NCCEMDNational Committee on Confidential Enquiries into Maternal Deaths (New Zealand)
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Failed intubation was the usual problem with GA, morbid obesity being implicated in 2 NCCEMD reports as a contributory factor in 2 out of 61 and 4 out of 183 deaths from failed intubations.
4] This problem was noted as contributory in two deaths in the 2005-2007 NCCEMD report [5] in South Africa (SA) and in another three cases in the 2008 2010 report.
There has been much discussion of the NCCEMD findings concerning bleeding at CS in obstetric and anaesthetic forums.
The NCCEMD has produced guidelines on the prevention and treatment of blood loss at CS adapted from World Health Organization guidelines, Royal College of Obstetricians and Gynaecologists guidelines and recommendations from obstetric anaesthetic experts.
The NCCEMD advocates that the problem of maternal death be approached under the '5Cs':
Table 1 presents a guideline for a stepwise approach to use of uterotonics at CS that has been mutually agreed on between obstetricians and anaesthetists of the NCCEMD and is evidence based.
14] The NCCEMD report for 2004-2007, published in 2011, stated that all maternity clinics must provide HAART on site, to prevent avoidable delays that were costing women their lives.
The NCCEMD sent the following recommendation to all heads of institutions and training schools involved in maternity care:
NCCEMD, Maternal, Child and Women's Health Directorate.