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Reducing Hemorrhage-Related Maternal Morbidity Using Interdisciplinary Simulation Training.

Jessica L Gerard1, Mark A Turrentine, Susan Leong-Kee

  • 1From the Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX.

Simulation in Healthcare : Journal of the Society for Simulation in Healthcare
|February 2, 2023
PubMed
Summary
This summary is machine-generated.

Simulation education for postpartum hemorrhage (PPH) reduced maternal morbidity despite an increased PPH rate. This training improved provider recognition and treatment, leading to better outcomes in hemorrhage management.

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Area of Science:

  • Obstetrics and Gynecology
  • Medical Education
  • Patient Safety

Background:

  • Postpartum hemorrhage (PPH) is a leading cause of preventable maternal morbidity in the US.
  • Simulation-based training aims to enhance provider recognition and management of PPH.
  • Limited research exists on the impact of PPH simulations on individual maternal outcomes.

Purpose of the Study:

  • To estimate the effect of a simulation-based educational intervention on PPH-related maternal morbidity.
  • To evaluate changes in maternal morbidity outcomes following the implementation of PPH simulations.

Main Methods:

  • Retrospective cohort analysis of hemorrhage outcomes (March 2012-January 2016).
  • Inclusion criteria: Women with PPH (EBL >500 mL vaginal, >1000 mL cesarean).
  • Primary outcome: Composite of hemorrhage-related maternal morbidity; multivariable logistic regression used for analysis.

Main Results:

  • PPH rate increased post-simulation (2.8% to 6.1%), OR 2.25 (95% CI, 1.95-2.60).
  • Composite hemorrhage-related morbidity decreased post-simulation (44% to 35%), OR 0.70 (95% CI, 0.52-0.93).
  • Reduced morbidity persisted after adjusting for confounders, aOR 0.66 (95% CI, 0.49-0.89).

Conclusions:

  • Simulation education for PPH was associated with a significant reduction in maternal morbidity.
  • Despite an increased incidence of PPH, simulation training improved patient outcomes.
  • High-fidelity PPH simulations can be effective in reducing severe maternal complications.