Preventability of severe acute maternal morbidity

Area of Science:

• Obstetrics and Gynecology
• Critical Care Medicine
• Public Health

Background:

• Severe acute maternal morbidity (SAMM) represents a critical public health concern.
• Maternal outcomes can be improved by identifying and addressing preventable factors in critical care admissions.

Purpose of the Study:

• To evaluate the preventability of severe acute maternal morbidity (SAMM) cases requiring intensive care.

Main Methods:

• Retrospective review of 98 SAMM admissions to ICUs/HDUs in New Zealand over 17 months.
• Cases involved women within 42 days of delivery.
• External multidisciplinary panels assessed preventability using a validated model.

Main Results:

• 38.8% of SAMM cases were deemed potentially preventable.
• 36.7% required care improvements but were not preventable.
• Clinician-related factors, including diagnostic delays and treatment errors, were frequent; postpartum hemorrhage and septicemia were common causes.

Conclusions:

• A significant proportion of SAMM cases are preventable or indicate a need for improved clinical care.
• Substandard care, particularly delays in diagnosis and treatment, contributed to severe maternal morbidity.
• Findings support enhanced clinical education and policy development to improve maternal outcomes, with a national audit underway.