Spontaneous haemoperitoneum in pregnancy: Nationwide surveillance and Delphi audit system.
ART
NethOSS
SHiP
endometriosis
fetal morbidity
maternal morbidity
obstetric surveillance system
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
revised:
29
04
2023
received:
19
11
2022
accepted:
11
05
2023
medline:
6
11
2023
pubmed:
7
6
2023
entrez:
6
6
2023
Statut:
ppublish
Résumé
To evaluate the incidence, diagnostic management strategies and clinical outcomes of women with spontaneous haemoperitoneum in pregnancy (SHiP) and reassess the definition of SHiP. A population-based cohort study using the Netherlands Obstetric Surveillance System (NethOSS). Nationwide, the Netherlands. All pregnant women between April 2016 and April 2018. This is a case study of SHiP using the monthly registry reports of NethOSS. Complete anonymised case files were obtained. A newly introduced online Delphi audit system (DAS) was used to evaluate each case, to make recommendations on improving the management of SHiP and to propose a new definition of SHiP. Incidence and outcomes, lessons learned about clinical management and the critical appraisal of the current definition of SHiP. In total, 24 cases were reported. After a Delphi procedure, 14 cases were classified as SHiP. The nationwide incidence was 4.9 per 100 000 births. Endometriosis and conceiving after artificial reproductive techniques were identified as risk factors. No maternal and three perinatal deaths occurred. Based on the DAS, adequate imaging of free intra-abdominal fluid, and identifying and treating women with signs of hypovolemic shock could improve the early detection and management of SHiP. A revised definition of SHiP was proposed, excluding the need for surgical or radiological intervention. SHiP is a rare and easily misdiagnosed condition that is associated with high perinatal mortality. To improve care, better awareness among healthcare workers is needed. The DAS is a sufficient tool to audit maternal morbidity and mortality.
Identifiants
pubmed: 37280664
doi: 10.1111/1471-0528.17556
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1620-1628Informations de copyright
© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
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