In the early 2000s, California experienced an alarming increase in the frequency of deaths among pregnant women and new mothers. The California Maternal Quality Care Collaborative, founded at Stanford in 2006, has made big strides in turning that trend around, and they've just completed another important step in the process.

To reduce maternal deaths, the CMQCC has closely analyzed the most common causes of pregnancy-related deaths and reviewed scientific evidence for how to prevent them. They've issued peer-reviewed toolkits that give physicians detailed guidance on how to spot, avert and treat high-risk situations during pregnancy, birth and the postpartum period.

Their final toolkit, focused on preventing maternal venous thromboembolism, has just been released. Patients affected by VTE develop dangerous blood clots, often starting in the large veins in the legs, that can go on to become lodged in the lungs. The condition causes about 10 percent of maternal deaths, and an analysis of such deaths in California found that more than half had a good-to-strong chance of being prevented.

Healthy pregnancy increases one's chance of developing VTE, so it's important for obstetricians to have it top of mind. The toolkit gives specific advice on when to assess a woman's VTE risk, what risk factors to watch out for, the situations in which it is and isn't a good idea to use blood-thinning medications as a preventive approach, and how to deal with special circumstances such as bed rest. Being hospitalized during pregnancy — which is necessary for women who have certain especially risky pregnancies — has been linked to a 12- to 18-fold increase in VTE risk, for example. Simple measures such as making sure that these patients stay hydrated and move around enough can greatly reduce their VTE risk.

On April 12, the CMQCC is hosting a free webinar for medical professionals who want to learn more about the toolkit. Online preregistration is required.

Photo by Douglas Porter