Standardized severe maternal morbidity review: Rationale and process

Sarah J. Kilpatrick, Cynthia Berg, Peter Bernstein, Debra Bingham, Ana Delgado, William M. Callaghan, Karen Harris, Susan Lanni, Jeanne Mahoney, Elliot Main, Amy Nacht, Michael Schellpfeffer, Thomas Westover, Margaret Harper

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Severe maternal morbidity and mortality have been rising in the United States. To begin a national effort to reduce morbidity, a specific call to identify all pregnant and postpartum women experiencing admission to an intensive care unit or receipt of four or more units of blood for routine review has been made. While advocating for review of these cases, no specific guidance for the review process was provided. Therefore, the aim of this expert opinion is to present guidelines for a standardized severe maternal morbidity interdisciplinary review process to identify systems, professional, and facility factors that can be ameliorated, with the overall goal of improving institutional obstetric safety and reducing severe morbidity and mortality among pregnant and recently pregnant women. This opinion was developed by a multidisciplinary working group that included general obstetrician-gynecologists, maternal-fetal medicine subspecialists, certified nurse-midwives, and registered nurses all with experience in maternal mortality reviews. A process for standardized review of severe maternal morbidity addressing committee organization, review process, medical record abstraction and assessment, review culture, data management, review timing, and review confidentiality is presented. Reference is made to a sample severe maternal morbidity abstraction and assessment form.

Original languageEnglish (US)
Pages (from-to)403-408
Number of pages6
JournalJOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing
Issue number4
StatePublished - 2014


  • Interdisciplinary review
  • Maternal morbidity
  • Maternal mortality
  • Standardized review

ASJC Scopus subject areas

  • Pediatrics
  • Critical Care
  • Maternity and Midwifery


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