Audit of massive obstetric haemorrhage in southmead hospital using modified Scottish confidential audit of severe maternal morbidity (SCASMM) data collection tool: Nov 2010 – OCT 2011: Abstract PL.31 Table

Abstract

To fulfil both risk management and CNST, we audit all haemorrhage >2000ml identified through EuroKing, against our departmental guideline, in a monthly multidisciplinary risk meeting (including laboratory staff). A modified data collection tool from SCASMM is used. Comparison is made with the most recent (2009) annual Scottish audit of haemorrhage >2500ml. Conclusions Data is broadly comparable with a recognised national audit. Our process provides a robust method for continuous audit of haemorrhage. Introduction of a proforma (Nov 2010), presentation at departmental meetings (6 month intervals) and improved awareness/accountability has achieved improvements including: Increased obstetric consultant presence; Improved documentation; Reduced blood in major haemorrhage pack from 6 to 4 units (>4 units only used in 9.7%). Abstract PL.31 Table Southmead Nov –Oct 11 SCASMM (2009) Number >2000ml 62 N/A >2500ml 28 (4.61 per 1000) 306 (5.18 per 1000) Most frequent causes (60 notes fully reviewed) Atony (33) 55% 54.5% Retained placenta (13) 21.7% 19.4% Vaginal laceration (11) 18.3% 20.1% Most frequent mode of delivery SVD (20) 33% 30% Emergency caesarean (19) 31.6% 41.4% Elective caesarean (8) 13.3% 9.8% Haemostatic surgical techniques Intrauterine balloon (6) 10% 19% B-Lynch suture (5) 8.3% 9% Ut. artery embolisation (1) 2% 3% Hysterectomy (1) 2% 8% Nov10-Apr11 May11–Nov11 Consultant obstetrician present >2000ml 72% 84% N/A >2500ml 93% 100% 73% Proforma used 65% 80%