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Published on December 14, 2018

mom with newborn baby

Nationally Published Article Addresses Safer Deliveries

Every mom hopes for a complication-free birth, and most are. If an issue does arise, you want to know your hospital has planned for an emergency situation and is ready to handle one.

“Our focus is on planning and prevention,” said Kimberlee McKay, MD, Avera OB-GYN Service Line Clinical Vice President, who is co-author of a nationally published article in the New England Journal of Medicine titled “What We Can Do about Maternal Mortality – And How to Do It Quickly.”

Communication, planning protocols and training for obstetric teams are among solutions for urban and rural hospitals alike.

“It’s a fact of life that childbirth poses hazards, and hospitals are equipped and staffed to address those hazards, McKay said. “As care teams, we must always be on the lookout for signs of complications, and be ready to intervene when needed. As a health system, we are having those conversations that will lead toward better outcomes for every mother and child.”

Post-partum bleeding, severe high blood pressure and blood clots are among the top complications that can arise with childbirth.

“Complications like these are rare but they can come on quickly,” said McKay. “They require a fast and proper response from the care team to prevent a life-threatening situation.”

Avera has many programs in place for maternal safety:

  • Shared best practices across the system and system-wide support for smaller hospitals.
  • Resource assessment to make sure all sites have the resources they need, for example, adequate blood supply for transfusions and supply of medications for treating high blood pressure.
  • A warning system built into the electronic medical record (EMR) that signals nurses in the case of high pulse, high or low blood pressure or poor urine output.
  • Telemedicine consults with maternal-fetal medicine specialists and other specialists.
  • Careflight air transport system to transfer mothers to a tertiary care center when necessary.
  • Protocols to limit caesarean deliveries (C-sections) to times when they are medically necessary, because bleeding is more likely during or after a C-section. While the national benchmark is less than 35 percent, the Avera rate is consistently in the 20th percentile.
  • A protocol for treatment of hypertension.
  • The PeriWatch labor analysis software system with decision support.

“Using a variety of means, medications and protocols, we can anticipate these conditions and treat them successfully,” McKay said. “That success requires a cautious team who is carefully monitoring the patient during each and every birth, and it’s a reality that we’re working toward both here in South Dakota and across the nation.”

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