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PPH Treatment Improves

Physicians can now respond faster and more efficiently to treat new mothers experiencing postpartum hemorrhage (PPH). The new evidenced-based protocol went into effect in March.

Sarah Newman

Sarah Newman, MD, FACOG

"PPH is similar to a trauma event in the ER. There is excessive and rapid blood loss so the team must work together, and the process has to be streamlined to prevent any delay in treatment," said Sarah Newman, MD, FACOG, with Meritas Health Pavilion for Women located on the campus of North Kansas City Hospital.

When a PPH occurs, a preprinted order set immediately activates emergency protocol to establish IV and tamponade. "The new protocol means that when an emergency occurs, physicians can be confident that staff is trained, roles are defined and a fully equipped cart is readily available with everything a physician most needs, including supplies, medications, IV lines and instruments," she explained. 

Fewer Transfusions/Fewer ICU Admits

The new protocol reduces the number of patients who need transfusions as well as the number of units transfused to individual patients. Rapid intervention during a PPH also helps reduce the number of ICU admits.

Bakri Balloon

Bakri Balloon included in the
new crash carts

"Improved treatment of PPH is critical because 3% of deliveries have a hemorrhage event," Dr. Newman noted, "Which equates to 3-4 cases per month at NKCH." Worldwide, a hemorrhagic event is the leading cause of maternal morbidity and the most important reason women need to be closely monitored in the hospital for the first 24 hours after giving birth.

In addition to PPH, other serious conditions physicians must be prepared to treat include abruptions and shoulder dystocia. "Referring physicians can be confident NKCH not only responds quickly to these maternal medical emergencies, we have the Northland’s only Level III NICU," Dr. Newman said.

The PPH Initiative

The PPH initiative resulted from the collaboration of an interdisciplinary team, including anesthesiology, pharmacy, and obstetrics, plus clinical staff from the maternal child and education departments.

The goal is to follow the California Maternal Quality Care Collaborative (CMQCC) guidelines for evidence-based medical practices designed to reduce maternal deaths. The team’s next step is to implement an OB STAT rapid response team, which functions much like the code blue team of the hospital but is specific to OB emergencies. An OB STAT team includes all disciplines of the health care team, which are specifically trained and experienced in obstetrical emergencies.

Read NKCH’s evidenced-based PPH initiative presented at Missouri Hospital Association and March of Dimes Kansas City conference on PPH and preeclampsia.

To learn more call, 816.691.1728.