Standardized Severe Maternal Morbidity Review

Kilpatrick, Sarah J.; Berg, Cynthia J.; Bernstein, Peter S.; Bingham, Debra; Delgado, Ana; Callaghan, William M.; Harris, Karen; Lanni, Susan; Mahoney, Jeanne; Main, Elliot; Nacht, Amy; Schellpfeffer, Michael A.; Westover, Thomas; Harper, Margaret

doi:10.1097/aog.0000000000000397

Cited by 71 publications

(36 citation statements)

References 13 publications

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“…23 Reviews of severe maternal morbidity can complement the information obtained from maternal mortality reviews and improve our understanding of factors leading to adverse maternal events. 24 …”

Section: Discussionmentioning

confidence: 99%

Pregnancy-Related Mortality in the United States, 2011–2013

Creanga

Syverson

Seed

et al. 2017

Obstetrics &Amp; Gynecology

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894

546

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OBJECTIVE To update national population-level pregnancy-related mortality estimates and examine characteristics and causes of pregnancy-related deaths in the United States during 2011–2013. METHODS We conducted an observational study using population-based data from the Pregnancy Mortality Surveillance System to calculate pregnancy-related mortality ratios by year, age group, and race–ethnicity groups. We explored 10 cause-of-death categories by pregnancy outcome during 2011–2013 and compared their distribution with those in our earlier reports since 1987. RESULTS The 2011–2013 pregnancy-related mortality ratio was 17.0 deaths per 100,000 live births. Pregnancy-related mortality ratios increased with maternal age, and racial–ethnic disparities persisted with non-Hispanic black women having a 3.4 times higher mortality ratio than non-Hispanic white women. Among causes of pregnancy-related deaths, the following groups contributed more than 10%: cardiovascular conditions ranked first (15.5%) followed by other medical conditions often reflecting pre-existing illnesses (14.5%), infection (12.7%), hemorrhage (11.4%), and cardiomyopathy (11.0%). Relative to the most recent report of Pregnancy Mortality Surveillance System data for 2006–2010, the distribution of cause-of-death categories did not change considerably. However, compared with serial reports before 2006–2010, the contribution of hemorrhage, hypertensive disorders of pregnancy, and anesthesia complications declined, whereas that of cardiovascular and other medical conditions increased (population-level percentage comparison). CONCLUSION The pregnancy-related mortality ratio and the distribution of the main causes of pregnancy-related mortality have been relatively stable in recent years.

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Section: Discussionmentioning

confidence: 99%

Pregnancy-Related Mortality in the United States, 2011–2013

Creanga

Syverson

Seed

et al. 2017

Obstetrics &Amp; Gynecology

Self Cite

894

546

View full text Add to dashboard Cite

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“…Good obstetric care will not only reduce the mortality index, but should also reduce the number of near misses. To improve obstetric care and to identify areas that require more primary obstetric caregiver training, deeper insight is needed in the population of women admitted to ICUs and the reason for ICU admission [4]. In this study, we retrospectively review reasons for ICU admission in relation to referral pattern in a tertiary care hospital in a developed country.…”

Section: Introductionmentioning

confidence: 99%

Obstetric Admissions to the Intensive Care Unit in a Tertiary Hospital

Greve

Mieghem²,

Berghe³

et al. 2016

Gynecol Obstet Invest

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Aims: A better understanding of the characteristics of obstetric patients admitted to an intensive care unit (ICU) could guide where the focus of obstetric training and awareness should be directed at to reduce further maternal mortality and morbidity. Methods: We retrospectively assessed the charts of all women admitted during pregnancy or postpartum to a tertiary ICU over a 12-year period. We retrieved whether women were followed locally or referred from another hospital and whether the ICU admission was prophylactic or therapeutic. Results: There were 190 admissions in 183 women. One-hundred and four admissions were in referred women and 86 in women cared for locally. Seventy-eight admissions (41.1%) were for direct obstetric causes (primarily postpartum hemorrhage (n = 14), hypertensive disorders of pregnancy (n = 12) and peripartum cardiomyopathy (n = 10)). Indirect obstetric admissions (n = 89; 46.8%) were primarily for cardiopathies (n = 35) and pulmonary diseases (n = 18). Among non-obstetric admissions, trauma (n = 6; 26.1%) and neurologic tumors (n = 6; 26.1%) were the most common. Conclusion: Pre-existing and acquired cardiopathies are the main reason for admission to an ICU in a developed country and have surpassed hypertensive disorders and hemorrhage. This should become a focus of obstetric care provider training.

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“…Although the achievement of a system for maternal riskappropriate health services is a national concern, here we focus on the services offered by California childbirth hospitals, which perform more than 500,000 births each year (12.7% of all US births), more than any other US state. 13 …”

mentioning

confidence: 97%

“…11 This year, in an effort to promote benchmarking and improvement, a call was made for the facility-based identification and reporting of women with severe maternal morbidity. 12,13 This call was further supported in February 2015 by the publication of a consensus-based statement from the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine that proposed the development of standards for maternal risk-appropriate care. 14 Given that childbirth is the number one reason for hospitalization in the United States at nearly 4 million births per year, 15 a national strategy is needed to address this observed increase in childbirth-related maternal morbidity.…”

mentioning

confidence: 98%