| Description |
Postpartum hemorrhage (PPH) is the leading cause of death among women during childbirth, according to the Centers for Disease Control and Prevention (CDC) (2014). The World Health Organization (WHO) defines postpartum hemorrhage as a blood loss of 500 ml or more in the first 24 hours after birth, during which time most deaths from postpartum hemorrhage occur (2009). A review of the 2011 CDC statistics regarding pregnancy mortality in the United States found that a total of 702 pregnancy-related deaths were reported, for a mortality ratio of 17.8 deaths per 100,000 live births (Centers for Disease Control and Prevention [CDC], 2014). Death from hemorrhage was the fourth highest leading cause of death during that time, accounting for 11.3% of all pregnancy-related deaths during 2011 (CDC, 2014). In addition, the incidence of PPH in the U.S. increased 26% between 1994 and 2006 (Callaghan, Kuklina & Berg, 2010). This trend has also been noted in other high-resource countries since the 1990s (Likis et al., 2015). This is an alarming situation that needs to be addressed if the incidence and severity of PPH and its sequelae are to be reduced. According to hospital discharge records, the PPH rate for Utah was 1,647 out of a total 49,320 hospital births (L. Baksh, personal communication, August 14, 2015). This 3.34% rate includes both immediate PPH data occurring in the first 24 hours after delivery and secondary PPH data from 24 hours after delivery onwards (L. Baksh, personal communication, August 14, 2015). One Utah organization that includes PPH in the database is a regional hospital in northern Utah. Hospital leaders are particularly interested in decreasing the PPH rates at the facility to below the national average. This hospital had a PPH of 4% of all deliveries in 2014 (J. Huntsman, personal communication, September 1, 2015). Decreasing the incidence and severity of PPH would reduce healthcare costs related to maternal morbidity and mortality and its sequelae, such as lengthy hospital stays, higher acuity of care, blood transfusion, adult respiratory distress syndrome and other complications. PPH incidence rates can be reduced by identifying risk factors for PPH early and by utilizing effective evidence-based measures to help decrease the occurrence of excessive bleeding. Once risk factors are identified, early management and treatment of PPH can be employed to stop the bleeding as quickly as possible. |
