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The Leeds University Maternity Audit Project
B Wilson1, J G Thornton, J Hewison
1Centre for Reproduction Growth and Development, Leeds University, UK.
Summary
UK obstetrics practice significantly improved adherence to evidence-based guidelines between 1988 and 1996. However, many units still require improvement, with preventable complications remaining. Availability of the Cochrane database correlated with better compliance.
Area of Science:
- Obstetrics and Gynecology
- Evidence-Based Medicine
- Healthcare Quality Improvement
Background:
- Compliance with evidence-based recommendations in UK obstetrics was assessed.
- Barriers and facilitators to compliance were investigated.
Purpose of the Study:
- To measure compliance levels and changes in UK obstetrics.
- To identify factors influencing compliance with evidence-based practices.
Main Methods:
- Quantitative case-note audit in 1988 and 1996 across 20 UK maternity units.
- Qualitative interviews with key maternity staff.
Main Results:
- Significant increases in the use of ventouse (vacuum extractor), polyglycolic acid sutures, maternal steroids for preterm delivery, and antibiotics for Caesarean sections were observed.
- No clear relationship was found between unit characteristics (size, facilities, attitudes) and compliance.
- Availability of the Cochrane database correlated positively with compliance.
Conclusions:
- A substantial shift towards evidence-based practice in UK obstetrics occurred, yet significant room for improvement remains.
- Preventable complications, including infections and perineal trauma, persist.
- Local factors and staff commitment, potentially linked to resource availability like the Cochrane database, may influence compliance.