Lotte B Colmorn1, Kathrine B Petersen2, Maija Jakobsson3, Pelle G Lindqvist4, Kari Klungsoyr5, Karin Källen6,7, Ragnheidur I Bjarnadottir8,9, Anna-Maija Tapper10,11, Per E Børdahl12, Karin Gottvall6,13, Lars Thurn14, Mika Gissler15,16, Lone Krebs17,18, Jens Langhoff-Roos1. 1. Department of Obstetrics, Rigshospitalet Copenhagen University Hospital/University of Copenhagen, Copenhagen, Denmark. 2. Fertility Clinic, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark. 3. Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland. 4. Clinitec, Karolinska Institute/Department of Gynecology and Obstetrics, Karolinska University Hospital, Stockholm, Sweden. 5. Department of Global Public Health and Primary Care, University of Bergen/Medical Birth Register of Norway, Norwegian Institute of Public Health, Bergen, Norway. 6. Epidemiology and Methodological Support Unit, Department of Evaluation and Analysis, National Board of Health and Welfare, Stockholm, Sweden. 7. Department of Obstetrics and Gynecology, Institution of Clinical Sciences, University of Lund, Lund, Sweden. 8. Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland. 9. Icelandic Medical Birth Register, Reykjavik, Iceland. 10. Department of Gynecology and Pediatrics, Helsinki University Central Hospital, Helsinki, Finland. 11. Department of Gynecology and Obstetrics, Hyvinkää Hospital, Helsinki and Uusimaa district, Finland. 12. Haukeland Hospital, Bergen, Norway. 13. Department of Obstetrics and Gynecology, Haukeland University Hospital/University of Bergen, Bergen, Norway. 14. Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden. 15. Karlskrona County Hospital, Karlskrona, Sweden. 16. THL National Institute for Health and Welfare, Helsinki, Finland. 17. Nordic School of Public Health, Gothenburg, Sweden. 18. Department of Obstetrics and Gynecology, Holbaek Hospital/University of Copenhagen, Holbaek, Denmark.
Abstract
OBJECTIVE: To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. DESIGN: Prospective, Nordic collaboration. SETTING: The Nordic Obstetric Surveillance Study (NOSS) collected cases of severe obstetric complications in the Nordic countries from April 2009 to August 2012. SAMPLE AND METHODS: Cases were reported by clinicians at the Nordic maternity units and retrieved from medical birth registers, hospital discharge registers, and transfusion databases by using International Classification of Diseases, 10th revision codes on diagnoses and the Nordic Medico-Statistical Committee Classification of Surgical Procedure codes. MAIN OUTCOME MEASURES: Rates of the studied complications and possible risk factors among parturients in the Nordic countries. RESULTS: The studied complications were reported in 1019 instances among 605 362 deliveries during the study period. The reported rate of severe blood loss at delivery was 11.6/10 000 deliveries, complete uterine rupture was 5.6/10 000 deliveries, abnormally invasive placenta was 4.6/10 000 deliveries, and peripartum hysterectomy was 3.5/10 000 deliveries. Of the women, 25% had two or more complications. Women with complications were more often >35 years old, overweight, with a higher parity, and a history of cesarean delivery compared with the total population. CONCLUSION: The studied obstetric complications are rare. Uniform definitions and valid reporting are essential for international comparisons. The main risk factors include previous cesarean section. The detailed information collected in the NOSS database provides a basis for epidemiologic studies, audits, and educational activities.
OBJECTIVE: To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. DESIGN: Prospective, Nordic collaboration. SETTING: The Nordic Obstetric Surveillance Study (NOSS) collected cases of severe obstetric complications in the Nordic countries from April 2009 to August 2012. SAMPLE AND METHODS: Cases were reported by clinicians at the Nordic maternity units and retrieved from medical birth registers, hospital discharge registers, and transfusion databases by using International Classification of Diseases, 10th revision codes on diagnoses and the Nordic Medico-Statistical Committee Classification of Surgical Procedure codes. MAIN OUTCOME MEASURES: Rates of the studied complications and possible risk factors among parturients in the Nordic countries. RESULTS: The studied complications were reported in 1019 instances among 605 362 deliveries during the study period. The reported rate of severe blood loss at delivery was 11.6/10 000 deliveries, complete uterine rupture was 5.6/10 000 deliveries, abnormally invasive placenta was 4.6/10 000 deliveries, and peripartum hysterectomy was 3.5/10 000 deliveries. Of the women, 25% had two or more complications. Women with complications were more often >35 years old, overweight, with a higher parity, and a history of cesarean delivery compared with the total population. CONCLUSION: The studied obstetric complications are rare. Uniform definitions and valid reporting are essential for international comparisons. The main risk factors include previous cesarean section. The detailed information collected in the NOSS database provides a basis for epidemiologic studies, audits, and educational activities.
Authors: Stacie E Geller; Abigail R Koch; Caitlin E Garland; E Jane MacDonald; Francesca Storey; Beverley Lawton Journal: Reprod Health Date: 2018-06-22 Impact factor: 3.223
Authors: G Vandenberghe; M De Blaere; V Van Leeuw; K Roelens; Y Englert; M Hanssens; H Verstraelen Journal: BMJ Open Date: 2016-05-17 Impact factor: 2.692