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Audit incorporating avoidability and appropriate intervention can significantly decrease perinatal mortality
H R Ward1, G R Howarth, O J Jennings
1Department of Obstetrics and Gynaecology, Livingstone Hospital, Port Elizabeth.
Summary
The Identification, Cause, Avoidable factor (ICA) Solution method of perinatal audit significantly reduced perinatal mortality by 23%. This audit identified key obstetric care issues, leading to improved outcomes.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Healthcare Quality Improvement
Background:
- Perinatal mortality remains a significant public health concern.
- Effective audit methods are crucial for identifying and addressing causes of perinatal loss.
- The Identification, Cause, Avoidable factor (ICA) Solution method offers a structured approach to perinatal audit.
Purpose of the Study:
- To evaluate the effectiveness of the ICA Solution method in reducing perinatal mortality.
- To identify major obstetric causes contributing to perinatal loss.
- To assess the impact of interventions based on identified avoidable factors.
Main Methods:
- A retrospective audit of 1,060 perinatal deaths at Livingstone Hospital Maternity Service.
- Deaths were classified by primary obstetric cause.
- In the second year, avoidable factors were identified, graded, and categorized.
Main Results:
- Intrapartum trauma, intrapartum asphyxia, and infection were major obstetric causes of perinatal loss.
- Potentially avoidable factors were identified in nearly 50% of perinatal deaths.
- Appropriate interventions led to a 23% reduction in the perinatal mortality rate (P < 0.05).
Conclusions:
- The ICA Solution method effectively identified critical issues in obstetric care.
- Implementation of interventions based on the audit facilitated a significant decrease in perinatal mortality.
- The ICA audit is a valuable tool for improving perinatal outcomes.