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Quantifying severe maternal morbidity in Scotland: a continuous audit since 2003
Leslie Marr1, Christopher Lennox, Angus K McFadyen
1aReproductive Health Programme, Healthcare Improvement Scotland, Edinburgh, Scotland bAKM-STAT, Glasgow, Scotland, UK.
Current Opinion in Anaesthesiology
|April 18, 2014
Summary
Scotland
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Maternal Health Surveillance
Background:
- A continuous audit of severe maternal morbidity has been conducted in Scotland since 2003.
- Data collection covers consistently defined events in all consultant-led maternity units.
Purpose of the Study:
- To summarize the methodology of the Scottish Confidential Audit of Severe Maternal Morbidity.
- To describe main results from the 10-year audit period (2003-2012).
Main Methods:
- Continuous audit methodology.
- Data collection on severe maternal morbidity events.
- Analysis of trends from 2003 to 2011/2012.
Main Results:
- Most causes of severe maternal morbidity decreased, but major obstetric hemorrhage increased.
- 1 in 700 births required intensive care unit (ICU) admission.
- Eclampsia cases decreased; deficiencies in antenatal risk identification noted.
- Consultant involvement in care was below guideline recommendations.
Conclusions:
- The audit demonstrates changes in clinical practice and guideline adherence over time.
- Audit findings have informed clinical practice in Scottish maternity units.
- Despite overall decreases, major obstetric hemorrhage remains a significant concern.
