Preventing Maternal Morbidity from Obstetric Hemorrhage: Implications of a Provider Training Initiative

Michelle A. Kominiarek*, Shirley Scott, Abigail R. Koch, Maripat Zeschke, Yvette Cordova, Samadh F. Ravangard, Deborah Schy, Stacie E. Geller

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Objective The objective of this study was to compare severe morbidity due to obstetrical hemorrhage and its potential preventability before and after a mandated provider training initiative on obstetric hemorrhage. Study Design Cases of severe morbidity due to obstetric hemorrhage during 2006 (n = 64 before training initiative) and 2010 (n = 71 after training initiative) were identified by a two-factor scoring system of intensive care unit admission and/or transfusion of ≥ 3 units of blood products and reviewed by an expert panel. Preventable factors were categorized as provider, system, and/or patient related. Results Potential preventability did not differ between 2006 and 2010, p = 0.19. Provider factors remained the most common preventable factor (88.2% in 2006 vs. 97.4% in 2010, p = 0.18), but the distribution in types of preventable factors improved over time for delay or failure in assessment (20.6 vs. 0%, p < 0.01) and delay or inappropriate treatment (76.5 vs. 39.5%, p < 0.01). System factors also differed (32.4 vs. 7.9%, p = 0.015) with a notable decline in factors related to policies and procedures (26.5 vs. 2.6%, p < 0.01) between 2006 and 2010. Conclusion We found significant improvement in provider assessment and treatment of obstetric hemorrhage and a significant reduction in preventable factors related to policies and procedures after the training initiative.

Original languageEnglish (US)
Pages (from-to)74-79
Number of pages6
JournalAmerican journal of perinatology
Volume34
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

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Keywords

  • hemorrhage
  • maternal morbidity
  • provider education
  • provider training

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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