UK Obstetric Surveillance System The results of the UKOSS HELLP Syndrome study have just been published. 129 women were identified who were diagnosed with HELLP syndrome and 81 women with ELLP syndrome, together with 476 controls. Key points: • Women with HELLP were more likely to be older, (aOR 1.9, 95%CI 1.1-3.1), nulliparous (aOR=4.2, 95%CI 2.5- 7.0), have had a previous gestational hypertensive disorder (aOR=3.5, 95%CI 1.5-8.1), and have a multiple pregnancy (aOR=4.5, 95%CI 1.5-14.1) than control women. • 138 women (66%) were diagnosed antenatally with HELLP/ELLP; 51% had planned management of immediate delivery and 43% had delivery planned within 48 hours. Only seven women (5%) had planned expectant (conservative) management. • Women with HELLP syndrome were more likely than women with ELLP syndrome to have a blood transfusion (46% vs 21%, p<0.001) and to have additional severe morbidity (13% vs 1%, p=0.003). • There were no significant differences in outcomes (blood transfusion, intensive care unit admission, additional severe maternal morbidity or major infant complications) between women with planned immediate delivery and those with planned delivery within 48 hours. • This suggests that a short delay in delivery, of up to 48 hours, may be considered when monitoring is reassuring and there are good clinical reasons for a delay, such as to allow administration of corticosteroids for fetal lung maturation. Reference: Fitzpatrick KE, Hinshaw K, Kurinczuk JJ, Knight M. Risk Factors, Management, and Outcomes of Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome and Elevated Liver Enzymes, Low Platelets Syndrome. Obstet Gynecol. 2014;123(3):618-627 Risk Factors, Management and Outcomes of HELLP and ELLP Syndrome - BPSU GBS study - Healthtalkonline website update 98% 79% THIS MONTH NEWSLETTER 36 - April 2014 37 37 UKOSS Regional Card Return Rates December 2013 – February 2014
Transcript
UK Obstetric Surveillance System
The results of the UKOSS HELLP Syndrome study have just been published. 129 women were identified who were diagnosed with HELLP syndrome and 81 women with ELLP syndrome, together with 476 controls.
Key points:• Women with HELLP were more likely to be older, (aOR
1.9, 95%CI 1.1-3.1), nulliparous (aOR=4.2, 95%CI 2.5-7.0), have had a previous gestational hypertensive disorder (aOR=3.5, 95%CI 1.5-8.1), and have a multiple pregnancy (aOR=4.5, 95%CI 1.5-14.1) than control women.
• 138 women (66%) were diagnosed antenatally with HELLP/ELLP; 51% had planned management of immediate delivery and 43% had delivery planned within 48 hours. Only seven women (5%) had planned expectant (conservative) management.
• Women with HELLP syndrome were more likely than women with ELLP syndrome to have a blood transfusion (46% vs 21%, p<0.001) and to have additional severe morbidity (13% vs 1%, p=0.003).
• There were no significant differences in outcomes (blood transfusion, intensive care unit admission, additional severe maternal morbidity or major infant complications) between women with planned immediate delivery and those with planned delivery within 48 hours.
• This suggests that a short delay in delivery, of up to 48 hours, may be considered when monitoring is reassuring and there are good clinical reasons for a delay, such as to allow administration of corticosteroids for fetal lung maturation.
