Emergency peripartum hysterectomy: results from the prospective Nordic Obstetric Surveillance Study (NOSS).
Acta Obstet Gynecol Scand
; 94(7): 745-754, 2015 Jul.
Article
em En
| MEDLINE
| ID: mdl-25845622
ABSTRACT
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 OUTCOMEMEASURES:
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Placenta Acreta
/
Ruptura Uterina
/
Emergências
/
Hemorragia Pós-Parto
/
Histerectomia
Tipo de estudo:
Clinical_trials
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article