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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; Källén, Karin; Bjarnadóttir, Ragnheiður I; Langhoff-Roos, Jens; Gissler, Mika.
Afiliación
  • Jakobsson M; Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
  • Tapper AM; Hyvinkää Hospital Area, Helsinki and Uusimaa Hospital District, Helsinki, Finland.
  • Colmorn LB; Juliane Marie Centre, Department of Obstetrics, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.
  • Lindqvist PG; Department of Gynecology and Obstetrics, Clinitec, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
  • Klungsøyr K; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
  • Krebs L; Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway.
  • Børdahl PE; Department of Obstetrics and Gynecology, Holbaek Hospital, Holbaek, Denmark.
  • Gottvall K; University of Copenhagen, Copenhagen, Denmark.
  • Källén K; Department of Obstetrics and Gynecology, Haukeland University Hospital, Haukeland, Norway.
  • Bjarnadóttir RI; University of Bergen, Bergen, Norway.
  • Langhoff-Roos J; Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
  • Gissler M; Epidemiology and Methodological Support Unit, Department of Evaluation and Analysis, National Board of Health and Welfare, Stockholm, Sweden.
Acta Obstet Gynecol Scand ; 94(7): 745-754, 2015 Jul.
Article en En | MEDLINE | ID: mdl-25845622
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placenta Accreta / Rotura Uterina / Urgencias Médicas / Hemorragia Posparto / Histerectomía Tipo de estudio: Clinical_trials / Guideline / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: Europa Idioma: En Revista: Acta Obstet Gynecol Scand Año: 2015 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placenta Accreta / Rotura Uterina / Urgencias Médicas / Hemorragia Posparto / Histerectomía Tipo de estudio: Clinical_trials / Guideline / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: Europa Idioma: En Revista: Acta Obstet Gynecol Scand Año: 2015 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Estados Unidos