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Facility-Based Identification of Women With Severe Maternal Morbidity: It Is Time to Start
Open accessAbstract
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 (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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Metadata
- Authors
- Callaghan, W. M., Grobman, W. A., Kilpatrick, S. J., Main, E. K., & D'Alton, M.
- Affiliations
- Northwestern University (US)
- Venue
- Obstetrics & Gynecology
- Published
- 2014-05
- Volume
- 123
- Issue
- 5
- Pages
- 978-981
- ISSN
- 0029-7844 (ISSN-L)
- 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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