AIM: Severe acute maternal morbidity (SAMM) is a state of the woman, when she nearly died, but survived. The aim of study was to fi nd out the exact incidence of SAMM in Slovakia, establishment of functional surveillance system and improve quality of health care. MATERIALS AND METHODS: The regular annual analyses of SAMM cases in Slovakia from January 1 st 2012 to December 31 st 2016. Observed SAMM included: peripartum haemorrhage, peripartum hysterectomy, uterine rupture, abnormally invasive placenta, HELLP syndrome, eclampsia, sepsis, transport to intensive care unit or anaesthesiology and non-fatal amniotic fl uid embolism. RESULTS: The response rate of questionnaires was 84.8 %. The overall confi rmed incidence of SAMM was 6.35/1,000 births (95% CI 6.03-6.67). The most often causes of SAMM were: peripartum haemorrhage (2.1/1,000 births), transport to intensive care unit or anaesthesiology (1.46/1,000 births), peripartum hysterectomy (0.84/1,000 births) and HELLP syndrome (0.63/1,000 births). The average age of women with SAMM was 30.3 years (14-46) and average parity was 1.16 (0-15). CONCLUSION: The incidence of SAMM and especially incidence of peripartum haemorrhage and peripartum hysterectomy in Slovakia is one of the highest in Europe. To decrease incidence and improve management and outcome of patients, regular audit of SAMM is needed (Tab. 3, Fig. 2, Ref. 30). Text in PDF www.elis.sk. KEY WORDS: severe acute maternal morbidity, surveillance system, severe postpartum haemorrhage, peripartum hysterectomy, eclampsia, HELLP syndrome, abnormally invasive placenta, uterine rupture, sepsis, amniotic fl uid embolism, transport to intensive care unit or anaesthesiology.
OBJECTIVE: Hemolysis, Elevated Liver Enzymes, Low Platelets syndrome (HELLP syndrome) is one of the actively haunted maternal morbidity through Slovak Obstetric Survey System (SOSS), the organisation for surveillance of severe maternal morbidity and mortality in Slovakia. METHODS: The questionaires were sent in 55 Obstetric Units in Slovakia. The analyzed and here presented data had been collected cases those happened in the period from 1.1.2012 till 31.12.2014. Controls were women from SR during observed years, who delivered without HELLP syndrome. RESULTS: The return rate of questionnaires was 89.67 %, thus covering 146 972 deliveries during the study period in Slovakia. The exact incidence of HELLP syndrome was 0.63/1000 deliveries (CI 95 % 0.51-0.78). Risk factors were age > 30 (OR = 1.63), nuliparous (OR = 2.96), pregnancy after assisted reproduction technology (OR = 8.29) and multiple pregnancy OR = 9.19). The mean gestation age at delivery was 33.8th weeks. Vaginal delivery was by 10 (10.8 %) patients with HELLP syndrome and in the 83 (89.2 %) patients pregnancy was terminated with acute caesarean section. There were reported 45 050 cases (30.7 %) of the caesarean section in the control group throughout the study period. CONCLUSION: The older age, nulliparity, multiple pregnancy and pregnancy after assisted reproduction techniques was identifi ed as a signifi cant risk factors of HELLP syndrome (Tab. 5, Fig. 1, Ref.
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