• Obstetrics and gynecology · Aug 2014

    Practice Guideline

    Standardized severe maternal morbidity review: rationale and process.

    • Sarah J Kilpatrick, Cynthia Berg, Peter Bernstein, Debra Bingham, Ana Delgado, William M Callaghan, Karen Harris, Susan Lanni, Jeanne Mahoney, Elliot Main, Amy Nacht, Michael Schellpfeffer, Thomas Westover, and Margaret Harper.
    • Departments of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, Montefiore Medical Center, Bronx, New York, University of Florida College of Medicine, Gainesville, Florida, Virginia Commonwealth University, Richmond, Virginia, California Pacific Hospital, San Francisco, California, Medical College of Wisconsin, Milwaukee, Wisconsin, and Wake Forest University, Winston-Salem, North Carolina; the Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia; the Association of Women's Health, Obstetric and Neonatal Nurses and the American College of Obstetricians and Gynecologists, Washington, DC; the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California; the University of Colorado College of Nursing, Aurora, Colorado; and the Cooper University Hospital, Cooper Medical School, Rowan University, Camden, New Jersey.
    • Obstet Gynecol. 2014 Aug 1;124(2 Pt 1):361-6.

    AbstractSevere maternal morbidity and mortality have been rising in the United States. To begin a national effort to reduce morbidity, a specific call to identify all pregnant and postpartum women experiencing admission to an intensive care unit or receipt of 4 or more units of blood for routine review has been made. While advocating for review of these cases, no specific guidance for the review process was provided. Therefore, the aim of this expert opinion is to present guidelines for a standardized severe maternal morbidity interdisciplinary review process to identify systems, professional, and facility factors that can be ameliorated, with the overall goal of improving institutional obstetric safety and reducing severe morbidity and mortality among pregnant and recently pregnant women. This opinion was developed by a multidisciplinary working group that included general obstetrician-gynecologists, maternal-fetal medicine subspecialists, certified nurse-midwives, and registered nurses all with experience in maternal mortality reviews. A process for standardized review of severe maternal morbidity addressing committee organization, review process, medical record abstraction and assessment, review culture, data management, review timing, and review confidentiality is presented. Reference is made to a sample severe maternal morbidity abstraction and assessment form.

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