Help a mother out: The impact of acute care surgeon response in postpartum hemorrhage.

ABSTRACT

INTRODUCTION: A Code White (CW) activation is a hospital-wide alert for postpartum hemorrhage (PPH) and acute care surgeons (ACS) were added to the response team to assist in resuscitation. A multidisciplinary training program was also implemented. This study aimed to evaluate the impact of ACS involvement and training on maternal outcomes. METHODS: A retrospective review was performed on all CW activations from 1/1/2015-8/31/2022. Three groups-pre-ACS response, ACS response, and ACS response â€‹+ â€‹training (R&T)-were compared. RESULTS: 218 patients had CW activations. ACS response increased MTP activations (50.0%vs76.5%vs76.2%, p â€‹= â€‹0.014) and TXA administration (50.0%vs96.5%vs93.3%, p â€‹< â€‹0.0001). The ACS R&T had the highest ACS presence (53.6%vs72.9%vs96.2%, p â€‹< â€‹0.0001), shortest operation (99 vs 67 vs 53min, p â€‹= â€‹0.002), lowest crystalloid use (2000 vs 1110 vs 800 â€‹ml, p â€‹= â€‹0.003), and lowest transfusion requirements. Mortality decreased from 17.9% in pre-ACS to 2.4% in ACS response and 0% in ACS R&T (p â€‹< â€‹0.0001). CONCLUSION: ACS assistance in CW activations and multidisciplinary PPH education led to the prevention of maternal mortality. ACS are a valuable resource in this unique population.