Joseph Apuzzio, MD
As I indicated in the last District III Reporter, one of my priorities as chair is to continue efforts on ACOG’s MOMS Initiative (Making Obstetrics and Maternity Safer) through maternal mortality review and patient safety. I am a long-time member and current chair of the New Jersey Maternal Mortality Review Team. The team met on March 17 to review 12 cases of maternal deaths that occurred up to 365 days after delivery.
Many of the deaths were considered to be not related to the pregnancy. However, several important issues arose and were discussed at the multidisciplinary meeting. Domestic violence, substance abuse, and lack of patient adherence to care plans and prescribed medications were common causes of death in the cases reviewed. They highlight how important it is for ob-gyns to screen for domestic violence and substance abuse during pregnancy and after delivery. When adherence to care plans and medications is an issue, ob-gyns should attempt to involve appropriate family members and/or social services in the plan.
One of the more common causes of maternal mortality in the US and worldwide is hemorrhage. None of the cases reviewed by the New Jersey Maternal Mortality Review Team involved hemorrhage as a cause of death. We believe that past attempts to highlight the issue of hemorrhage and provide education to ob-gyns on approaching and treating peripartum hemorrhage resulted in no recent deaths in New Jersey due to this cause.
The executive summary of the most recent report of the New Jersey Maternal Mortality Review Team contains a wealth of information. I encourage you to read it.
The ACOG website is an invaluable resource for information concerning patient care and other issues. In particular, there is an executive summary of Neonatal Encephalopathy and Neurologic Outcome in the April 2014 issue of the Green Journal that I think many members will find worthwhile.
Please feel free to contact me about District III issues or other ACOG issues at email@example.com.