Preventable Adverse Events in Obstetrics-Systemic Assessment of Their Incidence and Linked Risk Factors

Adverse events (AEs) come hand to hand in nearly every medical care. Obstetrics is unique as it encompasses a much heightened expectation concerning safety and includes infrequent cases of harm, but extremely high individual consequences of harm. 

Yet there is a lack of standardized identification, documentation, or uniform terminology for preventing AEs in obstetrics. 

A recent study thus documented an obstetrics-specific matrix on the preventable factors of AEs founded on existing literature to facilitate standardized reactive risk management in the concerned department. 

A criteria matrix regarding preventability was employed to retrospectively evaluate the AEs in obstetrics and the Risk factors for preventable AEs (pAEs) were recognized. 

The results obtained were as follows-

• 23% of 2865 births, revealed adverse events.
• Presence of a minimum of 1 pAE was found in 13% of the cases.
• The 6 categories of pAEs revealed 19 risk factors. 

The risk factor of primiparous women was found to be repeatedly associated with peripartum therapy delay, diagnostic error, and missed correct diagnosis of types in fetal positions. This is also true in some multiparous women. A missed due date was also found to be linked with the above pAE categories. Induction of labor and on-call duty were the risk factors oftentimes in peripartum therapy delay, diagnostic errors, and organizational errors. Inadequate fetal monitoring was found to be maximumly related to the risk factor of on-call duty. Cases of inadequate maternal birth position, a back position was most commonly observed.

Modifying these Preventable categories in the future with targeted efforts will help lower the pAEs in obstetrics.

SOURCE- Hüner B, Derksen C, Schmiedhofer M, Lippke S, Janni W, Scholz C. Preventable Adverse Events in Obstetrics-Systemic Assessment of Their Incidence and Linked Risk Factors. Healthcare (Basel). 2022 Jan 4;10(1):97. doi: 10.3390/healthcare10010097. PMID: 35052261; PMCID: PMC8775914.