Reference: Fitzpatrick KE, Hinshaw K, Kurinczuk JJ, Knight M. Risk Factors, Management, and Outcomes of Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome and Elevated Liver Enzymes, Low Platelets Syndrome. Obstet Gynecol. 2014;123(3):618-627
Risk Factors, Management and Outcomes of HELLP and ELLP Syndrome
This month:
Changes to the UKOSS team
The newsletter goes digital- BPSU GBS study
- Healthtalkonline website update
98%
79%
UKOSS Regional Card Return RatesDecember 2013 - February 2014
THIS MONTH
NEWSLETTER 36 - April 2014 3737
UKOSS Regional Card Return Rates December 2013 – February 2014
Thanks to the following hospitals who have returned cards for the last three months (November 2013, December 2013 and January 2014):Aberdeen Maternity Hospital, AberdeenAiredale General Hospital, KeighleyAltnagelvin Area Hospital, LondonderryAntrim Hospital, AntrimBarnet and Chase Farm Hospitals NHS Trust,
EnfieldBarnsley Hospital NHS Foundation Trust, BarnsleyBasildon Hospital, Canvey IslandBassetlaw District General Hospital, WorksopBedford Hospital, BedfordBirmingham City Hospital, BirminghamBirmingham Women’s Hospital, BirminghamBorders General Hospital, BordersBradfordRoyalInfirmary,BradfordBronglais Hospital, AberystwythBroomfieldHospital,ChelmsfordCaithness General Hospital, WickCalderdale Royal Hospital, HalifaxCauseway Hospital, ColeraineChelsea & Westminster Hospital, LondonChesterfield&NorthDerbyshireRoyalHospital,
ChesterfieldCountess of Chester Hospital, ChesterCroydon University Hospital, Thornton HeathDaisy Hill Hospital, NewryDarlington Memorial Hospital, DarlingtonDerby Hospitals NHS Foundation Trust, DerbyDerriford Hospital, PlymouthDewsbury and District Hospital, DewsburyDiana Princess of Wales Hospital, GrimsbyDoncasterRoyalInfirmary,DoncasterDorset County Hospital, DorchesterDr Gray’s Hospital, ElginDumfries&GallowayRoyalInfirmary,DumfriesEaling Hospital NHS Trust, LondonEast Surrey Hospital, RedhillEpsom General Hospital, EpsomForth Valley Royal Hospital, LarbertFriarage Hospital, NorthallertonFrimley Park Hospital, CamberleyGeorge Eliot Hospital, NuneatonGlan Clwyd District General Hospital,
BodelwyddanGloucestershire Royal Hospital, GloucesterGoodHopeHospital,SuttonColdfieldGuy’s and St Thomas’ Hospital, LondonHarrogate District Hospital, HarrogateHereford County Hospital, HerefordHinchingbrooke Hospital NHS Trust, HuntingdonHorton Maternity Hospital, BanburyHullRoyalInfirmary,HullIpswich Hospital, IpswichJames Cook University Hospital, MiddlesbroughJames Paget University Hospitals Trust, Great
YarmouthJersey General Hospital, St HelierJohn Radcliffe Hospital, OxfordKettering General Hospital, KetteringKing’s College Hospital, LondonKing’sMillHospital,SuttoninAshfieldLancashire Women and Newborn Centre, BurnleyLeicesterRoyalInfirmary,LeicesterLincoln County Hospital, LincolnLister Hospital, StevenageLiverpool Women’s Hospital, LiverpoolLuton & Dunstable Hospital, LutonMacclesfieldDistrictGeneralHospital,
Milton KeynesNew Cross Hospital, WolverhamptonNewham General Hospital, LondonNinewells Hospital & Medical School, Dundee
Nobles Hospital, DouglasNorfolk & Norwich University Hospital, NorwichNorth Devon District Hospital, BarnstapleNorth Manchester General Hospital, ManchesterNorthampton General Hospital, NorthamptonNorthwick Park Hospital, HarrowNottingham City Hospital, NottinghamNottingham University Hospitals NHS Trust,
NottinghamPeterborough City Hospital, PeterboroughPilgrim Hospital, BostonPinderfieldsGeneralHospital,WakefieldPoole Hospital, PoolePrinceCharlesHospital,MethyrTydfilPrincess Alexandra Hospital, HarlowPrincess Elizabeth Hospital, St MartinsPrincess Royal Hospital, Haywards HeathPrincess Royal Maternity Hospital, GlasgowPrincess Royal University Hospital, OrpingtonQueen Alexandra Hospital, PortsmouthQueen Elizabeth Hospital, GatesheadQueen Elizabeth Hospital, Kings LynnQueen Elizabeth Hospital, LondonQueen Elizabeth the Queen Mother Hospital,
MargateQueen’s Hospital, Burton upon TrentRaigmore Hospital, InvernessRosie Maternity Hospital, CambridgeRotherham District General Hospital, RotherhamRoyalAlbertEdwardInfirmary,WiganRoyal Berkshire Hospital, ReadingRoyal Cornwall Hospital, TruroRoyal Devon & Exeter Hospital, ExeterRoyal Glamorgan Hospital, LlantrisantRoyal Gwent Hospital, NewportRoyalLancasterInfirmary,LancasterRoyal Oldham Hospital, OldhamRoyal Preston Hospital, PrestonRoyal Surrey County Hospital, GuildfordRoyal Sussex County Hospital, BrightonRoyal United Hospital, BathRoyalVictoriaInfirmary,Newcastle-upon-TyneRussells Hall Hospital, DudleyScarborough Hospital, ScarboroughScunthorpe General Hospital, ScunthorpeSingleton Hospital, SwanseaSouth Tyneside NHS Foundation Trust,
