Audit of cases with uterine rupture: a process indicator of quality of obstetric care in Angola.

Abstract

Audit of uterine rupture (UR) used as a process indicator, can identify factors considered avoidable to improve future quality of obstetric care. Records of UR cases at a referral maternity in Luanda were studied retrospectively (n=43) and prospectively (n=67) including basic obstetric information, maternal and foetal outcome, duration of labour, time interval between diagnosis and intervention, drugs used, type of delivery and intervention, surgical procedures and complications. A clinical estimation of avoidability was based on this information. Prevalence of UR was 4.9%. Maternal case fatality rate was 14% and early perinatal mortality 71%. Women with previous Caesarean Section (CS) constituted 28%, grand multiparous women 44% and primiparous women 6%. Uterotonic treatment was given in 36%. Avoidability was estimated to 65%. Regular morbidity-oriented audits with analysis of clinical management reveal weaknesses in obstetric care and may serve as an instrument for future improvement.

• Authors: R T Strand, P Tumba, J Niekowal, S Bergström
• Journal: African journal of reproductive health (Afr J Reprod Health) Vol. 14 Issue 2 Pg. 55-62 (Jun 2010) ISSN: 1118-4841 [Print] Nigeria
• PMID: 21243919 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Angola (epidemiology)
• Delivery, Obstetric
• Female
• Humans
• Maternal Mortality
• Medical Audit
• Pregnancy
• Pregnancy Complications
• Pregnancy Outcome
• Prospective Studies
• Quality Indicators, Health Care
• Retrospective Studies
• Risk Factors
• Uterine Rupture (epidemiology, prevention & control)