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Title of Journal: Arch Gynecol Obstet

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Abbravation: Archives of Gynecology and Obstetrics

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Springer-Verlag

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DOI

10.1016/0022-2011(85)90115-6

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1432-0711

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A criterion based audit of the management of obstr

Authors: Eugene Justine Kongnyuy Grace Mlava Nynke van den Broek
Publish Date: 2008/09/09
Volume: 279, Issue: 5, Pages: 649-654
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Abstract

A criterion based audit of the management of obstructed labour was conducted in 8 hospitals in three districts in Malawi Management practices were a assessed by a retrospective review of 44 cases notes and b compared with local standards established by a multidisciplinary team based on the Malawi Ministry of Health guidelines and World Health Organisation manuals Gaps in current practice were identified reasons discussed and recommendations made and implemented A reaudit 41 case notes was conducted 3 months laterThere were significant improvements in the attainment of four standards draining of urinary bladder 705 vs 902 P = 0022 administration of broad spectrum antibiotics 727 vs 902 P = 0039 commencement of Caesarean section within 1 hour or delivery of the foetus within 2 h of diagnosis 386 vs 610 P = 0023 and maintaining an observation chart 455 vs 610 P  0001 However there was no significant change in two standards securing an intravenous line and hydrating the patient 955 vs 976 P = 0804 and typing and crossmatch of blood 773 vs 634 P = 0197 There was a reduction in case fatality rate 91 vs 24 P = 0361 and perinatal mortality 188 vs 122 P = 0462

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