CLINICAL AUDIT REPORT
LABOUR WARD
LOWER UMFOLOZI DISTRICT WAR MEMORIAL HOSPITAL
Dr A K M Hoque - Medical Manager
Dr W Edelstein - Senior Specialist
Perinatal mortality rate is a sensitive indicator used Nationally and Internationally to
measure and compare the health and, development status of the population. Fresh stillbirth
and early neonatal death rates are associated with maternal health and access to care around
the time of delivery, preventative and curative health services accessible to communities.
More than one third of all perinatal deaths are neonatal deaths in this institution. Care given
at intrapartum period is likely to be associated as high neonatal death rates. Clinical care
(medical and nursing) practices at labour ward are an important tool to identify the
gaps/strength in this regard. Clinical audit thus initiated to describe the care pattern during
intrapartum period in Labour Ward at this Hospital.
This report objectively assesses the management of different phases of labour namely:
Normal labour
Induction of labour - Reason for induction of labour
Labour history
Recording of physical examination of patient in labour
Use of analgesia during labour
METHODS AND MATERIALS
Retrospective record review of 105 post delivery patients were selected randomly for this
review over a four month period (February to May 2004). The Medical officers identified
the selected patients, collected demographic data during daily routine ward rounds (name,
age, referral status) on a standard questionnaire and kept the partly filled questionnaire in
the patients file. After the discharge of the patient, the patient’s file was brought to a
senior consultant for further data collection on labour ward practices. The offices at the
patient registry were instructed to bring the selected patients file to the consultant. The
consultant examined the patient’s clinical record, extracted the relevant information and
completed the questionnaire for the audit. Data from the questionnaire were captured on
EpiInfo and exported to SPSS for analysis.
VARIABLES MEASURED
• Demographics of attendance: Age, booking status
• Referral pattern (clinic, hospital or self)
• Types of labour: Spontaneous, induced
• History taken or not
• Record of physical examination on admission by a midwife or/and Medical Officer
(important examination of a patient in labour - 8 items) were considered such as;
o Fundal height
04/11/05 Page 1 of 5