Evaluation of multi-professional obstetric skills training for postpartum hemorrhage

Objective. To evaluate the effect of multi-professional obstetric skills training on the incidence of postpartum hemorrhage (PPH) indicated by red blood cell (RBC) transfusion and time delay in surgical interventions before, during, and after implementation of the training. Design. A database audit. Setting. University hospital, Rigshospitalet, Copenhagen, Denmark. Population. Women receiving RBC transfusion up to seven days postpartum before (2003), during (2005), and after (2007) the introduction of training. Methods. Linkage of the Danish Medical Birth Registry and the local transfusion database, followed by audit of medical records. We identified 148 women with RBC transfusion for PPH in a total of 10 461 deliveries and assessed the cause of PPH, surgical interventions and transfusion data. Main Outcome Measures. RBC transfusion. Delay to surgical intervention. Results. RBC transfusion rates for PPH were 1.5% (2003), 1.6% (2005) and 1.2% (2007) (not statistically significant). The transfusion rates did not change after vaginal delivery but decreased after cesarean section (2.4%, 2.1% and 0.7% (p