The Australasian Maternity Outcomes Surveillance System

What is AMOSS ?

The Australasian Maternity Outcomes Surveillance System (AMOSS) is a national surveillance mechanism designed to study a variety of rare or serious conditions in pregnancy, childbirth and the post-natal phase. Conditions studied by AMOSS have an estimated incidence of less than 1 in 1,000 births per annum. Data is collected from maternity units with more than 50 births per year across Australia and New Zealand. AMOSS aims to translate research findings to support evidence-based practice to improve the safety and quality of maternity care in Australia and New Zealand.

AMOSS is funded by a National Health and Medical Research Council grant.

AMOSS is important because:

  • The incidence of severe obstetric morbidity is unknown in Australia and New Zealand
  • Individually rare conditions are uncommon; together they are a considerable burden on women, their families and hospitals that care for them
  • Uncommon conditions are difficult to study by individual institutions
  • AMOSS will provide robust evidence to support clinicial practice and
  • As maternal mortality is rare in Australia, studies into potentially life threatening events may give more insight into risk factors and possible means of prevention

How AMOSS works

AMOSS is based on proven methodology used by the Australian Paediatric Surveillance Unit and the United Kingdom Obstetric Surveillance System

Surveillance is conducted prospectively by data coordinators at each maternity unit. Conditions that meet predetermined case definition criteria are reported electronically on a monthly basis. Surveillance will enable calculation of the annual incidence of rare obstetric conditions and case control studies may also be conducted. Only population level data will be published and findings will be disseminated through peer-reviewed journals, presentations, the AMOSS annual report and newsletters. An established national clinical advisory group will advise and agree upon conditions to be monitored. New conditions will be added on an annual basis.

Current conditions under surveillance:

  • Cardiac disease in pregnancy
  • Renal disease in pregnancy
  • Cancer and outcomes in pregnancy evaluation (COPE)

Completed studies:

  • Gestational breast cancer
  • Rheumatic heart disease in pregnancy
  • Massive obsteetric haemorrhage
  • Amniotic fluid embolism (AFE)
  • Antenatal pulmonary embolism
  • Eclampsia
  • Influenza in pregnancy (ICU Admission)
  • Peripartum hysterectomy
  • Placenta accreta
  • Super obesity
  • Vasa praevia