Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

70 Maternal Intensive Care in Belgium KCE Reports 94
The women in the standard care category do not have any recorded
pathology, while “intermediate care” women suffer from at least one pre-defined
pathology. Main pathologies that classified women into ‘intermediate care’ are listed in
the table 30 below. Almost every woman (99.0 %) entered the ‘intermediate care class’
thanks to ICD-9 codes and only 1.0% through ambulatory drugs.
The algorithm classifies a woman in the intermediate care category on the basis of only
one ‘coded pathology’, although in 13.9% of the cases 2 pathologies were attributed, and
in 3.5% of the cases several pathologies were attributed.
Table 30: 10 Main pathologies 53 classifying women into ‘Intermediate Care’
Pathology
Number of
cases
Proportion
Mild or unspecified pre-eclampsia 1,472 15.8
Diabetes with insulinetherapy 1,262 13.5
PPROM 1,009 10.8
Prenatally assessed severe fœtal
malformation
1,009 10.8
Placenta preavia 998 10.7
Placenta accreta and percreta 684 7.3
Oligohydramnios 390 4.2
Intrauterine death 362 3.9
Infection of amniotic cavity 324 3.5
History of recurrent perinatal loss 215 2.3
Polyhydramnios 207 2.2
Severe psychiatric disorders 192 2.06
Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004
As regards “grey zone” women, 91.5 % were qualified as such on the basis of ICD-9
codes, 5.6% through ambulatory medication and 2.7% through hospital medication.
The most frequent pathologies within the ‘Grey Zone’ are listed in table 31. They
mainly include poorly specified health conditions.
Table 31: 10 Main pathologies 54 classifying women into ‘Grey Zone’
Pathology
Number of
Proportion
cases
Anemia 5,201 17.2
Previous Caesarean section 3,870 12.8
Preterm labour 3,364 11.1
Fœtal distress 3,166 10.5
Advanced maternal age 2,754 9.1
Poor fœtal growth 1,467 4.9
Rhesus immunisation 1,443 4.8
Baby on NICU 1,057 3.5
Excessive fœtal growth 996 3.3
Complicated uro-genital disorders 965 3.2
Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004
Thirty one women are classified in the ‘Near Miss’ category thanks to the following
pathologies: hysterectomy (n=11), invasive uterine surgery n=10), surgery for uterine
rupture (n=1) and acute pulmonary embolism (n=2).
Seven hundred and seventeen women were according to our methodology in the
‘Intensive care’ category.
53 The main pathologies total 7,115 out of 9,723
54 The main pathologies total 24,283 out of 30,128