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Obstetric Hemorrhage: Clinical and System Reviews, Incident Analyses

Given the broad range of potential causes of obstetrical hemorrhage, clinical and system reviews should be conducted to identify potential causes and determine appropriate recommendations.

Occurrences of harm are often complex with many contributing factors. Organizations need to:

  1. Measure and monitor the types and frequency of these occurrences.
  2. Use appropriate analytical methods to understand the contributing factors.
  3. Identify and implement solutions or interventions that are designed to prevent recurrence and reduce risk of harm.
  4. Have mechanisms in place to mitigate consequences of harm when it occurs.

To develop aÌýmore in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources forÌýconducting chart auditsÌý²¹²Ô»åÌýanalysis methodsÌýare included in theÌýHospital Harm Improvement Resources Introduction

If your review reveals that your cases of obstetric Hemorrhage are linked to specific processes or procedures, you may find these resources helpful:

  • Association of Ontario Midwives.Ìý
  • Postpartum Hemorrhage. 2016.Ìý
  • American College of Obstetricians and Gynecologists (ACOG).Ìý
  • Obstetrics & Gynecology.ÌýACOG Practice Bulletin: Postpartum Hemorrhage.Ìý2017. DOI:Ìý
  • Obstetric Hemorrhage Bundle, Guidance Documents, and Additional ResourcesÌý
  • Committee Opinion: Preparing for Clinical Emergencies in Obstetrics and Gynecology. 2014.Ìý
  • Committee Opinion: Quantitative Blood Loss in Obstetric Hemorrhage.Ìý 2019.ÌýÌýÌý
  • Association of Women's Health Obstetric Neonatal Nurses (AWHONN).Ìý
  • Postpartum Hemorrhage.Ìý
  • California Maternal Quality Care Collaborative.Ìý
  • OB Hemorrhage Toolkit V 2.0. 2015.Ìý
  • Institute for Healthcare Improvement (IHI).ÌýÌý
  • How-to Guide: Prevent obstetrical adverse events. 2012.Ìý
  • National Institute for Health and Care Excellence (NICE)Ìýwww.nice.org.uk
  • Intrapartum care for healthy women and babies: Clinical guideline [CG190]. Published date:Ìý 2014 Last updated: 2017Ìý
  • The Global Library of Women’s Medicine.Ìý
  • A Comprehensive Textbook of Postpartum Hemorrhage 2nd Edition.Ìý
  • The Society of Obstetricians and Gynaecologists of Canada (SOGC) -Ìý
  • Journal of Obstetrics and Gynaecology of Canada (JOGC).ÌýÌýNo. 235-Active Management of the Third Stage of Labour: Prevention and Treatment of Postpartum Hemorrhage. 2018.Ìý
  • World Health Organization
  • WHO recommendations for the prevention and treatment of postpartum haemorrhage. 2012.Ìý
  • Uterotonics for the prevention of postpartum haemorrhage.Ìý 2018.Ìý
  • WHO Recommendations: Uterotonics for the prevention of postpartum haemorrhage Power Point Presentation.Ìý

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Obstetric Hemorrhage

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Obstetric Hemorrhage

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