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Physician-Patient Alliance for Health & Safety: Maternal Morbidity on the Rise and Likely to Climb Even Higher
Date:10/23/2013

CHICAGO, Oct. 23, 2013 /PRNewswire/ -- The Physician-Patient Alliance for Health & Safety (PPAHS) today joined prominent health experts in expressing concern about the rising of maternal morbidity in the United States.

According to the CDC, the maternal death rate in the U.S. has more than doubled since 1987.

In an article published October 21, 2013 in Becker's Clinical Quality & Infection Control, William M. Callaghan, M.D., M.P.H. (senior scientist for the maternal and infant health branch in CDC's Division of Reproductive Health at the National Center for Chronic Disease Prevention and Health Promotion) says this trend may actually be under-reported:

"These statistics may represent a conservative estimate of the problem.  Why?  Not all pregnancy-related deaths are accurately identified and reported. Hence, pregnancy-related deaths identified at the national level likely undercount the true number."

According to a CDC study the leading causes of maternal death are: hemorrhage, hypertensive disorder, pulmonary embolism, amniotic fluid embolism, infection, and pre-existing chronic conditions (such as cardiovascular disease).

Steven Clark, MD, medical director of women and newborn services at the Hospital Corporation of America, says more must be done to prevent these increasing complications. "Because the causes of morbidity are so many and so varied, it's critical that we identify the ones that are amenable to nationwide systemic prevention efforts," he says. "Venous thromboembolism is exactly such a cause. Research has shown repeatedly that pregnancy is a major risk factor for venous thrombosis and pulmonary embolism, especially following cesarean delivery.  At the same time, many cases of post-cesarean pulmonary embolism can be prevented with the prophylactic use of pneumatic compression devices or heparin. That connection needs to be made at the national level, and that's why HCA strongly advocates the universal use of prophylactic compression devices or heparin for all women undergoing cesarean delivery."

Research suggests that patients delivering by C-section are at particularly high risk for venous thromboembolism (VTE) – a patient population identified in the landmark Annals of Internal Medicine study, "Trends in the Incidence of Venous Thromboembolism During Pregnancy or Postpartum: A 30-year Population Study."

Mary D'Alton, MD, professor of obstetrics and gynecology in the Department of Obstetrics and Gynecology at Columbia University) believes that common and preventable causes of maternal death need to be addressed.

"Though research shows that certain patient populations are especially at risk for pregnancy-related deaths and complications, no woman is immune from them," she says.  "Especially in the first few days after delivery, otherwise healthy patients are at risk for hemorrhage, hypertension and pulmonary embolism. Pulmonary embolism lends itself to prevention measures that have been shown to work in other countries. Here at Columbia University Medical Center and New York-Presbyterian Hospital, we advocate the use of sequential compression devices as well as heparin for all patients undergoing cesarean delivery. The challenge before us is to reduce preventable maternal deaths and morbidity. It's absolutely vital that hospitals adopt standardized preventative and treatment measures for all pregnant women. Multiple national organizations are collaborating to achieve this goal, and it is hoped that all healthcare facilities will participate in this effort."

For more on this issue, the full article may be read at www.ppahs.org

About PPAHS

The Physician-Patient Alliance for Health & Safety (PPAHS) is an advocacy group devoted to improving patient health and safety. PPAHS supporters include physicians, patients, individuals, and organizations. For more information can be found at www.ppahs.org

PPAHS recently released a concise checklist that reminds caregivers of the essential steps needed to be taken to initiate Patient-Controlled Analgesia (PCA) with a patient and to continue to assess that patient's use of PCA. For a free download of the PCA safety checklist, please visit http://www.ppahs.org

PPAHS is also developing a checklist targeting venous thromboembolism (commonly referred to as blood clots) for women having cesarean and vaginal delivery, and the extension of prophylaxis post discharge; for more on this initiative, please see http://ppahs.org/2013/05/02/preventing-death-following-cesarean-delivery/


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SOURCE Physician-Patient Alliance for Health & Safety (PPAHS)
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