Major Obstetric Hemorrhage & Improving Hospital Systems:
Attention to improving the hospital systems necessary for the care of women at risk for major obstetric hemorrhage is important in the effort to decrease maternal mortality from hemorrhage. Nationwide, major obstetric hemorrhage and the need for cesarean hysterectomy have increased in recent years. In the setting of intractable obstetric hemorrhage, emergency peripartum hysterectomy is used as a life-saving procedure. Maternal death is a known complication of major obstetric hemorrhage. The creation of a patient safety team that works to improve the hospital systems for caring for women at risk for major obstetric hemorrhage can help to identify and manage these situations and save lives. Development of clinical pathways, guidelines and protocols designed to provide early diagnosis of patients at risk for major obstetric hemorrhage and for streamlined care in emergency situations are essential. A multidisciplinary patient safety team that includes individuals from the Division of Obstetric Anesthesiology, Maternal Fetal Medicine, Neonatology, and the Blood Bank as well as Departments of Nursing, Communication, and Administration and quarterly mock drills of rapid response team, helps to respond to these situations effectively (10).