Spontaneous haemoperitoneum in pregnancy: Nationwide surveillance and Delphi audit system

Anneke M F Schreurs; Evelien M Overtoom; Marjon A de Boer; Lisette E E van der Houwen; Marit C I Lier; Thomas van den Akker; Jerome Cornette; Tatjana E Vogelvang; Ingrid C M Beenakkers; Ageeth N Rosman; Jacques W M Maas; David J Heineman; Martijn J J Finken; Jan J J de Vries; Nicole B Burger; Timme P Schaap; Kitty W M Bloemenkamp; Velja Mijatovic

doi:10.1111/1471-0528.17556

Spontaneous haemoperitoneum in pregnancy: Nationwide surveillance and Delphi audit system

Anneke M F Schreurs
, Evelien M Overtoom
, Marjon A de Boer
, Lisette E E van der Houwen
, Marit C I Lier
, Thomas van den Akker
, Jerome Cornette
, Tatjana E Vogelvang
, Ingrid C M Beenakkers
, Ageeth N Rosman
, Jacques W M Maas
, David J Heineman
, Martijn J J Finken
, Jan J J de Vries
, Nicole B Burger
, Timme P Schaap
, Kitty W M Bloemenkamp
, Velja Mijatovic

University Medical Centre Utrecht
Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Obstetrics and Gynaecology and GROW - School for Oncology and Reproduction
Vrije Universiteit Amsterdam
Amsterdam Reproduction and Development
Utrecht University
Leiden University Medical Center
Erasmus MC
Diakonessenhuis Utrecht
Perined
Maastricht UMC+
From the Alzheimer Centre Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands (Leeuwis, Hooghiemstra, Prins, Scheltens, van der Flier); the Department of Neurology, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, the Netherlands (Weaver, Biesbroek, Exalto, Biessels)...

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE: To evaluate the incidence, diagnostic management strategies and clinical outcomes of women with spontaneous haemoperitoneum in pregnancy (SHiP) and reassess the definition of SHiP.

DESIGN: A population-based cohort study using the Netherlands Obstetric Surveillance System (NethOSS).

SETTING: Nationwide, the Netherlands.

POPULATION: All pregnant women between April 2016 and April 2018.

METHODS: 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.

MAIN OUTCOME MEASURES: Incidence and outcomes, lessons learned about clinical management and the critical appraisal of the current definition of SHiP.

RESULTS: 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.

CONCLUSIONS: 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.

Original language	English
Pages (from-to)	1620-1628
Number of pages	9
Journal	BJOG
Volume	130
Issue number	13
Early online date	2023
DOIs	https://doi.org/10.1111/1471-0528.17556
Publication status	Published - Dec 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Female
Humans
Pregnancy
Cohort Studies
Hemoperitoneum/diagnosis
Parturition
Perinatal Death
Perinatal Mortality
Pregnancy Complications/diagnosis
Infant, Newborn
ART
NethOSS
SHiP
endometriosis
fetal morbidity
maternal morbidity
obstetric surveillance system
Pregnancy Complications/epidemiology

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Schreurs, A. M. F., Overtoom, E. M., de Boer, M. A., van der Houwen, L. E. E., Lier, M. C. I., van den Akker, T., Cornette, J., Vogelvang, T. E., Beenakkers, I. C. M., Rosman, A. N., Maas, J. W. M., Heineman, D. J., Finken, M. J. J., de Vries, J. J. J., Burger, N. B., Schaap, T. P., Bloemenkamp, K. W. M., & Mijatovic, V. (2023). Spontaneous haemoperitoneum in pregnancy: Nationwide surveillance and Delphi audit system. BJOG, 130(13), 1620-1628. https://doi.org/10.1111/1471-0528.17556

@article{df3de208f31c4cb7aa3fe53c00a8a124,

title = "Spontaneous haemoperitoneum in pregnancy: Nationwide surveillance and Delphi audit system",

abstract = "OBJECTIVE: To evaluate the incidence, diagnostic management strategies and clinical outcomes of women with spontaneous haemoperitoneum in pregnancy (SHiP) and reassess the definition of SHiP.DESIGN: A population-based cohort study using the Netherlands Obstetric Surveillance System (NethOSS).SETTING: Nationwide, the Netherlands.POPULATION: All pregnant women between April 2016 and April 2018.METHODS: 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.MAIN OUTCOME MEASURES: Incidence and outcomes, lessons learned about clinical management and the critical appraisal of the current definition of SHiP.RESULTS: 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.CONCLUSIONS: 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.",

keywords = "Female, Humans, Pregnancy, Cohort Studies, Hemoperitoneum/diagnosis, Parturition, Perinatal Death, Perinatal Mortality, Pregnancy Complications/diagnosis, Infant, Newborn, ART, NethOSS, SHiP, endometriosis, fetal morbidity, maternal morbidity, obstetric surveillance system, Pregnancy Complications/epidemiology",

