Studio pre-post introduzione di un protocollo terapeutico per la prevenzione dell'emorragia post partum

Introduction: Maternal death represents a dramatic event and it is the crucial indicator of the general situation of a country’s health and development. Obstetric hemorrhage represents the main cause of maternal death, followed by hypertensive disorders and sepsis. The adoption of protocols leads to advantages such as the adequate coordination of staff and better communication. Objective: The analysis aims at investigating if it is possible to record a reduction in the frequency of sentinels phenomena after the adoption in 2012 of the percorso diagnostico terapeutico assistenziale (PDTA) focused on post-partum bleeding and the reduction in the number of cases due to bleeding. Methods: An analytical study has been carried out at the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, with the intent to detect cases of post partum hemorrhage in two months of operation of the delivery room before the introduction of PDTA and in two months after the introduction of PDTA with the aim to prevent postpartum hemorrhage. The sample was divided into quotas. The gathering of data took place during two different time frames. The Gruppo pre PDTA includes the patients who gave birth between January 8th and February 8th 2009 and who experienced post-partum hemorrhage, while the Gruppo Post PDTA includes patients who gave birth between January 8th and February 8th 2014 and who experienced post-partum hemorrhage. Results: The Gruppo pre PDTA is composed of 548 patients; 55.8% gave birth with vaginal delivery and 44.2% gave birth with caesarean section. The total percentage of cases experiencing post-partum hemorrhage was 22.1%. The Gruppo post PDTA is composed of 478 patients: 54.8% gave birth with vaginal delivery, while 45.2% with caesarean section. The total percentage of cases experiencing post partum hemorrhage 19.7%. Conclusions: Despite the adoption of the PDTA there hasn’t been a substantial reduction in the number of cases of post-partum hemorrhage and in their entity.