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Objective: To evaluate the effectiveness of the implementation of intervention packages for postpartum hemorrhage (PPH) management in pregnant women hospitalized in a High Obstetric Complexity Unit in a Latin American country. Methods: Retrospective cohort study including pregnant women with PPH attended between January 2011 to December 2019. Three periods of time were defined according to management strategies We performed univariate and multivariate robust Poisson regression logistic models for each of the outcomes derived from each period. Results: We included 602 patients. There was a reduction in period 3 of the incidence of massive PPH (16% versus 12% P < 0.001, relative risk [RR] 0.61, 95% confidence interval [CI] 0.44–0.85; P = 0.003), major surgery (24%, 13%, 11%, P = 0.002, RR 0.54, 95% CI 0.33–0.883; P = 0.014), and admission to the intensive care unit (ICU) (14%, 7%, 6.1%, P = 0.0, RR 0.40, 95% CI 0.17–0.96 P = 0.00). Conclusion: The implementation of PPH intervention packages in a hospital in a middle‐income country from Latin America, led to a significant decrease in the incidence of massive bleeding, the rate of major surgery, and the ICU stay of pregnant women affected by this condition. Synopsis: Intervention packages for PPH in LMICs enable integrated care for early detection of PPH risk, early recognition, and interventions to reduce its progression. [ABSTRACT FROM AUTHOR]

Objective To determine the spectrum of etiology and the incidence of healthcare-associated infections (HAIs) among gynecologic and obstetric patients. Methods In a descriptive survey, data were analyzed from in-patients at the Department of Gynecology and Obstetrics, University Hospital and Faculty of Medicine in Hradec Králové, Czech Republic, between January 2007 and December 2011. Results Among 21 937 patients treated during the study period, there were 189 (0.86%) cases of HAI. Gynecologic patients had a higher incidence of HAIs (1.31%) compared with pregnant women (0.60%). The incidence of HAI was 0.13% after laparoscopic surgery, 0.63% after a minor gynecologic intervention, and 3.73% after major surgery. Vaginal delivery (0.36%) represented a low risk of HAI. Compared with vaginal delivery, the incidence of HAI increased twofold for planned cesarean delivery (0.64%), and tenfold for emergency cesarean delivery (3.63%). The majority of causative microorganisms (72.7%) were susceptible to penicillin antibiotics. None of the patients died as a result of HAI. Conclusion The incidence of HAIs at a university hospital in the Czech Republic was very low. Antibiotic resistance was only a minor problem, and the incidence of multiresistant strains was rare. [ABSTRACT FROM AUTHOR]