Clinical audit of intra-partum care at secondary health facilities in Nigeria.
OBJECTIVE
Intra-partum care has a significant influence on birth outcomes. Gap however exists between evidence and practice. This study documented pattern of intra-partum monitoring among birth attendants in public secondary healthcare facilities and related findings to quality of care provided.


METHODS
Intra-partum monitoring records of vaginal examination, fetal heart and blood pressure were reviewed. Research assistants extracted information and documented same in appropriate section of Safe Motherhood Needs Assessment forms. Monitoring records were categorized into optimal and sub-optimal care. Proportions were calculated for parturients who received either optimal or sub-optimal care. Chi-square test of statistics was used to explore differences. Level of significance was p < 0.05.


RESULTS
Areview of 349 records of paturients was carried out. Their mean age was 23.4 +/- 3.3 years. Pregnancy outcome was a live-birth in 329 (97.3%). Optimal care of vaginal examination, fetal heart monitoring and blood pressure measurement was provided in 243 (71.9%), 73 (21.6%) and 52 (15.4%) parturients respectively and diminished significantly as labour progressed.


CONCLUSIONS
Intra-partum care provided by birth attendants was generally sub-optimal and use of the monitoring records to influence birth outcome is doubtful. Improvement in record keeping practices and skills in intra-partum monitoring for decision making, are suggested.
Osungbade
K O
KO
Department of Community Medicine, College of Medicine, University College Hospital, Ibadan, Nigeria. koosungbade@yahoo.com
Oginni
S A
SA
Olumide
E A A
EA
Owoaje
E T
ET
D000293:Adolescent; D000328:Adult; D054869:Clinical Audit; D003430:Cross-Sectional Studies; D005260:Female; D005323:Fetal Monitoring / Q000379:methods / Q000592:standards*; D006268:Health Facilities; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D007743:Labor, Obstetric; D008499:Medical Records; D008875:Middle Aged; D008880:Midwifery; D008991:Monitoring, Physiologic / Q000592:standards*; D009549:Nigeria; D036801:Parturition / Q000502:physiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011787:Quality of Health Care; D013997:Time Factors; D055815:Young Adult