author = "Schreurs, \{Anneke M F\} and Overtoom, \{Evelien M\} and \{de Boer\}, \{Marjon A\} and \{van der Houwen\}, \{Lisette E E\} and Lier, \{Marit C I\} and \{van den Akker\}, Thomas and Jerome Cornette and Vogelvang, \{Tatjana E\} and Beenakkers, \{Ingrid C M\} and Rosman, \{Ageeth N\} and Maas, \{Jacques W M\} and Heineman, \{David J\} and Finken, \{Martijn J J\} and \{de Vries\}, \{Jan J J\} and Burger, \{Nicole B\} and Schaap, \{Timme P\} and Bloemenkamp, \{Kitty W M\} and Velja Mijatovic",

note = "{\textcopyright} 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley \& Sons Ltd.",

year = "2023",

month = dec,

doi = "10.1111/1471-0528.17556",

language = "English",

volume = "130",

pages = "1620--1628",

journal = "BJOG",

issn = "1470-0328",

publisher = "Wiley Blackwell",

number = "13",

}

Schreurs, AMF, Overtoom, EM, de Boer, MA , van der Houwen, LEE, Lier, MCI, van den Akker, T, Cornette, J, Vogelvang, TE, Beenakkers, ICM, Rosman, AN, Maas, JWM, Heineman, DJ , Finken, MJJ, de Vries, JJJ, Burger, NB, Schaap, TP, Bloemenkamp, KWM & Mijatovic, V 2023, 'Spontaneous haemoperitoneum in pregnancy: Nationwide surveillance and Delphi audit system', BJOG, vol. 130, no. 13, pp. 1620-1628. https://doi.org/10.1111/1471-0528.17556

TY - JOUR

T1 - Spontaneous haemoperitoneum in pregnancy

T2 - Nationwide surveillance and Delphi audit system

AU - Schreurs, Anneke M F

AU - Overtoom, Evelien M

AU - de Boer, Marjon A

AU - van der Houwen, Lisette E E

AU - Lier, Marit C I

AU - van den Akker, Thomas

AU - Cornette, Jerome

AU - Vogelvang, Tatjana E

AU - Beenakkers, Ingrid C M

AU - Rosman, Ageeth N

AU - Maas, Jacques W M

AU - Heineman, David J

AU - Finken, Martijn J J

AU - de Vries, Jan J J

AU - Burger, Nicole B

AU - Schaap, Timme P

AU - Bloemenkamp, Kitty W M

AU - Mijatovic, Velja

PY - 2023/12

Y1 - 2023/12

N2 - OBJECTIVE: To evaluate the incidence, diagnostic management strategies and clinical outcomes of women with spontaneous haemoperitoneum in pregnancy (SHiP) and reassess the definition of SHiP.DESIGN: A population-based cohort study using the Netherlands Obstetric Surveillance System (NethOSS).SETTING: Nationwide, the Netherlands.POPULATION: All pregnant women between April 2016 and April 2018.METHODS: 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.MAIN OUTCOME MEASURES: Incidence and outcomes, lessons learned about clinical management and the critical appraisal of the current definition of SHiP.RESULTS: 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.CONCLUSIONS: 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.

AB - OBJECTIVE: To evaluate the incidence, diagnostic management strategies and clinical outcomes of women with spontaneous haemoperitoneum in pregnancy (SHiP) and reassess the definition of SHiP.DESIGN: A population-based cohort study using the Netherlands Obstetric Surveillance System (NethOSS).SETTING: Nationwide, the Netherlands.POPULATION: All pregnant women between April 2016 and April 2018.METHODS: 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.MAIN OUTCOME MEASURES: Incidence and outcomes, lessons learned about clinical management and the critical appraisal of the current definition of SHiP.RESULTS: 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.CONCLUSIONS: 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.

KW - Female

KW - Humans

KW - Pregnancy

KW - Cohort Studies

KW - Hemoperitoneum/diagnosis

KW - Parturition

KW - Perinatal Death

KW - Perinatal Mortality

KW - Pregnancy Complications/diagnosis

KW - Infant, Newborn

KW - ART

KW - NethOSS

KW - SHiP

KW - endometriosis

KW - fetal morbidity

KW - maternal morbidity

KW - obstetric surveillance system

KW - Pregnancy Complications/epidemiology

UR - https://www.scopus.com/pages/publications/85161574721

U2 - 10.1111/1471-0528.17556

DO - 10.1111/1471-0528.17556

M3 - Article

C2 - 37280664

SN - 1470-0328

VL - 130

SP - 1620

EP - 1628

JO - BJOG

JF - BJOG

IS - 13

ER -

Spontaneous haemoperitoneum in pregnancy: Nationwide surveillance and Delphi audit system

Abstract

UN SDGs

Keywords

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