EXPERTS in Scotland are calling for new measures to prevent women dying during pregnancy or after childbirth, saying symptoms should be “red flagged” by doctors.
A new drive, backed by Scotland’s Chief Medical Officer Dr Catherine Calderwood, is urging frontline NHS staff to listen carefully to expectant mothers when they raise health concerns – and not dismiss them as simple side-effects of pregnancy.
The campaign was prompted by an official review of maternal deaths which found there had been no significant decrease in the number of mothers dying around the time of childbirth from medical and mental health problems in the last 10 years.
While fewer women are killed UK-wide by pregnancy-related problems such as pre-eclampsia and bleeding, other fatal problems such as heart conditions and strokes persist.
Posters are being sent to accident and emergency departments and other medical assessment units across the UK urging staff to fully investigate health issues in pregnant women. A video talking them through key points has also been released.
Dr Calderwood said: "No one expects a pregnant or recently pregnant woman to die- yet this still happens every other day in the UK. Symptoms may be misinterpreted even by doctors and midwives because problems are rare. This brilliant five minute (video) clip should be shown to as many healthcare professionals who see pregnant women as possible - it will save lives."
Dr Rebecca Northridge, a senior trainee doctor in obstetrics and gynaecology for NHS Tayside, led the project which brought together the Royal College of Physicians and Surgeons of Glasgow and the Royal College of Obstetricians and Gynaecologists.
The campaign tells NHS staff never to assume symptoms are just caused by pregnancy. Staff are advised to “red flag pregnant and post-partum women who arrive at hospital complaining of ill health and make sure they are assessed by senior doctors and obstetricians before discharge, as pregnant women may look well but still become sick very quickly.”
Dr Northridge said seeking advice from other specialists on pregnant women's symptoms should also be prioritised and made by phone rather than a written referral. She said: “At the moment I think communication could be improved a lot of the time because we all work to a certain extent in silos, in departments. The doctors in accident and emergency will not see a lot of pregnant women, so while they are very experienced at dealing with a lot of problems, they may be relatively inexperienced in dealing with pregnant women.”
She also stressed staff should not be afraid to carry out investigations such as scans for fear of harming unborn babies. Never stopping women taking medication they were already using, without consulting an expert, is also emphasised by the new guidance.
Professor Hazel Scott, honorary secretary of the Royal College of Physicians and Surgeons of Glasgow, said: "When patients who are pregnant or have been recently pregnant present unwell, all clinicians, whether they are physicians, specialists in A&E, or obstetricians and midwives, need to pick up the phone and work across disciplines to improve outcomes."
Dr Northridge said they did not want to frighten women as most pregnancies are healthy.
In the UK and Ireland one in every 10,000 pregnancies results in the death of the mother – suggesting there maybe five or six deaths a year in Scotland. Separate data for Scotland is not routinely published although a freedom of information request by The Herald revealed an increase in maternal deaths from a low of three to six a year between 2005 and 2009.
An audit across the UK and Ireland in 2014 revealed 32 per cent of maternal deaths were due to pregnancy related conditions and 68 per cent were the result of other health issues. These included cardiac problems, 23 per cent, flu and pneumonia, 14 per cent, deep vein thrombosis, 11 per cent, and neurological conditions such as stroke and epilepsy, 11 per cent. A further nine per cent of deaths were due to suicide.
Professor David Galloway, president of the Royal College of Physicians and Surgeons of Glasgow, said: “Preventable death, wherever it occurs, is a tragedy. The strong messages which particularly relate to indirect causes of maternal mortality deserve wide publicity. We should aspire to the dramatic improvement that has already been achieved in the maternal death rate from complications directly related to pregnancy and delivery."
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