well-defined international diagnostic codes are still needed.},
  author       = {Jakobsson, Maija and Tapper, Anna-Maija and Colmorn, Lotte Berdiin and Lindqvist, Pelle G. and Klungsoyr, Kari and Krebs, Lone and Bordahl, Per E. and Gottvall, Karin and Källén, Karin and Bjarnadottir, Ragnheiour I. and Langhoff-Roos, Jens and Gissler, Mika},
  issn         = {1600-0412},
  keyword      = {Abnormally invasive placenta,cesarean section,emergency peripartum,hysterectomy,postpartum hemorrhage,near-miss complication},
  language     = {eng},
  number       = {7},
  pages        = {745--754},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Emergency peripartum hysterectomy: results from the prospective Nordic Obstetric Surveillance Study (NOSS)},
  url          = {http://dx.doi.org/10.1111/aogs.12644},
  volume       = {94},
  year         = {2015},
}