Increasing maternal death rates - news story

Specialties Ob/Gyn

Published

Specializes in Transplant, LVAD, cardiac.

http://abcnews.go.com/WN/changing-life-preventing-maternal-mortality/story?id=9914009&page=1

This news story brought to light increasing maternal deaths following childbirth, including many following c-sections. I thought you might find it interesting and maybe even helpful. While it doesn't always shock me, I'm still sometimes shocked at how many women undergo c-sections!

Has anyone seen the boots used? It seems like something patients may not normally be informed about...

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The 'boots' sound like SCD's. Pretty standard for pt.'s after abdominal surgery, along with TED hose, at least until they are walking around. I've seen them at every hospital I've worked/been a student at.

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The "boots" are SCD's. It is pretty standard practice to use SCD's on post-op c-sections these days to prevent this type of thing. Most hospitals put them on when the patient is on the OR table and they stay with them until the patient gets up out of bed. The earlier you can get the moms up and ambulating again after surgery greatly reduces the risk of post-op complications including DVT's and atelectasis. Patients often don't understand why we're anxious to kick them out of that bed the morning after their c-section but it's for their own good. Of course if mom has an underlying undiagnosed cardiac problem, this can lead to unforseen complications. Seen it happen.

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What shocked me the most was the mom who died, she had been lying in bed for 30hrs post op!!

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Specializes in NICU Transport/NICU.
What shocked me the most was the mom who died, she had been lying in bed for 30hrs post op!!

Can't agree with this more. I was quite suprised when I read this fact. :down:

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The key here is her not being gotten OOB promptly, certainly within 8 hours or whenever her anesthetic (spinal?) wore off and she could move again. Lawsuit time.

Can't help but wonder, of course, how many patients her nurse and aide had, or just exactly what the reason was for not getting her up.

Crying shame.

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Specializes in student; help!.

I had SCDs for my TVH, and that was only a 2h procedure. I was surprised when my doc wrote the order, but now I'm glad I had them.

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Specializes in Cardiac.

Every post op Csection gets them at my hospital. Also the nurses are getting them OOB the next day!! You don't even need a dr order for the cuffs here. Its a nursing judgment thing.

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Specializes in L&D,Wound Care, SNC.

Every patient who has a c-section gets SCDs at our hospital. They are placed and started prior to surgery start time and are worn until the patient gets OOB.

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What shocked me the most was the mom who died, she had been lying in bed for 30hrs post op!!

If that's not shocking enough, her friend (and fellow teacher at a local elementary school) had a c-section 15 days later at the SAME hospital and died after bleeding out. NJ is a horrible place to give birth. CA made news with a maternal death rate of 16.9/100,000 birth. NJ's maternal death rate is 21/100,000.

ETA: link to NJ story: http://cbs3.com/topstories/Woodbury.Avon.Elementary.2.308949.html

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the hospital i work at uses ted hose and the scds. There is one dr that writes an order that the pt can not get up unti 24 hours after surgery. Most it is our choice to get them up between 12 and 24 hours. You have to also remember that they could of lost a lot of blood during surgery and if you get them up after 8 hours they are going to be dizzy and faint on you.

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Rarely does a c/s where I work have SCDs, no TEDS on either. Drives me bonkers.

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