Indicators of quality of antenatal care: a pilot study.
OBJECTIVE
To pilot a list of indicators of quality of antenatal care across a range of maternity care settings. For each indicator to determine what is achieved in current clinical practice, to facilitate the setting of audit standards and calculation of appropriate sample sizes for audit.


METHODS
A multicentre retrospective observational study.


METHODS
Nine maternity units in the United Kingdom.


METHODS
20,771 women with a singleton pregnancy, who were delivered between 1 August 1994 and 31 July 1995.


RESULTS
Nine of the eleven suggested indicators were successfully piloted. Two indicators require further development. In seven of the nine hospitals external cephalic version was not commonly performed. There were wide variations in the proportions of women screened for asymptomatic bacteriuria. Screening of women from ethnic minorities for haemoglobinopathy was more likely in hospitals with a large proportion of non-caucasian women. A large number of Rhesus negative women did not have a Rhesus antibody check performed after 28 weeks of gestation and did not receive anti-D immunoglobulin after a potentially sensitising event during pregnancy. As a result of the study appropriate sample sizes for future audit could be calculated.


CONCLUSIONS
Measuring the extent to which evidence-based interventions are used in routine clinical practice provides a more detailed picture of the strengths and weaknesses in an antenatal service than traditional outcomes such as perinatal mortality rates. Awareness of an appropriate sample size should prevent waste of time and resources on inconclusive audits.
Vause
S
S
Royal College of Obstetricians and Gynaecologists Audit Unit, St Mary's Hospital, Manchester, UK.
Maresh
M
M
D036861:Delivery, Obstetric / Q000592:standards; D019317:Evidence-Based Medicine; D005260:Female; D006453:Hemoglobinopathies / Q000175:diagnosis / Q000208:ethnology; D006757:Hospital Units / Q000592:standards; D006801:Humans; D008485:Medical Audit / Q000379:methods; D009775:Obstetrics and Gynecology Department, Hospital / Q000592:standards; D010865:Pilot Projects; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D018401:Sample Size; D006113:United Kingdom