PTP (Perinatal Training Program) - Maternity Crisis Management Training

Regular training is imperative for potentially catastrophic emergencies that can arise in childbirth. The Perinatal Training Program's Maternity Crisis Management (MCM) track provides exciting new content covering high-risk, low incidence OB emergencies, enabling clinicians to be prepared. Topics in this training track include Shoulder Dystocia, Antepartum Hemorrhage, Postpartum Hemorrhage, Cord Presentation/Prolapse, Uterine Rupture/Inversion, Hypertensive Disorders of Pregnancy, Maternal Collapse, and Maternal Sepsis.   

This nursing continuing professional development activity was approved by Connecticut Nurses’ Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. (7.5 CNE contact hours)

MCM Screenshot Gallery:

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Why is Maternity Crisis Management Training so important?

High risk, low incidence OB emergencies require skill and decisive action to avoid catastrophic consequences

  • Shoulder Dystocia, occurring in more than 1% of deliveries, is often unanticipated and considered a primary cause of perinatal mortality and morbidity, and maternal morbidity. ACOG Practice Bulletin: Shoulder Dystocia, No. 40, Nov. 2002
  • Postpartum hemorrhage occurs in 10 – 15% of women after delivering and is a leading cause of maternal death. Bateman et al, 2010 It is responsible for 10-12% of maternal deaths in the US. Evenson et al. 2017  
  • Preeclampsia and hypertensive disorders of pregnancy affect up to 10% of all pregnancies worldwide and is a leading contributor to prematurity. In the United States, these disorders have increased by 25% over the past 2 decades, accounting for a 17% maternal mortality rate. It is estimated that there would be a 50-70% reduction in maternal morbidity and mortality with improved recognition, diagnosis and treatment of these disorders, especially preeclampsia(CMQCC, 2014).
  • Maternal Sepsis accounts for up to 28% of maternal deaths and 15% of ICU admissions. It is estimated that 63% are preventable (CMQCC, 2020). 

Avoidable Poor Outcomes Increase Litigation & Cost

  • For obstetric-related paid claims, the average payment involving a neurologically impaired infant was $982,051 and $364,794 for “other infant injury-major”. (ACOG, 2012)

The Answer is Training!

High risk, low incidence OB emergencies require regular training.


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MCM Topics covered:

Antepartum Hemorrhage

  • Risk factors of APH
  • Main Causes of APH - placenta previa, placental abruption and vasa previa.
  • The priniciples of APH management
1 CNE contact hour


Cord Presentation and Prolapse

  • Risk factors of Cord Presentation and Prolapse
  • Identification/Recognition of Cord Presentation and Prolapse
  • Management of Cord Presentation and Prolapse
0.75 CNE contact hour


Postpartum Hemorrhage

  • Risk factors of PPH
  • Main causes of PPH
  • The principles of PPH management
  • Updated definitions in accordance with ACOG and CMQCC* Guidelines
  • An explanation of QBL- the use of quantified blood loss evaluation, for standardized care and improved outcomes
  • Staging of hemorrhage defined
  • Active Management of Third Stage Labor (AMTSL) redefined as recommended by ACOG, CMQCC, and AAP to support delayed cord clamping benefits for the newborn, and decrease risk of PPH
  • Introduction to the use of Tranexamic Acid (TXA), in accordance with 2017 ACOG and 2017 CMQCC (California Maternal Quality Care Collaborative) recommendations to improve maternal outcomes in PPH
1 CNE contact hour


Shoulder Dystocia Chapter

  • Definition and Causes of Shoulder Dystocia
  • Maternal and Neonatal Complications
  • Management and Maneuvers
  • Post-Partum Care and On-going
  • Risk Management
1 CNE contact hour


Uterine Rupture/Inversion

  • Risk factors of Uterine and Inversion
  • Incidence of Uterine and Inversion
  • Complications of Uterine Rupture and Inversion
  • Recognition of Uterine Rupture and Inversion
  • Management of Uterine Rupture and Inversion
0.75 CNE contact hour

Hypertensive Disorders of Pregnancy

  • Definitions of hypertensive disorders in accordance with ACOG and CMQCC* Guidelines
  • A discussion of the effects of hypertension and preeclampsia on maternal and fetal systems
  • Review of preeclampsia symptoms respective of organ system involvement
  • Discussion of lab values, medication regimens, fetal surveillance and timing of delivery
  • Role of magnesium sulfate, seizure prophylaxis, and management of eclampsia
  • Prevalence of hypertensive disorders in the postpartum period and the role of consistent patient education
 1.0 CNE contact hour

Maternal Collapse

  • Causes of Maternal Collapse
  • Changes in anatomy and physiology during pregnancy
  • Use of an Early Warning System to detect the deteriorating woman
  • Use of the DRSABCD mnemonic and its application in pregnancy 
  • Changes that occur during pregnancy and how they can affect effective resuscitation
 1.0 CNE contact hour 

Maternal Sepsis

  • Progression of Infection, Sepsis and Septic shock
  • Risk factors contributing to maternal sepsis
  • Physiological changes of pregnancy that can mask signs of sepsis
  • Causes of maternal sepsis
  • Sources and symptoms of maternal sepsis
  • Use of an Early Warning System, screening for maternal sepsis 
  • Initiating a Sepsis Bundle 
  • Managing Sepsis
  • Sequalae of Sepsis
  • Prevention
 1.0 CNE contact hour