Hi Fiona,
Thanks for that.
From what I can gather, long term stats are pretty allusive both sides of
the boarder!
Best wishes
Mandie Scamell
CHSS
University of Kent
-----Original Message-----
From: A forum for discussion on midwifery and reproductive health research.
[mailto:[log in to unmask]] On Behalf Of Dagge-Bell Fiona
(NHS Quality Improvement Scotland)
Sent: 2009-11-05 10:08
To: [log in to unmask]
Subject: Re: National PPH rates
Hello, Fiona Dagge-Bell here from NHS Quality Improvement Scotland.
The original audits were set up under the Scottish Programme for Clinical
Effectiveness in Reproductive Health (SPCERH), these audit and the other
confidential enquiry work have been with us now for around 2 years. The
programme co-ordinator is Leslie Marr and I have copied her into my reply
here so that she can share the Scottish findings with you.
I hope this is helpful
Fiona
Fiona Dagge-Bell
Professional Officer - Maternal & Child Health NHS Quality Improvement
Scotland
0131 623 4340
________________________________________
From: A forum for discussion on midwifery and reproductive health research.
[[log in to unmask]] On Behalf Of Macfarlane, Alison
[[log in to unmask]]
Sent: 05 November 2009 09:03
To: [log in to unmask]
Subject: Re: National PPH rates
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the survey was in 2003 so the data are now out of date, but it sounds like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]
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-----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)
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