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Am J Perinatol 2011; 28(10): 753-760
DOI: 10.1055/s-0031-1280856
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Assessing Preventability for Obstetric Hemorrhage

Micaela Della Torre
1   Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago
,
Sarah J. Kilpatrick
1   Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago
,
Judith U. Hibbard
1   Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago
,
Louise Simonson
1   Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago
,
Shirley Scott
1   Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago
,
Abby Koch
1   Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago
,
Deborah Schy
2   Advocate Lutheran General Hospital, Park Ridge, Illinois
,
Stacie E. Geller
1   Department of Obstetrics and Gynecology, College of Medicine, University of Illinois at Chicago, Chicago
› Author Affiliations
Further Information

Publication History

01 March 2011

06 March 2011

Publication Date:
22 June 2011 (online)

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Abstract

We sought to determine preventability for cases of obstetric hemorrhage, identify preventable factors, and compare differences between levels of hospital. We retrospectively reviewed a 1-year cohort of severe and near-miss obstetric hemorrhage in an urban perinatal network. An expert panel, using a validated preventability model, reviewed all cases. Preventability and distribution of preventability factors were compared between levels of hospital care. Sixty-three severe and near-miss obstetric hemorrhage cases were identified from 11 hospitals; 54% were deemed potentially preventable. Overall preventability was not statistically different by level of hospital, and 88% were provider related. The only treatment-related preventability factors were significantly different between levels of hospital and significantly less common in level III hospitals (p < 0.01). The majority of obstetric hemorrhage was preventable. The most common potentially preventable factor was provider treatment error, and this was significantly more common in level II hospitals. New interventions should be focused on decreasing providers' treatment errors.

Keywords

Preventability - maternal morbidity and mortality - near miss - obstetric hemorrhage
 

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