PLD.38 Major Obstetric Haemorrhage in a Tertiary Maternity Unit in Scotland: Review of Practice and Future Implications

    loading  Checking for direct PDF access through Ovid

Abstract

Background

The incidence of major obstetric haemorrhage (MOH), defined as ≥2.5 litres of blood loss, is rising. It is a leading cause of significant maternal morbidity.1

Objectives

To review the management of MOH in a tertiary maternity unit, compare practice against recommended guidelines1 and suggest changes for improving future practice.

Method

Retrospective review of case notes for 6 months (Jan 2013 to June 2013) in Princess Royal Maternity Unit, Glasgow.

Results

There were 28 patients with MOH in the 6 month period, reflecting an incidence of 9.70 per 1000 births.

Results

A consultant obstetrician was less likely to be present overnight 0100–0900 (4 out of 8 patients), when compared to 0900–1700 (5 out of 7 patients) and 1700–0100 (12 out of 13 patients).

Results

A significant number of patients (5 out of 28) received more than the recommended 3.5L of intravenous fluids before receiving blood.1

Results

There were 7 patients (25%) which could be identified as “high risk” before labour – all of which were identified in the antenatal period. A detailed action plan of management was recorded antenatally in 6 out of these 7 and followed in 5 out of the 7 patients.

Conclusion

The unit has been effective in identifying and planning for “high risk” patients. However, there is room for improvement in our management of MOH, such as improving consultant presence and early initiation of blood transfusion.

Related Topics

    loading  Loading Related Articles