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

Maija Jakobsson; Anna Maija Tapper; Lotte Berdiin Colmorn; Pelle G Lindqvist; Kari Klungsøyr; Lone Krebs; Per E. Børdahl; Karin Gottvall; Karin Källen; Ragnheiður I Bjarnadóttir; Jens Langhoff-Roos; Mika Gissler

doi:10.1111/aogs.12644

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

Maija Jakobsson, Anna Maija Tapper, Lotte Berdiin Colmorn, Pelle G Lindqvist, Kari Klungsøyr, Lone Krebs, Per E. Børdahl, Karin Gottvall, Karin Källen, Ragnheiður I Bjarnadóttir, Jens Langhoff-Roos, Mika Gissler

Department of Clinical Medicine

20 Citations (Scopus)

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 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.

Original language	English
Journal	Acta Obstetricia et Gynecologica Scandinavica
Volume	94
Issue number	7
Pages (from-to)	745-54
Number of pages	10
ISSN	0001-6349
DOIs	https://doi.org/10.1111/aogs.12644
Publication status	Published - 1 Jul 2015

Keywords

Adult
Cesarean Section
Emergencies
Female
Humans
Hysterectomy
Incidence
Maternal Mortality
Placenta Accreta
Population Surveillance
Postpartum Hemorrhage
Pregnancy
Pregnancy, Prolonged
Premature Birth
Prevalence
Prospective Studies
Puerperal Disorders
Scandinavian and Nordic Countries
Stillbirth
Uterine Rupture
Young Adult
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/aogs.12644

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Jakobsson, M., Tapper, A. M., Colmorn, L. B., Lindqvist, P. G., Klungsøyr, K., Krebs, L., Børdahl, P. E., Gottvall, K., Källen, K., Bjarnadóttir, R. I., Langhoff-Roos, J., & Gissler, M. (2015). Emergency peripartum hysterectomy: results from the prospective Nordic Obstetric Surveillance Study (NOSS). Acta Obstetricia et Gynecologica Scandinavica, 94(7), 745-54. https://doi.org/10.1111/aogs.12644

Jakobsson, M, Tapper, AM, Colmorn, LB, Lindqvist, PG, Klungsøyr, K, Krebs, L, Børdahl, PE, Gottvall, K, Källen, K, Bjarnadóttir, RI, Langhoff-Roos, J & Gissler, M 2015, 'Emergency peripartum hysterectomy: results from the prospective Nordic Obstetric Surveillance Study (NOSS)', Acta Obstetricia et Gynecologica Scandinavica, vol. 94, no. 7, pp. 745-54. https://doi.org/10.1111/aogs.12644

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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 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.",

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author = "Maija Jakobsson and Tapper, {Anna Maija} and Colmorn, {Lotte Berdiin} and Lindqvist, {Pelle G} and Kari Klungs{\o}yr and Lone Krebs and B{\o}rdahl, {Per E.} and Karin Gottvall and Karin K{\"a}llen and Bjarnad{\'o}ttir, {Ragnhei{\dh}ur I} and Jens Langhoff-Roos and Mika Gissler",

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year = "2015",

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doi = "10.1111/aogs.12644",

language = "English",

volume = "94",

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journal = "Acta Obstetricia et Gynecologica Scandinavica",

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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

PY - 2015/7/1

Y1 - 2015/7/1

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.

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KW - Cesarean Section

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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

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DO - 10.1111/aogs.12644

M3 - Journal article

C2 - 25845622

SN - 0001-6349

VL - 94

SP - 745

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JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 7

ER -

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

Abstract

Keywords

UN SDGs

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