Skip Navigation LinksHome > August 2014 - Volume 124 - Issue 2, PART 1 > Standardized Severe Maternal Morbidity Review: Rationale and...
Obstetrics & Gynecology:
doi: 10.1097/AOG.0000000000000397
Contents: Current Commentary

Standardized Severe Maternal Morbidity Review: Rationale and Process

Kilpatrick, Sarah J. MD, PhD; Berg, Cynthia MD, MPH; Bernstein, Peter MD; Bingham, Debra DrPH, RN; Delgado, Ana CNM, MSN; Callaghan, William M. MD, MPH; Harris, Karen MD, MPH; Lanni, Susan MD; Mahoney, Jeanne RN, BSN; Main, Elliot MD; Nacht, Amy CNM, MSN; Schellpfeffer, Michael MD; Westover, Thomas MD; Harper, Margaret MD

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Abstract

Severe 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.

© 2014 by The American College of Obstetricians and Gynecologists.

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