Abstract
Objective
To measure the accuracy of blood transfusion (timing and number of blood units) in
postpartum hemorrhage (PPH) in a perinatal network.
Study design
(1) The ANONYMAT software system was used for anonymization and linkage of two large
stand-alone databases, the Burgundy Perinatal Network (BPN) and the National Blood
Centre (EFS) databases, which contain, respectively, clinical data from hospital discharges
and information concerning any blood transfusion in France (considered as the gold
standard database for identifying any transfusion). (2) Identification of prescriptions
of at least one red blood cell (RBC) unit at the day of delivery (≥22 weeks) and up to 42 days, with manual reviewing of medical records in case of discordant recording. (3)
Assessing the sensitivity and positive predictive value of data from the BPN database.
Results
Among the 9736 women receiving at least one blood product dispensed between 01/01/2006
and 12/31/2007 and the 35,779 women who delivered, 233 women (0.65% of deliveries)
received at least one RBC unit for post partum hemorrhage. In the BPN database according
to the type of hospital stay in our perinatal network (delivery stay only, delivery
and post-delivery stays), sensitivity and positive predictive value for RBC transfusion
ranged from 61.4% (55.1–67.6) to 67.8% (61.8–73.8) and 82.2% (76.5–87.9) to 83.2%
(77.8–88.5), respectively. Linkage of both BPN and EFS databases allowed accurate
recording of all but one RBC transfusion.
Conclusion
Our approach allowed 100% electronic recording of PPH requiring blood transfusion,
making it an important sentinel event of maternal morbidity to assess the perinatal
network.
Keywords
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References
- Pregnancy-related deaths in four regions of Europe and the United States in 1999–2000: characterisation of unreported deaths.Eur J Obstet Gynecol Reprod Biol. 2007; 133: 179-185
- The P.M.S.I. enlargement: evaluation system of perinatal care networks in Bourgogne, France.Gynecol Obstet Fertil. 2003; 31: 162-166
- National estimates for maternal mortality: an analysis based on the WHO systematic review of maternal mortality and morbidity.BMC Public Health. 2005; 5: 131
- Effect of a collector bag for measurement of postpartum blood loss after vaginal delivery: cluster randomised trial in 13 European countries.BMJ. 2010; 340: c293
- Measuring maternal morbidity in routinely collected health data: development and validation of a maternal morbidity outcome indicator.Med Care. 2008; 46: 786-794
- Severe acute maternal morbidity in high-income countries.Best Pract Res Clin Obstet Gynaecol. 2009; 23: 297-304
- Brazilian network for the surveillance of maternal potentially life threatening morbidity and maternal near-miss and a multidimensional evaluation of their long term consequences.Reprod Health. 2009; 6: 15
- How accurate is the reporting of obstetric haemorrhage in hospital discharge data? A validation study.Aust N Z J Obstet Gynaecol. 2008; 48: 481-484
- Severe maternal morbidity in Canada, 1991–2001.CMAJ. 2005; 173: 759-764
- Incidence and predictors of severe obstetric morbidity: case–control study.BMJ. 2001; 322 (discussion 93-4): 1089-1093
- Epidemiology of postpartum haemorrhage: a systematic review.Best Pract Res Clin Obstet Gynaecol. 2008; 22: 999-1012
- Underreporting of major obstetric haemorrhage in the Netherlands.Transfus Med. 2010; 20: 118-122
- Similarly increased congenital anomaly rates after intrauterine insemination and IVF technologies: a retrospective cohort study.Hum Reprod. 2012;
- Automatic record hash coding and linkage for epidemiological follow-up data confidentiality.Methods Inf Med. 1998; 37: 271-277
- Using discharge abstracts to evaluate a regional perinatal network: assessment of the linkage procedure of anonymous data.Int J Telemed Appl. 2009; 2009: 181842
- The measurement of observer agreement for categorical data.Biometrics. 1977; 33: 159-174
- Trends in postpartum hemorrhage: United States, 1994–2006.Am J Obstet Gynecol. 2010; 202 (e1–e6): 353
- Maternal mortality in developed countries: not just a concern of the past.Obstet Gynecol. 1995; 86: 700-705
- Quantifying severe maternal morbidity: a Scottish population study.BJOG. 2004; 111: 481-484
- Severe maternal morbidity during pregnancy, delivery and puerperium in the Netherlands: a nationwide population-based study of 371,000 pregnancies.BJOG. 2008; 115: 842-850
- Investigation of an increase in postpartum haemorrhage in Canada.BJOG. 2007; 114: 751-759
- Generic obstetric database systems are unreliable for reporting the hypertensive disorders of pregnancy.Aust N Z J Obstet Gynaecol. 2004; 44: 505-509
- In search of perinatal quality outcome measures: 1 hospital's in-depth analysis of the Adverse Outcomes Index.Am J Obstet Gynecol. 2010; 203: 336e1-336e7
- Reporting of routinely collected data by public and private hospitals.Aust N Z J Obstet Gynaecol. 2008; 48: 521-522
- Research on severe maternal morbidities and near-misses in Brazil: what we have learned.Reprod Health Matters. 2007; 15: 125-133
- Maternal near miss – towards a standard tool for monitoring quality of maternal health care.Best Pract Res Clin Obstet Gynaecol. 2009; 23: 287-296
Article info
Publication history
Published online: March 07, 2012
Accepted:
February 21,
2012
Received in revised form:
January 26,
2012
Received:
November 21,
2011
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
