Effect of the postpartum hemorrhage intervention package implementation in a fourth‐level hospital in Latin America

Abstract

ObjectiveTo evaluate the effectiveness of the implementation of intervention packages for postpartum hemorrhage (PPH) management in pregnant women hospitalized in a High Obstetric Complexity Unit in a Latin American country.MethodsRetrospective cohort study including pregnant women with PPH attended between January 2011 to December 2019. Three periods of time were defined according to management strategies We performed univariate and multivariate robust Poisson regression logistic models for each of the outcomes derived from each period.ResultsWe included 602 patients. There was a reduction in period 3 of the incidence of massive PPH (16% versus 12% P < 0.001, relative risk [RR] 0.61, 95% confidence interval [CI] 0.44–0.85; P = 0.003), major surgery (24%, 13%, 11%, P = 0.002, RR 0.54, 95% CI 0.33–0.883; P = 0.014), and admission to the intensive care unit (ICU) (14%, 7%, 6.1%, P = 0.0, RR 0.40, 95% CI 0.17–0.96 P = 0.00).ConclusionThe implementation of PPH intervention packages in a hospital in a middle‐income country from Latin America, led to a significant decrease in the incidence of massive bleeding, the rate of major surgery, and the ICU stay of pregnant women affected by this condition.

Hospital padrino: a collaborative strategy model to tackle maternal mortality: a mixed methods study in a middle-income region

“…Before implementation, we standardized management protocols, medical guides, checklists, and educational modules using obstetric emergency management bundles previously tested in FVL. 13 , 14 , 15 , 16 , 17 , 18 Additionally, workshops focused on strengthening concepts of communication, teamwork, and safety culture were carried out. 19 , 20 …”