Facility-Based Identification of Women With Severe Maternal Morbidity: It Is Time to Start

Callaghan, William M.; Grobman, William A.; Kilpatrick, Sarah J.; Main, Elliott K.; D'Alton, Mary

doi:10.1097/aog.0000000000000218

Cited by 137Maternal and fetal healthcareGlobal Maternal and Child HealthMaternal and Perinatal Health Interventions

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Facility-Based Identification of Women With Severe Maternal Morbidity: It Is Time to Start

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Callaghan, William M., Grobman, William A., Kilpatrick, Sarah J., Main, Elliott K., D'Alton, Mary·2014·Obstetrics & Gynecology

DOI 10.1097/aog.0000000000000218PMC PMC4293012

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Abstract

In Brief Although maternal deaths have been the traditional indicator of maternal health, these events are the “tip of the iceberg” in that there are many women who have significant complications of pregnancy, labor, and delivery. Identifying women who experience severe maternal morbidity and reviewing their care can provide critical information to inform quality improvement in obstetrics. In this commentary, we review methods to identify women who experienced severe complications of pregnancy. We propose a simple validated approach based on transfusion of four or more units of blood products, admission to an intensive care unit, or both as a starting point for identification and review of severe maternal morbidity in health care settings for the purpose of understanding successes and failures in systems of care. Facility-based identification of women with severe maternal morbidity and review of their care can further efforts to improve the quality of obstetric care.

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Transfusion of ≥4 units is a marker of significant obstetrical morbidity.
“Transfusion of ≥4 units is a marker of significant obstetrical morbidity (79).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [79]

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Authors: Callaghan, W. M., Grobman, W. A., Kilpatrick, S. J., Main, E. K., & D'Alton, M.
Affiliations: Northwestern University (US)
ORCID: Grobman, William A.
Kilpatrick, Sarah J.
Main, Elliott K.
Venue: Obstetrics & Gynecology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2014-05
Volume: 123
Issue: 5
Pages: 978-981
ISSN: 0029-7844 (ISSN-L)
DOI: 10.1097/aog.0000000000000218
PMC: PMC4293012
OpenAlex: W2060359125
Cited by: 137
References: 11
Citations by year: 2026: 4 · 2025: 6 · 2024: 9 · 2023: 10 · 2022: 4 · 2021: 12 · 2020: 16 · 2019: 15 · 2018: 16 · 2017: 12 · 2016: 12 · 2015: 17 · 2014: 4
FWCI: 14.10
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (CC999999)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords: severe maternal morbidity, obstetric quality improvement, maternal mortality, blood transfusion, intensive care unit admission, case review, systems of care, pregnancy complications
MeSH terms: Blood Transfusion, Critical Care, Female, Humans, Pregnancy, Pregnancy Complications, Severity of Illness Index, Quality Indicators, Health Care

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Facility-Based Identification of Women With Severe Maternal Morbidity: It Is Time to Start

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