Society for Maternal-Fetal Medicine Consult Series #54: Assessing the risk of maternal morbidity and mortality

Lappen, Justin R.; Pettker, Christian M.; Louis, Judette

doi:10.1016/j.ajog.2020.12.006

Cited by 18 publications

(4 citation statements)

References 115 publications

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“…Due to difficulty documenting perinatal outcomes, women who delivered at home before admission and those transferred from other hospitals after delivery were excluded. Excluded were women with conditions associated with a high-risk pregnancy [ 15 ], including those with pre-existing chronic medical conditions, including chronic infections, women with certain obstetrical conditions such as multiple pregnancies (pregnancies with more than one fetus) in the current pregnancy, and those with a history of substance abuse. Chronic medical conditions include hypertension, diabetes mellitus, and chronic thyroid, cardiovascular, or renal disease.…”

Section: Methodsmentioning

confidence: 99%

The Association between Grand Multiparity and Adverse Neonatal Outcomes: A Retrospective Cohort Study from Ha’il, Saudi Arabia

Alkwai,

Khan,

Alshammari

et al. 2023

Children

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Inconsistent evidence exists regarding the association of grand multiparity with adverse neonatal outcomes. This study aims to compare specific adverse outcomes in grand multiparas (those with five or more births at twenty or more weeks of gestation, regardless of fetal outcome) compared to those with lower parity (those with less than five births at twenty or more weeks of gestation, regardless of fetal outcome). A retrospective cohort study was undertaken at the Maternity and Children Hospital in Ha’il region, Saudi Arabia. After calculating the required sample size, data were collected from consenting participants with a viable singleton delivery. Socio-demographic variables, select maternal characteristics, and adverse neonatal outcomes (admission to the neonatal intensive care unit, low birth weight, prematurity, and APGAR score less than 7 in the first 5 min) were compared between grand multiparas and women with lower parity. Two hundred ninety-four participants were recruited (ninety-eight grand multiparas and one hundred ninety-six of lower parity). There was a statistically significant difference between the two groups in relation to age, level of education, body mass index, and the occurrence of gestational diabetes. Out of the studied adverse neonatal outcomes after the adjustment for maternal age between the two groups, no statistically significant difference in the adverse neonatal outcomes was found between the two groups. Grand multiparity does not incur an additional risk of adverse neonatal outcomes compared to women of lower parity. Furthermore, increasing maternal age and comorbid conditions might have a more detrimental effect on neonatal outcomes than grand multiparity per se.

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Section: Methodsmentioning

confidence: 99%

The Association between Grand Multiparity and Adverse Neonatal Outcomes: A Retrospective Cohort Study from Ha’il, Saudi Arabia

Alkwai,

Khan,

Alshammari

et al. 2023

Children

View full text Add to dashboard Cite

show abstract

“…Therefore, prompt follow-up with either a primary care physician or a cardiologist should be strongly considered for risk mitigation. 18,19 Similarly, gestational diabetes mellitus is a known risk factor for type 2 diabetes mellitus and cardiovascular disease. 20 Consequently, patients with gestational diabetes mellitus in pregnancy, particularly those with impaired fasting glucose levels or evidence of persistent glucose intolerance in the postpartum period, may benefit from early referral for preventative or medical therapy to prevent the progression to overt diabetes mellitus.…”

Section: Checklist Of Additional Considerations For Postpartum Patien...mentioning

confidence: 99%

Society for Maternal-Fetal Medicine Special Statement: Postpartum visit checklists for normal pregnancy and complicated pregnancy

Morgan¹,

Bauer²,

Whitsel³

et al. 2022

American Journal of Obstetrics and Gynecology

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“…Insufficient staffing or inappropriate allocation of resources to provide safe high-quality care during labor and birth can result in omission, partial completion, or delay of essential aspects of care (Roth et al, 2020; Simpson et al, 2019). Delays in identification of maternal or fetal deterioration can increase risk of near miss or adverse perinatal outcomes (Guglielminotti et al, 2021; Simpson, 2022; Society for Maternal-Fetal Medicine et al, 2021). Nurses who work in environments where nurse staffing is inadequate report stress, job dissatisfaction, burnout, and plans to leave their position (ANA, 2015; Roth et al, 2020; Simpson et al, 2019), which can result in significant costs to hospitals and health care systems (ANA, 2018; NSI Nursing Solutions, 2021).…”

Section: Problem Descriptionmentioning

confidence: 99%

Acuity-Based Staffing in Labor and Delivery Using Electronic Health Record Data

Jones

Hall

2022

McN: The American Journal of Maternal/Child Nursing

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Background:Planning safe and effective nurse staffing can be challenging for nurse leaders of labor and delivery units due to the dynamic nature of birth and unpredictable fluctuations in census and acuity. The electronic health record (EHR) has a vast source of patient data that can be used to retrospectively review patient needs and nurse staffing gaps that can serve as a basis for prospective planning for nurse staffing.Purpose:This quality improvement project was initiated with the goal of developing real-time and longitudinal reports to quantify hourly nurse staffing needs based on patient census, acuity, and required clinical interventions from data that are contained with the EHR. The plan was to determine trends and nurse staffing needs for each 24-hour period every day of the week and identify ongoing staffing patterns to meet the Association of Women's Health, Obstetric, and Neonatal Nurses' (AWHONN) staffing guidelines.Methods:The obstetric nursing leadership team worked with the information technology specialists and developed an algorithm that identifies patient acuity level, indicated clinical interventions, and outlines necessary staffing requirements to provide safe high-quality care. Various reports were built in the EHR to inform the nursing leadership team about nurse staffing on a real-time and historical basis.Results:The reports provided quantitative data that supported a budgetary increase in nurse staffing and a more flexible nurse staffing scheduling system to meet the needs of the patients. The project was successfully implemented in all four of the hospital system maternity units.Clinical Implications:Use of EHR in labor and delivery units is nearly universal. Working with the information technology specialists to integrate nurse staffing data into the EHR is one way to align nurse staffing with the AWHONN nurse staffing standards in real-time and for projections of nurse staffing needs based on unit historical patient data.

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Society for Maternal-Fetal Medicine Consult Series #54: Assessing the risk of maternal morbidity and mortality

Cited by 18 publications

References 115 publications

The Association between Grand Multiparity and Adverse Neonatal Outcomes: A Retrospective Cohort Study from Ha’il, Saudi Arabia

The Association between Grand Multiparity and Adverse Neonatal Outcomes: A Retrospective Cohort Study from Ha’il, Saudi Arabia

Society for Maternal-Fetal Medicine Special Statement: Postpartum visit checklists for normal pregnancy and complicated pregnancy

Acuity-Based Staffing in Labor and Delivery Using Electronic Health Record Data

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