Severe obstetric maternal morbidity: a 15-year population-based study.
Using a provincial perinatal database for 15 years, 1988-2002. Cases were identified with one or more of the following markers of severe maternal morbidity: blood transfusion > or = 5 units, emergency hysterectomy, uterine rupture, eclampsia, intensive care (ICU) admission. There were 159,896 mothers delivered of whom 313 (2.0/1000) had 385 markers of severe morbidity (257 had one, 42 had two, 12 had three, and two had four). The following rates of morbidity were recorded: blood transfusion > or = 5 units 119 (0.74/1000); emergency hysterectomy 88 (0.55/1000); uterine rupture 49 (0.31/1000); eclampsia 46 (0.28/1000); ICU 83 (0.52/1000). There was a statistically significant association between multiparity > or = 1, and emergency hysterectomy and uterine rupture; between age > or = 35 years, and emergency hysterectomy, uterine rupture and ICU; and between caesarean delivery and blood transfusion > or = 5 units, emergency hysterectomy, uterine rupture, eclampsia and ICU. The main contributing obstetric complications were haemorrhage (64.7%) and complications of hypertensive disorders (16.8%).
Baskett
T F
TF
Department of Obstetrics and Gynaecology and Perinatal Epidemiology Research Unit, Dalhousie University, Halifax, Nova Scotia, Canada.
O'Connell
C M
CM
D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D003422:Critical Care / Q000706:statistics & numerical data; D004461:Eclampsia / Q000453:epidemiology; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007044:Hysterectomy / Q000706:statistics & numerical data; D009017:Morbidity; D009674:Nova Scotia / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D014592:Uterine Hemorrhage / Q000453:epidemiology; D014597:Uterine Rupture / Q000453:epidemiology