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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Obstetric Quality and Safety

Poster Session 4

(1241) Characteristics and Preventability of Severe Maternal Morbidity Before and After Implementation of SMM-targeting Interventions

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Objective:
Severe maternal morbidity (SMM) is rising in the US. Institutional review of SMM cases has the potential to improve obstetric care, yet there is limited evidence supporting its efficacy. As a quality improvement project here we assess the impact of implementation of new policies and care pathways that stem from the SMM review process on SMM characteristics and preventability.

Study Design:
This is a retrospective cohort study of SMM cases (defined by the ACOG/SMFM criteria) managed at a single tertiary referral center from 9/1/2015, when the SMM review started, to 4/1/2024. SMM cases were compared across two time periods: before and after June 1, 2019, marking the start of SMM review-based interventions. Patient data and event details were manually extracted from EMR and reviewed by a multidisciplinary team. Consensus on ability to alter outcome (“strong” with definitive opportunities to alter outcome, “possible” with some opportunity to alter outcome and “none” with no opportunity to alter outcome) was reached.  The presence of various patient, provider and system-level factors was also assessed. Bivariate analysis was performed to compare the two groups using chi-square or t-tests.

Results:
A total of 304 SMM cases were reviewed: 130 cases before and 175 after 6/1/2019. Patient characteristics and etiologies of SMM were comparable across both groups (Table 1). In the post-intervention group, there were fewer cases with strong (13.2 vs 17.7%) or possible (37.4% vs 46.9%) opportunity to alter outcome (p=0.049). Additionally, provider factors, issues with management hierarchy, staff education, policies and procedures, team communication and equipment were significantly less commonly identified as contributors to SMM in the post-intervention group (Table 2).

Conclusion:
Implementation of SMM-targeting interventions based on a rigorous institutional SMM review process was significantly associated with less frequent identification of provider and system factors as contributors and an overall significant reduction in preventable and potentially preventable SMM cases.