The acute presentation of pregnant women to non-maternity Emergency departments

Patients admitted with a pregnancy related event. Granular care pathways. Multi-morbidity, investigations, interventions and treatments. Serial physiology, blood biomarkers, physiotherapy, outcome. Deeply phenotyped. Each year, there are audits to assess maternal & foetal outcomes across the UK. In 2016-18, 217 women died during or up to six weeks after pregnancy, from causes associated with their pregnancy, among 2,235,159 women giving birth in the UK. 9.7 women per 100k died during pregnancy or up to six weeks after childbirth or the end of pregnancy. There was an increase in the overall maternal death rate in the UK between 2013-15 & 2016-18. Assessors judged that 29% of women who died had good care. However, improvements in care which may have made a difference to the outcome were identified for 51% of women who died. Birmingham has a higher than average maternal & foetal death rate. This dataset includes detailed information about the reasons pregnant women seek acute care, & their care pathways & outcomes. PIONEER geography: The West Midlands (WM) has a population of 5.9m & includes a diverse ethnic, socio-economic mix. There is a higher than average % of minority ethnic groups. WM has the youngest population in the UK with a higher than average birth rate. There are particularly high rates of physical inactivity, obesity, smoking & diabetes. 51.2% of babies born in Birmingham have at least one parent born outside of the UK, this compares with 34.7% for England. Each day >100k people are treated in hospital, see their GP or are cared for by the NHS. EHR: University Hospitals Birmingham NHS Foundation Trust (UHB) is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & 100 ITU beds. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”. Scope: Pregnant or post-partum women from 2015 onwards who attended A&E in Queen Elizabeth hospital. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics (including gestation & postpartum period), co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (admissions, wards, practitioner changes & discharge outcomes), presenting complaints, physiology readings (temperature, blood pressure, NEWS2, SEWS, AVPU), referrals, all prescribed & administered treatments & all outcomes. Available supplementary data: More extensive data including granular serial physiology, bloods, conditions, interventions, treatments. Ambulance, 111, 999 data, synthetic data. Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.


Name: HDR UK Innovation Gateway Access


pregnancy maternity childbirth women's health obstetrics gynaecology gestation foetus post-partum miscarriage bleeding thrombus pulmonary embolus abdominal pain nausea hyperemesis gravidarum chest pain breathlessness asthma ethnicity multi-morbidity age social deprivation observations heart rate respiratory rate blood pressure

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