Activities of the Japan Council for Implementation of the Maternal Emergency Life Support System reduced direct causes of maternal deaths in Japan

Abstract

Here, we aimed to provide an overview of Japan Council for the Implementation of the Maternal Emergency Life‐Saving System (J‐CIMELS) and its simulation program, which has reduced maternal mortality due to direct causes in Japan. The Japan Association of Obstetricians and Gynecologists (JAOG), Japan Association of Obstetricians and Gynecologists, and Maternal Death Exploratory Committee (JMDEC) launched the Maternal Death Reporting Project in 2010. The project analyzed obstetricians' tendency to delay their initial response to sudden maternal deterioration. Obstetricians can predict small changes before deterioration by monitoring vital signs. In 2015, the J‐CIMELS was established to provide practical education. J‐CIMELS developed a simulation program (J‐MELS; Japan Maternal Emergency Life Support) to ensure that the obstetricians acquire the latest knowledge of emergency physicians, anesthesiologists, and other general practitioners and apply it in clinical situations. In the last 7 years, the J‐MELS basic course has been conducted 1000 times with a total attendance of 19 890 people. As a result, the incidence of obstetric hemorrhage progressively decreased from 29% in 2010 to 7% in 2020. We believe that the activities of J‐CIMELS are improving obstetric care providers' medical practices in Japan.

Haemostatic Support in Postpartum Haemorrhage: A Review of the Literature and Expert Opinion

“…J-CIMELS developed a simulation program (Japan Maternal Emergency Life Support; J-MELS) to help obstetricians gain the latest knowledge that emergency physicians, anesthesiologists, and other general practitioners possess, and apply it to clinical crisis situations. 2,3 Since then, this program has spread throughout Japan and resulted in a significant reduction in maternal death rate. Maternal death rate, especially because of obstetric critical hemorrhage, decreased.…”

“…Maternal death rate, especially because of obstetric critical hemorrhage, decreased. 2,4 These critical consequences can be preventable because of sufficient time delay (1 to 3 h) between the initial symptom and cardiopulmonary arrest. 5 Thus, this article reminds us once again that efforts to address PPH require a multifaceted approach that differs from other medical areas.…”

“…Therefore, in 2015, the Japan Council for the Implementation of Maternal Emergency Life Support System (J-CIMELS) was established to provide better obstetric skills education. J-CIMELS developed a simulation program (Japan Maternal Emergency Life Support; J-MELS) to help obstetricians gain the latest knowledge that emergency physicians, anesthesiologists, and other general practitioners possess, and apply it to clinical crisis situations 2,3 . Since then, this program has spread throughout Japan and resulted in a significant reduction in maternal death rate.…”

“…Since then, this program has spread throughout Japan and resulted in a significant reduction in maternal death rate. Maternal death rate, especially because of obstetric critical hemorrhage, decreased 2,4 . These critical consequences can be preventable because of sufficient time delay (1 to 3 h) between the initial symptom and cardiopulmonary arrest 5 …”