TY - JOUR

T1 - Defining definitions

T2 - a Delphi study to develop a core outcome set for conditions of severe maternal morbidity

AU - Schaap, T.

AU - Bloemenkamp, K.

AU - Deneux-Tharaux, C.

AU - Knight, M.

AU - Langhoff-Roos, J.

AU - Sullivan, E.

AU - van den Akker, T.

AU - Rigouzzo, Agnès

AU - Kristufkova, Alexandra

AU - Creanga, Andreea

AU - Koopman, Ankie

AU - Gemert, Van

AU - Tapper, Anna Maija

AU - Dijkman, Anneke

AU - Kwee, Anneke

AU - Franx, Arie

AU - Veersema, Bas

AU - Nemethova, Bianka

AU - Seelbach-Göbel, Birgit

AU - Bateman, Brian

AU - Daelemans, Caroline

AU - Zelop, Carolyn

AU - Andersson, Charlotte

AU - Nagata, Chie

AU - Farquhar, Cindy

AU - Huisman, Claartje

AU - von Kaisenberg, Constantin

AU - Henriquez, Dacia

AU - Ellwood, David

AU - Moolenaar, David

AU - Tuffnell, Derek

AU - Kuklina, Elena

AU - Main, Elliott

AU - Woods, Erica

AU - Stekkinger, Eva

AU - Gollo, Evelina

AU - Goffinet, François

AU - Kainer, Franz

AU - Mantel, Gerald

AU - Stralen, Giel

AU - Kayem, Gilles

AU - Duvekot, Hans

AU - Franz, Heiko B.G.

AU - Engjom, Hilde

AU - Beenakkers, Ingrid

AU - Al-Zirqi, Iqbal

AU - Danis, Jakub

AU - Berlac, Foss

AU - Kurinczuk, Jenny

AU - Krebs, Lone

AU - INOSS

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

KW - Abnormally invasive placentation

KW - amniotic fluid embolism

KW - cardiac arrest in pregnancy

KW - Delphi

KW - eclampsia

KW - pregnancy-related hysterectomy

KW - severe acute maternal morbidity

KW - severe primary postpartum haemorrhage

KW - spontaneous hemoperitoneum in pregnancy

KW - uterine rupture

U2 - 10.1111/1471-0528.14833

DO - 10.1111/1471-0528.14833

M3 - Journal article

C2 - 28755459

AN - SCOPUS:85028018087

VL - 126

SP - 394

EP - 401

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

SN - 0140-7686

IS - 3

ER -