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Reducing maternal deaths through state maternal mortality review.

Sarah J Kilpatrick1, Patricia Prentice, Robin L Jones

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The Illinois Maternal Mortality Review Committee (MMRC) improved maternal death reviews, changing outcomes in 20% of cases. Their work led to a mandatory hemorrhage education program for obstetric providers.

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Area of Science:

  • Public Health
  • Maternal Health
  • Healthcare Quality Improvement

Background:

  • Illinois faces high maternal mortality rates, prompting the 2000 establishment of the Illinois Maternal Mortality Review Committee (MMRC).
  • The MMRC was created to address and reduce the state's elevated maternal death rate.

Purpose of the Study:

  • To detail the development and process of the Illinois MMRC.
  • To assess the MMRC's impact on state-level attention to maternal mortality and obstetric care.
  • To summarize initial findings from the MMRC's review of maternal deaths.

Main Methods:

  • Development of a multidisciplinary committee for secondary review of select maternal deaths.
  • Analysis of 45 maternal deaths between 2000 and 2010.
  • Comparison of MMRC findings with primary reviews conducted by the State Perinatal Center.

Main Results:

  • Hemorrhage identified as the leading cause of death; 69% of cases were deemed potentially avoidable.
  • MMRC secondary review altered the cause of death in 20% and avoidability in 36% of cases compared to primary reviews.
  • Advocacy led to a 2008 mandate for maternal hemorrhage education for all obstetric providers in Illinois.

Conclusions:

  • The MMRC significantly impacted Illinois' maternal death reduction strategy, driving a mandatory obstetric hemorrhage education program.
  • Multidisciplinary, independent review of maternal deaths is crucial for accurate data and targeted interventions.
  • The MMRC's findings highlight the need for improved data to decrease preventable maternal deaths.