Open AccessEvaluation of multi‐professional obstetric skills training for postpartum hemorrhage
Author(s) -
MARKOVA VERONIKA,
SØRENSEN JETTE LED,
HOLM CHARLOTTE,
NØRGAARD ASTRID,
LANGHOFFROOS JENS
Publication year - 2012
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2011.01344.x
Subject(s) - medicine , blood transfusion , obstetrics , psychological intervention , pregnancy , audit , emergency medicine , surgery , nursing , genetics , management , economics , biology
Objective. To evaluate the effect of multi‐professional obstetric skills training on the incidence of postpartum hemorrhage (PPH) indicated by red blood cell (RBC) transfusion and time delay in surgical interventions before, during, and after implementation of the training. Design . A database audit. Setting . University hospital, Rigshospitalet, Copenhagen, Denmark. Population . Women receiving red blood cell (RBC) transfusion up to seven days postpartum before (2003), during (2005), and after (2007) the introduction of training. Methods . Linkage of the Danish Medical Birth Registry and the local transfusion database, followed by audit of medical records. We identified 148 women with RBC transfusion for PPH in 10 461 deliveries and assessed the cause of PPH, surgical interventions and transfusion data. Main outcome measures . RBC transfusion. Delay to surgical intervention. Results . RBC transfusion rates for PPH were 1.5% (2003), 1.6% (2005), and 1.2% (2007) (not statistically significant). The transfusion rates did not change after vaginal delivery but decreased after cesarean section [2.4, 2.1 and 0.7% ( p <0.01)]. Transfusion requirements and pre‐transfusion hemoglobin values did not change. The median time from delivery to manual removal of the placenta increased non‐significantly (64, 70 and 75 minutes). The median time from decision to manual removal of the placenta remained unchanged (30 minutes). Conclusion . There was no effect of multi‐professional obstetric skills training on the rate of RBC transfusion for PPH. The unchanged long delay in handling a retained placenta indicates a need for multi‐disciplinary training in collaboration with staff from anesthesiology and the operation theater.