Defining definitions: a Delphi study to develop a core outcome set for conditions of severe maternal morbidity. (24th August 2017)

• Record Type: Journal Article
• Authors: Schaap, T; Bloemenkamp, K; Deneux‐Tharaux, C; Knight, M; Langhoff‐Roos, J; Sullivan, E; van den Akker, T
• Other Names: Rigouzzo Agnès investigator.; Kristufkova Alexandra investigator.; Creanga Andreea investigator.; Koopman Ankie investigator.; Gemert Van investigator.; Tapper Anna‐Maija investigator.; Dijkman Anneke investigator.; Kwee Anneke investigator.; Franx Arie investigator.; Veersema Bas investigator.; Nemethova Bianka investigator.; Seelbach‐Göbel Birgit investigator.; Bateman Brian investigator.; Daelemans Caroline investigator.; Zelop Carolyn investigator.; Andersson Charlotte investigator.; Nagata Chie investigator.; Farquhar Cindy investigator.; Huisman Claartje investigator.; von Kaisenberg Constantin investigator.; Henriquez Dacia investigator.; Ellwood David investigator.; Moolenaar David investigator.; Tuffnell Derek investigator.; Kuklina Elena investigator.; Main Elliott investigator.; Woods Erica investigator.; Stekkinger Eva investigator.; Gollo Evelina investigator.; Goffinet François investigator.; Kainer Franz investigator.; Mantel Gerald investigator.; Stralen Giel investigator.; Kayem Gilles investigator.; Duvekot Hans investigator.; Franz HeikoB. G. investigator.; Engjom Hilde investigator.; Beenakkers Ingrid investigator.; Al‐Zirqi Iqbal investigator.; Danis Jakub investigator.; Berlac Foss investigator.; Kurinczuk Jenny investigator.; Langhof‐Roos Jens investigator.; Zwart Joost investigator.; Roosmalen Jos investigator.; Klungsor Kari investigator.; Lust Karin investigator.; Vetter Klaus investigator.; Calsteren Kristel investigator.; Roelens Kristien investigator.; Krebs Lone investigator.; Colmorn Berdiin investigator.; MacKillop Lucy investigator.; Tanaka Mamoru investigator.; Rijken Marcus investigator.; Bonnet Marie‐Pierre investigator.; Boer Marjon investigator.; Jokinen Mervi investigator.; Belfort Michael investigator.; Peek Michael investigator.; Gisler Mika investigator.; Foley Mike investigator.; Tikkanen Minna investigator.; Korbel Miroslav investigator.; Dugatova Monika investigator.; Laubach Monika investigator.; Schuitemaker Nico investigator.; Engel Nicole investigator.; McDonnell Nolan investigator.; Emonts Patrick investigator.; Rozenberg Patrick investigator.; Hillemanns Peter investigator.; Rauskolb Rüdiger investigator.; Takeda Satoru investigator.; Donati Serena investigator.; Ferrazzani Sergio investigator.; Matsubara Shigeki investigator.; Saito Shigeru investigator.; Jesudason Shilpanjali investigator.; Satoh Shoji investigator.; Vangen Siri investigator.; Clark Steven investigator.; Koenen Steven investigator.; Grüßner Susanne investigator.; Miyashita Susumu investigator.; Fischer Thorsten investigator.; Todros Tullia investigator.; Todros Tullia investigator.; Harskamp Valerie investigator.; Mijatovic Velja investigator.; Basevi Vittorio investigator.; Pollock Wendy investigator.; Callaghan William investigator.; Parsonage William investigator.; Henrich Wolfgang investigator.; Schyns Xandra investigator.; Fujita Yasuyuki investigator.; Matsuda Yoshio investigator.; Garnier Yves investigator.; Dominica Zentner investigator.;
• Is Part Of: BJOG. Volume 126:Number 3(2019)
• Page Start: 394
• Page End: 401
• Publication Date: 2017-08-24
• Subjects: Abnormally invasive placentation -- amniotic fluid embolism -- cardiac arrest in pregnancy -- Delphi -- eclampsia -- pregnancy‐related hysterectomy -- severe acute maternal morbidity -- severe primary postpartum haemorrhage -- spontaneous hemoperitoneum in pregnancy -- uterine rupture; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.14833
• Languages: English
• ISSNs: 1470-0328

Abstract

Abstract : Objective: Develop a core outcome set of international consensus definitions for severe maternal morbidities. Design: Electronic Delphi study. Setting: International. Population: Eight expert panels. Methods: All 13 high‐income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions. From these suggestions, a steering committee distilled critical components: eclampsia: 23, amniotic fluid embolism: 15, pregnancy‐related hysterectomy: 11, severe primary postpartum haemorrhage: 19, uterine rupture: 20, abnormally invasive placentation: 12, spontaneous haemoperitoneum in pregnancy: 16, and cardiac arrest in pregnancy: 10. These components were assessed by the expert panel using a 5‐point Likert scale, following which a framework for an encompassing definition was constructed. Possible definitions were evaluated in rounds until a rate of agreement of more than 70% was reached. Expert commentaries were used in each round to improve definitions. Main outcome measures: Definitions with a rate of agreement of more than 70%. Results: The invitation to participate in one or more of eight Delphi processes was accepted by 103 experts from 13 high‐income countries. Consensus definitions were developed for all of the conditions. Conclusion: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. These should be used in national registrations and international studies, and should be taken up by the Core Outcomes in Women's and Newborn Health initiative. Tweetable abstract: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. Tweetable abstract: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.