Main Category: Pregnancy / Obstetrics
Also Included In: Women's Health / Gynecology;  Nursing / Midwifery
Article Date: 01 Feb 2010 - 2:00 PST

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The Joint Commission on Tuesday issued its latest sentinel event alert highlighting maternal death in the U.S. as a serious, though rare, issue that should receive more attention from hospitals and caregivers, HealthLeaders Media reports.

According to the Centers for Disease Control and Prevention's National Center for Health Statistics, 13.3 women died per 100,000 live births in 2006, marking an increase compared with previous years. Maternal death is defined as a death occurring within 42 days of birth or termination of pregnancy, HealthLeaders Media reports. Researchers speculate that one reason for the rise in maternal deaths could be the growing number of pregnant women with pre-existing health conditions, such as morbid obesity, high blood pressure or diabetes.

The alert said that while the increase could be attributed to more widespread reporting of maternal death, the overall situation is not improving. Joint Commission President Mark Chassin said in a statement that it is "a profound tragedy whenever a mother dies in childbirth." He said, "Fortunately, these are rare events," adding, "Achieving our national goal of reducing their frequency even further requires organizations and caregivers to have a thorough understanding of the underlying causes of maternal deaths and a disciplined focus on assuring consistent excellence in the early recognition and management of complications of delivery."

The alert lists several actions to reduce maternal deaths in the U.S., including educating caregivers to inform women with pre-existing conditions of the risks associated with pregnancy, referring those with high-risk conditions to experienced prenatal care providers and offering contraception to women with such conditions. The alert also suggests establishing a protocol for dealing with changes in a pregnant woman's vital signs -- particularly for conditions like pre-eclampsia and hemorrhage -- and making emergency department staff aware of any pregnant patients, as they may prescribe different care for them. In addition, the alert recommends that pneumatic compression devices be readily available for women undergoing caesarean sections because of the risk for pulmonary embolisms and that caregivers evaluate the use of low-molecular-weight heparin for post-delivery care of patients at risk for thromboembolism (Comak, HealthLeaders Media, 1/27).

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