Effect of the maternal care manual from the perinatal education programme on the quality of antenatal and intrapartum care rendered by midwives

Objectives. To assess changes in the quality of antenatal and intrapartum care  rendered by midwives following intervention with the Maternal Care Manual from the Perinatal Education Programme (PEP).Design. A prospective controlled study.Setting. A study town and two control towns in the Eastern Cape.Subjects. Before the study a sample of files was drawn to provide baseline  information. Subsequently all the midwives in the study town studied the manual,  following which a second sample of files was drawn.Outcome measures. A check-list was used to assess antenatal cards and  partograms.Results. The mean score allocated to the four subunits evaluating the front page of the antenatal card in the study town improved significantly (P = 0.000) from 58.5% (standard deviation (SD) 20.6) to 74.5% (SD 19.2). No changes occurred in the control towns (47.5% and 52.9%). The score obtained for the completion of the back page also improved significantly (P = 0.014), from 69% (SD 13.7) to 75.6% (SD 14.2), with no changes in the control towns. The mean score achieved for the completion of the partogram did not change in the study town or control towns.Conclusions. The improved scores obtained for the antenatal card in the study town reflects improved quality of antenatal care. Documentation that improved  significantly included important aspects of antenatal care, i.e. previous obstetrichistory, gestational age, special investigations and correct charting offundal growth. Three of the four subunits that did not improve were already familiar to the midwives before the study. Documentation of the partogram did not improve for reasons outside the control of the PEP

Maternal and perinatal morbidity and mortality of Caesarean delivery in the late first stage and second stage of labour

Objective: To determine whether there is a higher maternal and perinatal morbidity in Caesarean deliveries performed in the late first stage and second stage of labour compared to Caesarean deliveries earlier in the first stage of labour.Design: A case control retrospective study.Setting: Tygerberg Academic Hospital, Cape Town (South Africa).Subject: A cohort of 85 cases and 86 controls was selected from labour ward birth registers and data were collected from patient files. Rates of predefined complications of caesarean sections and perinatal morbidity were analysed using SPSS version 15 (statistical Package for the Social Science).Results: There was no difference between cases and controls for the following variables: age, gravidity, parity, past obstetric history, gestational age, HIV status, cardiotocography (CTG) tracing, labour and anaesthesia. Intra-operative complications rates were higher in cases than control though not statistically significant. Maternal high care/ICU admission and neonatal complications rates were significantly higher in cases than controls.Conclusion: Caesarean deliveries which are performed in the late first stage and second stage of labour are not associated with more maternal intra-operative complications but with significantly higher maternal high care and ICU admissions as well as neonatal complications compared to Caesarean deliveries earlier in the first stage of labour

Moederlike mortaliteitskoers in Potchefstroom Hospitaal, 2000-2002: hoe kan hierdie risiko's vir moeders verlaag word?

Maternal mortality rate in Potchefstroom Hospital, 2000 - 2002: How can these risks for mothers be reduced? Background The aim of this study was to determine the maternal mortality ratio (MMR) in Potchefstroom Hospital, situated in North-West Province, for 2000-2002. The main causes of maternal deaths in Potchefstroom Hospital were determined and compared to the main causes for maternal deaths nationally. Methods Data were collected in a retrospective manner from Potchefstroom Hospital's yearbooks and statistics, 2000-2002. The number of deliveries per month, the total number of maternal deaths and the main causes for these deaths were recorded. Results The MMR for Potchefstroom Hospital in 2000-2002 was 354.7/100000 live births, compared to the estimated MMR for SA in 1999-2001 of 170-200/100 000 live births. The main causes of maternal deaths in Potchefstroom Hospital include non-pregnancy-related infection (mainly AIDS), complications of hypertension in pregnancy, obstetrical haemorrhage, preexisting maternal disease and pregnancy-related sepsis. Conclusions,br> The main causes for maternal deaths in Potchefstroom Hospital correlated well with the main causes nationally. Of interest was that, compared to national statistics, there was a higher percentage of indirect causes of maternal death (mainly due to HIV/AIDS) than direct causes of deaths in Potchefstroom Hospital. However, it has been observed nationally that the percentage of indirect deaths compared to direct deaths is on the increase. This national trend is caused by the HIV/AIDS pandemic. General recommendations are made, which can be instituted to help lower the MMR in Potchefstroom Hospital and nationally.Keywords: Maternal mortality; hypertension; HIV; postpartum bleeding; maternal deathsFor full text, click here:SA Fam Pract 2005;47(9):63-6

Antenatal prevention of mother to child transmission of HIV.

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The effect of the Maternal Care Manual of the Perinatal Education Programme on the Attitude of Mid wives towards their work

In this study the changes in attitude of midwives towards their work following completion of the Maternal Care Manual of the Perinatal Education Programme (PEP), were determined

Improved practical skills of midwives practising in the Eastern Cape Province of the Republic of South Africa through the study of a self-education manual

GesondheidswetenskappeVerloskunde En GinekologiePlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected]

Surgical management of postpartum haemorrhage.

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