South ShieldsSouth West Acute Hospital, EnniskillenSouthend University Hospital NHS FT,
OrmskirkSt George’s Hospital, LondonSt John’s Hospital, LivingstonSt Mary’s Hospital, LondonSt Mary’s Hospital, ManchesterSt Michael’s Hospital, BristolSt Peter’s Hospital, ChertseySt Richard’s Hospital, ChichesterStaffordshire General Hospital, StaffordStepping Hill Hospital, StockportStoke Mandeville Hospital, AylesburyTameside General Hospital, Ashton-under-LyneTaunton and Somerset Hospital, TauntonThe Great Western Hospitals NHS Foundation
Trust, SwindonTheJessopWing,SheffieldThe Tunbridge Wells Hospital, Tunbridge WellsTorbay Hospital, TorquayUlster Hospital, BelfastUniversity College Hospital, LondonUniversity Hospital Lewisham, London
University Hospital of North Tees, Stockton-on-Tees
University Hospital of Wales, CardiffVictoria Hospital, BlackpoolVictoria Hospital, KirkcaldyWansbeck General Hospital, AshingtonWarrington and Malton Hospitals NHS FT,
WarringtonWarwick Hospital, WarwickWatford General Hospital, WatfordWest Cumberland Hospital, WhitehavenWest Middlesex University Hospital, IsleworthWest Wales General Hospital, CarmarthenWestern Isles Hospital, StornowayWexham Park Hospital, SloughWhiston Hospital, PrescotWhittington Hospital, LondonWilliam Harvey Hospital, AshfordWishaw General Hospital, WishawWithybush Hospital, HaverfordwestWorthing Hospital, WorthingWrexham Maelor Hospital, WrexhamWythenshawe Hospital, ManchesterYork Hospital, YorkYsbyty Gwynedd District General Hospital, BangorAlexandra Hospital, RedditchArrowe Park Hospital, WirralAyrshire Maternity Unit, KilmarnockBirmingham Heartlands Hospital, BirminghamCity Hospitals Sunderland NHS Trust, SunderlandColchester General Hospital, ColchesterConquest Hospital, St Leonards-on-SeaCumberlandInfirmary,CarlisleDarent Valley Hospital, DartfordFurness General Hospital, Barrow-in-FurnessKingston Hospital, Kingston upon ThamesLeedsGeneralInfirmary,LeedsLeicester General Hospital, LeicesterNevill Hall Hospital, AbergavennyNorth Hampshire Hospital, BasingstokePrincess Anne Hospital, SouthamptonPrincess of Wales Hospital, BridgendQueen Charlotte’s and Chelsea Hospital, LondonQueen’s Hospital, RomfordRoyal Free Hospital, LondonRoyal Hampshire County Hospital, WinchesterRoyal Jubilee Maternity Service, BelfastRoyal Shrewsbury Hospital, ShrewsburySalisbury District Hospital, SalisburySimpson Centre for Reproductive Health,
EdinburghSt Helier Hospital, CarshaltonSt James’s University Hospital, LeedsSt Mary’s Hospital, NewportThe Portland Hospital, LondonUniversity Hospital of Coventry & Warwickshire,
CoventryUniversity Hospital of North Durham, DurhamUniversity Hospital of North Staffordshire,
Stoke on TrentWest Suffolk Hospital, Bury St EdmundsWorcestershire Royal Hospital, WorcesterYeovil Women’s Hospital, YeovilBarnet General Hospital, BarnetHomerton University Hospital, LondonLeighton Hospital, CreweNorth Middlesex University Hospital, LondonRoyal Alexandra Hospital, PaisleyRoyal Bolton Hospital, BoltonThe Hillingdon Hospitals NHS Foundation Trust,
UxbridgeWhipps Cross University Trust Hospital, LondonCraigavon Area Hospital, PortadownRoyal London Hospital, London
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Returned all three cards. Returned two cards. Returned one card. No Cards Returned.
Healthtalkonline – new scrapbook feature!Healthtalkonline, which features the UKNeS module on life-threatening conditions in pregnancy, has now launched a “scrapbook” feature. This feature is available for anyone to use and allows you to save in one place collections of pages or video clips that interest you from across the whole website. Scrapbooks can be shared with colleagues, friends and family and can importantly be used to generate teaching materials. To find out more about this feature, please visit
Funding: * This study represents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Programme Grant RP-PG-0608-10038)
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