Emergency peripartum hysterectomy: results from the prospective Nordic Obstetric Surveillance Study (NOSS)
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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; Klungsøyr, Kari; Krebs, Lone; Børdahl, Per E.; Gottvall, Karin; Källen, Karin; Bjarnadóttir, Ragnheiður I; Langhoff-Roos, Jens; Gissler, Mika.
I: Acta Obstetricia et Gynecologica Scandinavica, Bind 94, Nr. 7, 07.2015, s. 745-54.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Emergency peripartum hysterectomy
T2 - results from the prospective Nordic Obstetric Surveillance Study (NOSS)
AU - Jakobsson, Maija
AU - Tapper, Anna Maija
AU - Colmorn, Lotte Berdiin
AU - Lindqvist, Pelle G
AU - Klungsøyr, Kari
AU - Krebs, Lone
AU - Børdahl, Per E.
AU - Gottvall, Karin
AU - Källen, Karin
AU - Bjarnadóttir, Ragnheiður I
AU - Langhoff-Roos, Jens
AU - Gissler, Mika
N1 - © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.
PY - 2015/7
Y1 - 2015/7
N2 - OBJECTIVE: To assess the prevalence and risk factors of emergency peripartum hysterectomy.DESIGN: Nordic collaborative study.POPULATION: 605 362 deliveries across the five Nordic countries.METHODS: We collected data prospectively from patients undergoing emergency peripartum hysterectomy within 7 days 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 3.5/10 000 (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 0.17/100 000 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.
AB - OBJECTIVE: To assess the prevalence and risk factors of emergency peripartum hysterectomy.DESIGN: Nordic collaborative study.POPULATION: 605 362 deliveries across the five Nordic countries.METHODS: We collected data prospectively from patients undergoing emergency peripartum hysterectomy within 7 days 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 3.5/10 000 (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 0.17/100 000 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.
KW - Adult
KW - Cesarean Section
KW - Emergencies
KW - Female
KW - Humans
KW - Hysterectomy
KW - Incidence
KW - Maternal Mortality
KW - Placenta Accreta
KW - Population Surveillance
KW - Postpartum Hemorrhage
KW - Pregnancy
KW - Pregnancy, Prolonged
KW - Premature Birth
KW - Prevalence
KW - Prospective Studies
KW - Puerperal Disorders
KW - Scandinavian and Nordic Countries
KW - Stillbirth
KW - Uterine Rupture
KW - Young Adult
KW - Journal Article
KW - Multicenter Study
KW - Research Support, Non-U.S. Gov't
U2 - 10.1111/aogs.12644
DO - 10.1111/aogs.12644
M3 - Journal article
C2 - 25845622
VL - 94
SP - 745
EP - 754
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
SN - 0001-6349
IS - 7
ER -
ID: 179628297