TY - JOUR

T1 - Use of ICD-10 codes to monitor uterine rupture

T2 - validation of a national birth registry

AU - Thisted, Dorthe L A

AU - Mortensen, Laust Hvas

AU - Hvidman, Lone

AU - Rasmussen, Steen C

AU - Larsen, Torben

AU - Krebs, Lone

N1 - Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

PY - 2014/2

Y1 - 2014/2

N2 - OBJECTIVES: Uterine rupture is a rare but severe complication in pregnancies after a previous cesarean section. In Denmark, the monitoring of uterine rupture is based on reporting of relevant diagnostic codes to the Danish Medical Birth Registry (MBR). The aim of our study was to examine the validity of registration of uterine rupture in the MBR within the population of pregnant women with prior cesarean section by conducting a review of the medical records.STUDY DESIGN: We reviewed 1709 medical records within the population of singleton pregnant woman delivering at term between 1997 and 2007. We retrieved the medical records of all women in the MBR with a code for uterine rupture during labor regardless of whether or not a prior cesarean section had been reported to the registry. In addition medical records of all women with a code for previous cesarean section and delivery of a child with adverse perinatal outcome were retrieved.RESULTS: Among women recorded in the MBR with a previous cesarean section and uterine rupture, only 60.4% actually had a uterine rupture (partial or complete). At least 16.2% of complete uterine ruptures were not reported to the registry. Considering only complete uterine ruptures, the sensitivity and specificity of the codes for uterine rupture were 83.8% and 99.1%, respectively.CONCLUSION: During the study period the monitoring of uterine rupture in the MBR was inadequate.

AB - OBJECTIVES: Uterine rupture is a rare but severe complication in pregnancies after a previous cesarean section. In Denmark, the monitoring of uterine rupture is based on reporting of relevant diagnostic codes to the Danish Medical Birth Registry (MBR). The aim of our study was to examine the validity of registration of uterine rupture in the MBR within the population of pregnant women with prior cesarean section by conducting a review of the medical records.STUDY DESIGN: We reviewed 1709 medical records within the population of singleton pregnant woman delivering at term between 1997 and 2007. We retrieved the medical records of all women in the MBR with a code for uterine rupture during labor regardless of whether or not a prior cesarean section had been reported to the registry. In addition medical records of all women with a code for previous cesarean section and delivery of a child with adverse perinatal outcome were retrieved.RESULTS: Among women recorded in the MBR with a previous cesarean section and uterine rupture, only 60.4% actually had a uterine rupture (partial or complete). At least 16.2% of complete uterine ruptures were not reported to the registry. Considering only complete uterine ruptures, the sensitivity and specificity of the codes for uterine rupture were 83.8% and 99.1%, respectively.CONCLUSION: During the study period the monitoring of uterine rupture in the MBR was inadequate.

KW - Denmark

KW - Female

KW - Humans

KW - International Classification of Diseases

KW - Monitoring, Physiologic

KW - Pregnancy

KW - Registries

KW - Risk Factors

KW - Uterine Rupture

KW - Vaginal Birth after Cesarean

U2 - 10.1016/j.ejogrb.2013.10.033

DO - 10.1016/j.ejogrb.2013.10.033

M3 - Journal article

C2 - 24287285

VL - 173

SP - 23

EP - 28

JO - European Journal of Obstetrics, Gynecology and Reproductive Biology

JF - European Journal of Obstetrics, Gynecology and Reproductive Biology

SN - 0301-2115

ER -