Hi Alison

Many thanks for that, most useful.  I shall read your findings with  
great interest!

I have been able to get, all be it potentially unreliable, figures off  
the Hess stats which does suggest a small increase over the past 4  
year period but can not seem to go back any further than 07.  I am  
worried this may be more of a reflection of my own incompetence in  
negotiating the site more than a representation of the material that  
is available!

Would you know if there are any national stats held for the years  
proceeding this, if so where might I go to find them?

Warm regards

Mandie Scamell
CHSS
University of Kent


On 5 Nov 2009, at 09:03, Macfarlane, Alison wrote:

> In the EUPHRATES study mentioned below, we tried to get units to  
> tell us how many PPHs they had had in the previous calendar year,  
> but we were unsuccessful. We also asked people about their  
> definition of PPH and severe PPH and there were considerable  
> differences. We didn't have room for that in the main paper and were  
> going to write it in another. The problem is that the survey was in  
> 2003 so the data are now out of date, but it sounds like it might be  
> still worth getting it together.
>
> Given the lack of consensus, there are problems in getting data from  
> routine systems. In England, PPH is included among the complications  
> recorded in Maternity HES and the reported rate is 10.1 per cent for  
> the financial year 2008-09. Before quoting this, read the stuff on  
> data quality, though. Before we did EUPHRATES, I looked at data by  
> unit and the range was something like 3 per cent to 30 per cent,  
> suggesting that wildly different definitions and inclusion criteria  
> were being used.
>
> In Scotland, special audits of severe maternal morbidity were set up  
> but I can't find the link now as the organisation which did them got  
> merged into NHS Quality Improvement Scotland. I am copying this to  
> Jim Chalmers at ISD Scotland, so he can tell us what happened if no  
> one on this list knows.
>
>
>
> Alison Macfarlane
> Department of Midwifery and Child Health
> City University London
> 20 Bartholomew Close
> London EC1A 7QN
> Phone (0) (44) 207 040 5832
> Fax   (0) (44) 207 040 5717
> Email [log in to unmask]
>
> www.city.ac.uk
> This email and its contents are the property of City University  
> London. If you are not the intended recipient of this message and  
> any attached files, please delete it. Unauthorised copying or  
> distribution of this message, its attachments or parts thereof, is  
> strictly prohibited unless specifically stated otherwise.
>
> Please consider the environment before printing my email
>
>
>
> -----Original Message-----
> From: Briley, Annette [mailto:[log in to unmask]]
> Sent: 04 November 2009 19:41
> To: [log in to unmask]
> Subject: Re: National PPH rates
>
> Hi Mandie
> We have been collected data about all PPHs over a year in a London  
> teaching hospital and will soon collect data for the same year from  
> a DGH. Finding reliable stats is tricky as reporting varies hugely,  
> with some areas reporting severe PPH as the need for a 4 or 5 unit  
> transfusion, which probably gives more indication of practice than  
> severity of PPH.
>
> The LEMMoN study in the Netherland and the Euphrates study across  
> Europe reported variance in measurement and treatment between units  
> let alone regions and countries.
>
> There are some papers out of Australia showing a rise in PPH  
> regardless of mode of delivery (Ford et al and Crowther et al) and  
> an increase from 5% to 12% with normal deliveries in one city-  
> although I can't remember which paper this is right now- will check  
> and get back to you
>
> If you find something more concrete do let me know!
>
> Annette
> Annette Briley
> Consultant Midwife/Clinical Trial Manager
> Maternal and Fetal Research Unit
> 10th Floor North Wing
> St Thomas' Hospital
> LONDON SE1 7EH
> tel: 020 7188 3641
> fax: 020 7620 1227
> mob: 07710 348443
>
> -----Original Message-----
> From: A forum for discussion on midwifery and reproductive health  
> research. [mailto:[log in to unmask]] On Behalf Of  
> Mandie Scamell
> Sent: 04 November 2009 12:53
> To: [log in to unmask]
> Subject: National PPH rates
>
> Hi,
> Hoping someone might be able to help me!
> Have come across interesting ethnographic data RE midwifery  
> perception of
> PPH rates and am trying to test the perception against recorded  
> national
> rates.
> Not with standing difficulties with definition and EBL etc. etc I am  
> looking for
> rough ball park figures for the last 20 yrs.  While mortality rates  
> from PPH are
> easily available, I am having trouble locating stats on the trends  
> in over all
> incident rates.
> Any suggestions where a stats illiterate researcher should look?
> Thanks
>
> Mandie
>
> PS my data suggests midwives think the rate is increasing.   
> Surprising I think
> given the moving gate posts where a more symptomatic approach is  
> applied in
> the defining process and where an appreciation that physiological  
> third stage
> management is likely to be associated with an increase in initial  
> loss (which,
> incidentally, is considered to be normal)
>
> No virus found in this incoming message.
> Checked by AVG - www.avg.com
> Version: 9.0.698 / Virus Database: 270.14.48/2479 - Release Date:  
> 11/03/09 19:38:00

Mandie Scamell
Centre for Health Service Studies
University of Kent