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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.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|March 1, 1995
PubMed
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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.

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  • 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.