Risk management and medicolegal issues related to postpartum haemorrhage

Postpartum haemorrhage (PPH) is a major cause of maternal mortality and morbidity. Despite several local and national guidelines and recommendations, the incidence of major obstetric haemorrhage has not declined significantly over the years. A high proportion of these cases involve patient safety incidents. The major themes in such incidents are: delay in diagnosis, failure to adhere to protocols, lack of consultant supervision, communication and documentation problems, inefficient teamwork and organizational failure. This chapter deals with ways of identifying the major contributory factors for adverse events associated with PPH and suggests solutions to minimize errors.

Key words: postpartum haemorrhage, maternal morbidity, hysterectomy, risk management, safety, adverse events, medicolegal