Primigravida Emergency CS Sept - Oct 2010 Audit by Astrid Osbourne Consultant Midwife UCLH
Rationale for audit & method <ul><li>To identify key features in care that impact on the outcome of Caesarean Section in p...
Audit measurements <ul><li>Level of emergency for the CS: </li></ul><ul><li>Maternal age:  </li></ul><ul><li>High risk at ...
<ul><li>Latent phase identified? </li></ul><ul><li>Evidence of a birth plan? </li></ul><ul><li>Named A/N midwife? </li></u...
Emergency caesarean n=53
Maternal age n=53
BMI at booking n=53
Fetal blood sampling attempted  n=53
Decision for caesarean n=53
Dilatation of cervix at epidural n=29
Reason for caesarean  ( N.B. some cases >1 reason)
Choice: Birth centre
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Emergency caesarean section and primip oct 2010 astrid

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Emergency caesarean section and primip oct 2010 astrid

  1. 1. Primigravida Emergency CS Sept - Oct 2010 Audit by Astrid Osbourne Consultant Midwife UCLH
  2. 2. Rationale for audit & method <ul><li>To identify key features in care that impact on the outcome of Caesarean Section in primigravid women </li></ul><ul><li>Potential changes in practice </li></ul><ul><li>34 points examined in the case notes </li></ul><ul><li>Audit started in September and will run for one year </li></ul><ul><li>Today – evidence from the first batch of case notes </li></ul>
  3. 3. Audit measurements <ul><li>Level of emergency for the CS: </li></ul><ul><li>Maternal age: </li></ul><ul><li>High risk at booking? </li></ul><ul><li>Low risk at booking? </li></ul><ul><li>Length of labour prior to CS decision: </li></ul><ul><li>Cervical dilatation at time of CS: </li></ul><ul><li>Primary reason for the CS: </li></ul><ul><li>Instrumental birth attempted? </li></ul><ul><li>If instrumental birth how many attempts? </li></ul><ul><li>Grade of Dr attempting instrumental birth? </li></ul><ul><li>Decision for CS by whom? </li></ul><ul><li>Grade of Dr? </li></ul><ul><li>Maternal complications in pregnancy or labour? </li></ul><ul><li>Fetal complications in labour? </li></ul><ul><li>BMI </li></ul>
  4. 4. <ul><li>Latent phase identified? </li></ul><ul><li>Evidence of a birth plan? </li></ul><ul><li>Named A/N midwife? </li></ul><ul><li>Labour on or off the bed? </li></ul><ul><li>Use of birthing /labour aids: </li></ul><ul><li>Transfer in from other area or unit? </li></ul><ul><li>Multiple pregnancy: </li></ul><ul><li>Labour induced: </li></ul><ul><li>Reason for induction: </li></ul><ul><li>If induced – how many does of Prostin: </li></ul><ul><li>Was Prostin given as per guideline: </li></ul><ul><li>Epidural sited: </li></ul><ul><li>Cms dilated when epidural sited: </li></ul><ul><li>How long was the epidural working before CS: </li></ul><ul><li>Augmentation of labour: </li></ul><ul><li>ARM: </li></ul><ul><li>SROM: </li></ul><ul><li>Labour in water: </li></ul><ul><li>Other forms of pain relief given or techniques used: </li></ul><ul><li>CS Night time 8pm – 8am? </li></ul>
  5. 5. Emergency caesarean n=53
  6. 6. Maternal age n=53
  7. 7. BMI at booking n=53
  8. 8. Fetal blood sampling attempted n=53
  9. 9. Decision for caesarean n=53
  10. 10. Dilatation of cervix at epidural n=29
  11. 11. Reason for caesarean ( N.B. some cases >1 reason)
  12. 12. Choice: Birth centre

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