Evaluation of the Implementation of Guidelines for Managing Obstetric Emergencies in the Emergency Operating Room: Effectiveness and Impact on Maternal and Neonatal Outcomes

Abstract

This mixed-methods study aimed to evaluate the effectiveness of newly developed clinical practice guidelines for managing obstetric emergencies in the emergency operating room, assess their impact on maternal and neonatal outcomes, and identify factors influencing the success of, or barriers to, its implementation. A quasi-experimental research was used to compare the clinical outcomes of mothers and neonates who received care using the newly implemented clinical guidelines and those who received standard care. Quantitative data were collected from the medical records of, and questionnaires completed by, 282 mothers who underwent emergency surgery. The data were analyzed using descriptive and inferential statistics, including Chi-square and Fisher’s exact tests. Qualitative data were obtained through in-depth interviews and focus group discussions with 30 healthcare professionals and analyzed using thematic content analysis.

The findings showed that the implementation of the newly developed guidelines significantly improved clinical outcomes. Maternal complications decreased from 18.30% to 12.10%, maternal survival increased from 92.50% to 97.80%, and neonatal mortality declined from 5.70% to 2.30%, all with statistical significance at    p <.05. In terms of team performance, 53.90% of the teams following the new guideline achieved an “excellent” rating compared to only 1.42% in the conventional group. Qualitative analysis revealed three key themes: 1) enhanced team coordination leading to more accurate and timely emergency responses; 2) improved availability of medical supplies and resources, which minimized delays in care delivery; and 3) effective training programs which boosted staff competency and confidence in managing obstetric emergencies. The study concludes that well-structured, context-specific clinical guidelines can systematically enhance team performance, improve the quality of maternal and neonatal care, and reduce the risks associated with obstetric emergencies.