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

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Authors
Jakobsson, Maija
Tapper, Anna-Maija
Colmorn, Lotte Berdiin
Lindqvist, Pelle G
Klungsøyr, Kari
Krebs, Lone
Børdahl, Per E
Gottvall, Karin
Källén, Karin
Bjarnadóttir, Ragnheiður I
Langhoff-Roos, Jens
Gissler, Mika
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Issue Date
2015-07

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Citation
Acta Obstet Gynecol Scand. 2015, 94 (7):745-54
Abstract
To assess the prevalence and risk factors of emergency peripartum hysterectomy.
Nordic collaborative study.
605 362 deliveries across the five Nordic countries.
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.
Emergency peripartum hysterectomy rate.
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).
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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Additional Links
http://dx.doi.org/ 10.1111/aogs.12644
http://onlinelibrary.wiley.com/doi/10.1111/aogs.12644/epdf
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Archived with thanks to Acta obstetricia et gynecologica Scandinavica
ae974a485f413a2113503eed53cd6c53
10.1111/aogs.12644
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English Journal Articles (Peer Reviewed)

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