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The Swedish Pregnancy Register

The Swedish Pregnancy Register. Michaela Granfors Vice register holder, Pregnancy Register Consultant in Fetal medicine and Obstetrics, Karolinska University Hospital PhD, post doc Clinical Epidemiology Unit, KI. Contents of presentation. Perinatal care in Sweden

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The Swedish Pregnancy Register

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  1. The Swedish PregnancyRegister MichaelaGranfors Vice register holder, PregnancyRegister Consultant in Fetal medicine and Obstetrics, Karolinska UniversityHospital PhD, post doc Clinical Epidemiology Unit,KI

  2. Contents ofpresentation • Perinatal care inSweden • The Swedish Pregnancy Register • Data from the Register / newDashboards • Time forquestions

  3. Contents ofpresentation • Perinatal care in Sweden • The Swedish PregnancyRegister • Data from theRegister • Time forquestions

  4. Perinatal care inSweden • Perinatal care in Swedenis • standardized • free ofcharge • almost all womenattend

  5. Perinatal care inSweden • During pregnancy • Maternity carecenters • Midwives are the main providers of antenatalcare • Referral to Obstetrician just ifneeded • Ultrasound • all women offered one ultrasound at 18-19 weeks of gestation • 1 trimester ultrasound: ~50%

  6. Perinatal care inSweden • Deliveries • Deliveries occur at hospitals, led bymidwifes • Around 115 000 deliveries /year • Gothenburg University Hospital: ~ 10000/y • Lycksele Hospital: ~350/y • Deliveries are centralized whenneeded • Births before 27 weeks of gestation to University Hospitals • Small hospitals: ≥ 37 weeks ofgestation, • uncomplicated pregnancies • ….

  7. Perinatal care inSweden • Postnatalcare • Hospitalstay • Around 50% ≤ 48 hours, 50% > 48hours • Aftercare visit (6-8 weeks afterdelivery) • Maternity care center,midwife

  8. Contents ofpresentation • Perinatal care in Sweden • The Swedish PregnancyRegister • Data from theRegister • Time forquestions

  9. Our vision is to improve the health of mothers andbabies

  10. The SwedishPregnancy Register a certified national quality register initiated bythe SwedishHealthcare Qualitytool Decisionsupport KUB Research

  11. The Swedish PregnancyRegister • Start2013 • With around 115,000 births in Sweden per year, the registry isa • great source of knowledge anddevelopment www.graviditetsregistret.se

  12. Covers the complete chain ofcare Neonatal care -SNQ Ultrasound Childbirth 3 month before conception Conception Prenatalcare Check-upat prenatalcare Assisterad befruktning Q-IVF ”Bristningsregistret”- Register of obstetric lacerations

  13. Who works for the PregnancyRegister? • Olof Stephansson, registerholder • Michaela Granfors, vice registerholder • 3 workinggroups • Maternity care, head: KerstinPetersson • Fetal diagnostics, head: PeterConner • Delivery, head: Anna-KarinWikström • Jonas Söderling and John Moshtaghi-Svensson,statisticians • Else Friis,administrator • Petra Ryman och Linda Rilby,midwifes • Controlgroup • Camilla Björk, managing director forMedSciNet

  14. Transfer ofdatainto theregister Directly from KUB+ (decision support as well) • Frommedical • records* • Antenatalcare • Ultrasound • Delivery PregnancyRegister Trigger points for automatic transfer to theregister: Delivery Finalsigning Archivesigning + Data is entered directly into theregister

  15. 92% of all deliveries are transferred directly from electronic medicalrecords

  16. Eliminating doubleregistration

  17. How often is the dataupdated? • Twice aday

  18. Which women are registered? • Information at first visit at maternity care center • All pregnant women who do not actively opt out

  19. Who can see thedata? • Public dashboards (homepage, vården i siffror,mm) • All midwifes, nurses and doctors who work within obstetrics and gynecology in Sweden can log into theRegister • Differentpermissions

  20. Is the Pregnancy Register the sameas the medical birth register(MFR)? • No! • Medical birthregister • National Board of Health andWelfare • Compulsory for health care providers to report • Data since1973 • Delay for presentation ofdata • Fewer variables

  21. Some ongoingprojects • Pregnancysurvey • Education • NewDashboards

  22. Pregnancy survey -pilot • Survey to women (1177, health care guide) • Pregnancy week25 • 2 monthsand • 1 year afterdelivery • Questions • PROM (patient reported outcomemeasures) • PREM (patient reported experiencemeasures)

  23. Transfer ofdatainto theregister Manually web-entered Directly from KUB+ (decision support as well) • Frommedical • records* • Antenatalcare • Ultrasound • Delivery - gest week 12+ - 2 months after delivery+ PregnancyRegister Trigger points for automatic transfer to theregister: Delivery Finalsigning Archivesigning + Data is entered directly into theregister

  24. Educationinitiative • 2 midwives work 40% for the register sincejanuari • Education delivery units – use of PregnancyRegister

  25. Newdashboards • Newdesign • Updated everyday!

  26. Contents ofpresentation • Perinatal care inSweden • The Swedish Pregnancy Register • Data from the Register / newdashboards • Time forquestions

  27. Årsrapporten finns tillgänglig för alla påhemsidan

  28. Data - Cesarean frequency intotal

  29. Vårapartner

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