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Arch Gynecol Obstet. 2015 Apr;291(4):825-30. doi: 10.1007/s00404-014-3474-3. Epub 2014 Sep 23.

Patient safety and adverse events related with obstetric care.

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Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Calle Domingo Miral s/n, 50009, Zaragoza, Spain,



To determine the frequency and distribution of Adverse Events (AE) in obstetrics departments at Spanish hospitals.


We present a retrospective cohort study including 816 women admitted to the obstetrics departments at 41 hospitals that took part in the National Adverse Effects Study in Spain (ENEAS) and an extension of this study in all hospitals located in two Autonomous Regions. To identify AE, nurses from each participating hospital examined all medical records, and completed a validated screening guide. A team of external reviewers evaluated the medical records of all women who met at least one of the criteria in the screening guide to verify all AE. The main outcome measure was the incidence of AE during hospitalization.


The cumulative incidence of patients with obstetric care-related AE was 3.6% (95% CI 2.3-4.8). The most frequent AE were those related with surgical interventions or procedures (59.4%). None of the AE detected were considered severe. 36.7% of the AE lengthened the woman's hospital stay, and 13.3% led to hospital admission. Additional procedures were needed after 71.9% of the AE, and additional treatment was needed after 59.4%. 56.3% of the AE were considered preventable.


Obstetric care is characterized by generally younger ages among patients, their low frequency of comorbidities and high expectations for successful outcomes of care. However, some factors can increase obstetric risk and favor the appearance of preventable incidents and AE. Systems are needed to detect preventable AE, and measures are needed to reduce risks or attenuate their consequences.

[Indexed for MEDLINE]

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