leonardo da vinci the baby in the womb a nno 1511
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1. 1. 1. Leonardo da Vinci The baby in the womb A nno 1511. Uterusruptur i Norge. I Al-Zirqi, S Vangen, L Forsén, A K Daltveit, B Stray-Pedersen. Bakgrunn. Bakgrunn : En sjelden peripartum komplikasjon ( 0.7/1000) 2 - 8/1000 hos mødre med uterin arr Ofte katastrofalt utfall - PowerPoint PPT PresentationTRANSCRIPT
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Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
11Leonardo da Vinci The baby in the wombAnno 1511
I Al-Zirqi, S Vangen, L Forsén, A K Daltveit, B Stray-Pedersen
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Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Bakgrunn
Bakgrunn:• En sjelden peripartum komplikasjon
(0.7/1000)• 2 - 8/1000 hos mødre med uterin arr • Ofte katastrofalt utfall • Økt keisersnitt (KS) på verden basis:
– økt uterus ruptur?
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Mål
Studere: • trenden av forekomst og utfall av
uterusruptur i Norge i 1967-2008.• Risiko faktorer for uterus ruptur i Norge• Beskrivelse av uterus rupturer før
fødselsstart / rupturer før term• Risiko faktorer for alvorlig utfall for mor og
barn som følger rupturer
Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Validerings studie
• Acta Obstet Gynecol Scand. 2013 Sep;92(9):1086-93. doi: 10.1111/aogs.12148. Epub 2013 May 20.
• Validation study of uterine rupture registration in the Medical Birth Registry of Norway.
• Al-Zirqi I, Stray-Pedersen B, Forsén L, Kjersti Daltveit A, Vangen S; NUR group.
Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Validering
• Medisinsk fødselsregister (MFR)
• Pasient administrasjonssystem (PAS)
• Medisinske journaler
Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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7Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Validity of diagnosis of uterine rupture in MBRN in 1999-2008
MBRN
Medical records Rupture (+) Not rupture (-)
Registered as rupture (+) 151
TP141
FP10
PPV93.4%
Not registered as rupture(-) 392 956
FN82
TN392 874
NPV99.97%
Sensitivity63.2%
Specificity99.99%
Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Incidence of uterine rupture, 1999-2008 (per 1000)
Before correction
After correction
All maternities
-All ruptures -Complete
151 (0.38) 76 (0.19)
223 (0.56)109 (0.27)
Scarred uterus
-All ruptures -Complete
125 (3.92) 63 (1.97)
199 (6.20) 89 (2.80)
Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Key message:• The registration of uterine rupture diagnosis in
MBRN is not optimal.• This is mainly due to use of plain text in
registration form & recoding by MBRN.• Studies on uterine rupture based on MBRN alone
are not accurate.• A particular concern: No differentiation between
complete and partial ruptures• Ticked boxes may improve quality of registration
Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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Iqbal Al-Zirqi Nasjonal kompetansetjeneste for kvinnehelse
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The study was approved by The Regional Ethical Committee & Data Inspectorate of Norway.Funding: South-East Health Region, Norway.No conflict of interest in connection with this study.