Analyses of severe acute maternal morbidity in Slovakia during years 2012–2016

Abstract

AIM: Severe acute maternal morbidity (SAMM) is a state of the woman, when she nearly died, but survived. The aim of study was to fi nd out the exact incidence of SAMM in Slovakia, establishment of functional surveillance system and improve quality of health care. MATERIALS AND METHODS: The regular annual analyses of SAMM cases in Slovakia from January 1 st 2012 to December 31 st 2016. Observed SAMM included: peripartum haemorrhage, peripartum hysterectomy, uterine rupture, abnormally invasive placenta, HELLP syndrome, eclampsia, sepsis, transport to intensive care unit or anaesthesiology and non-fatal amniotic fl uid embolism. RESULTS: The response rate of questionnaires was 84.8 %. The overall confi rmed incidence of SAMM was 6.35/1,000 births (95% CI 6.03-6.67). The most often causes of SAMM were: peripartum haemorrhage (2.1/1,000 births), transport to intensive care unit or anaesthesiology (1.46/1,000 births), peripartum hysterectomy (0.84/1,000 births) and HELLP syndrome (0.63/1,000 births). The average age of women with SAMM was 30.3 years (14-46) and average parity was 1.16 (0-15). CONCLUSION: The incidence of SAMM and especially incidence of peripartum haemorrhage and peripartum hysterectomy in Slovakia is one of the highest in Europe. To decrease incidence and improve management and outcome of patients, regular audit of SAMM is needed (Tab. 3, Fig. 2, Ref. 30). Text in PDF www.elis.sk. KEY WORDS: severe acute maternal morbidity, surveillance system, severe postpartum haemorrhage, peripartum hysterectomy, eclampsia, HELLP syndrome, abnormally invasive placenta, uterine rupture, sepsis, amniotic fl uid embolism, transport to intensive care unit or anaesthesiology.

Management of major obstetric hemorrhage prior to peripartum hysterectomy and outcomes across nine European countries

“…We performed a multi‐country, population‐based study combining data from nine countries of the International Network of Obstetric Survey Systems (INOSS) 9‐16 . INOSS is an international collaboration of national survey systems, aiming to improve management of uncommon obstetric complications 17 .…”

“…We performed a multi-country, population-based study combining data from nine countries of the International Network of Obstetric Survey Systems (INOSS). [9][10][11][12][13][14][15][16] INOSS is an international collaboration of national survey systems, aiming to improve management of uncommon obstetric complications. 17 Data from obstetric surveillance studies on peripartum hysterectomy were collected from: Methods of data collection for all individual survey studies have previously been described more extensively.…”

Risk factors, management, and outcomes of amniotic fluid embolism: A multicountry, population-based cohort and nested case-control study

“…The studies were conducted in Australia between 1 January 2010 and 31 December 2016, using the Australasian Maternity Outcomes Surveillance System (AMOSS) [11]; in France between 1 May 2012 and 30 November 2013, using the Épidémiologie de la Morbidité Maternelle Sévère (EPIMOMS) [12] study; in the Netherlands between 1 September 2013 and 31 August 2016, using the Netherlands Obstetric Surveillance System (NethOSS); in Slovakia between 1 January 2012 and 31 December 2016, using the Slovak Obstetric Survey System (SOSS); and in the UK between 1 February 2005 and 31 January 2018, using the UK Obstetric Surveillance System (UKOSS) [13]. Australia, Slovakia, and the UK have previously published some of their data in peer-reviewed journals [1,6,14–17]. With the exception of the French study, which was conducted in six regions of France (Alsace, Auvergne, Basse-Normandie, Ile-de-France, Lorraine, and Rhône-Alpes) covering one-fifth of all deliveries in the country, studies were nationwide, with nominated clinicians in each maternity unit in the country contacted on a monthly basis and asked to report all cases of AFE (see Table 1 for definitions of AFE used by participating countries).…”

Epidemiological analysis of peripartum hysterectomy across nine European countries

“…Most of these countries, except France and Slovakia, have previously published outcomes of peripartum hysterectomy surveillance. [11][12][13][14][15][17][18][19][20] is an international collaboration of national obstetric survey systems, aiming to increase knowledge of management of uncommon obstetric complications. 16 Participating in this study were: Slovak Obstetric Methods of data collection were described previously.…”

“…10 Hence, indications and outcomes are often studied retrospectively, or through national obstetric survey systems. [11][12][13][14][15] Multinational comparisons of prevalence and outcomes to optimize management strategies may be facilitated by international collaborations combining national data. 1,16 The main aim of this study was to compare the prevalence of peripartum hysterectomy between high-income countries, as part of the International Network of Obstetric Survey Systems (INOSS).…”