title: The Dutch Perinatal Audit Project: a feasibility study for nationwide perinatal audit in the Netherlands.
abstract: OBJECTIVE
  To investigate the feasibility of nationwide perinatal mortality audits in the Netherlands.
  
  
  METHODS
  Over a one-year period, data for all cases of perinatal mortality were collected. Six perinatal audit panels of professionals within perinatal care investigated and classified causes of death and identified the presence of substandard care factors (SSF).
  
  
  RESULTS
  Out of 22,189 newborns, 228 cases of perinatal mortality were audited. Placental pathology, congenital anomalies and preterm birth were the main causes of perinatal death. SSF by caregivers were identified in 72 cases (32 %). Almost 20% of the cases were not reported.
  
  
  CONCLUSIONS
  In the Netherlands, perinatal audit is well supported by all groups of caregivers. It reveals usable facts and findings for the quality assessment of perinatal care. This audit showed that in 9% of the cases perinatal death was related to SSF and potentially avoidable. However, immediate reporting of cases of perinatal death apart from regular registration in the perinatal database proved to be inaccurate. Once a nationwide audit program is realized, in which data from the different caregivers will be collected in a single database instead of collection by linkage afterwards, this problem should be solved. Local audits will start from 2009. These audits will assess mortality cases within their respective areas and may initiate adjustments for perinatal care and optimize the quality of care and inter-professional collaboration. Yearly nationwide audits will focus on specific items (e.g. term or post-term deliveries) and may well offer an opportunity for the development or adjustment of national guidelines.
authors.affiliation: Midwifery, V.C.M.B., Boxtel, Netherlands. penmdereu@vcmb.info
authors.forename: Paul
authors.initials: P
authors.lastname: de Reu
authors.forename: Mariet
authors.initials: M
authors.lastname: Van Diem
authors.forename: Martine
authors.initials: M
authors.lastname: Eskes
authors.forename: Herman
authors.initials: H
authors.lastname: Oosterbaan
authors.forename: Luc
authors.initials: L
authors.lastname: Smits
authors.forename: Hans
authors.initials: H
authors.lastname: Merkus
authors.forename: Jan
authors.initials: J
authors.lastname: Nijhuis
mesh_terms: D002423:Cause of Death; D000013:Congenital Abnormalities; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008485:Medical Audit; D009426:Netherlands / Q000453:epidemiology; D018743:Perinatal Care; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications