Audit of lower segment caesarean section at New Mowasat hospital in
Kuwait: “Cross -section study”
Abstract
Background Auditing the CS according to a standard criterion will lead
to avoid many complications. Clinical audit is a tool to improve quality
of care and to reduce maternal and perinatal morbidity and mortality.
Objective: to evaluate the current practice and audit against
international standards for various parameters relating to elective
lower segment caesarean section and to assess compliance of physicians
to audit standards. Design: A cross-sectional study. Setting: New
Mowasat Hospital in Kuwait from 1st October 2018 until 1st October 2019.
Sample: Three hundred and twenty six (326) cases of elective caesarean
sections. Methods: The hospital medical, electronic records and case
notes were reviewed for study participants. Those women were booked
under the care of internal and external physicians. Demographic data and
primary outcomes were collected. Outcome: measuring the compliance to
the recognized Caesarean Section international standards: consent form,
grade of LSCS, antacid and anti-emetics, type of anesthesia, uses of
antibiotics, umbilical cord blood PH, and thrombopropylaxis. Results:
compliance for a signed consent form (100%) ,cord blood PH(100%),use
of preoperative antacid and antiemetic (99.4%) , combined regional
anesthesia(53.4%), second generation cephalosporin(61.3%) ,
thrombopophylaxis ( 78.5 %)of which (33.6%) completed a 10 days
duration . There was a statistically significant difference between
internal and external physicians compliance regarding, type of
anesthesia 2.3 (95%CI, 1.3-4.1p=0.004), type and timing of antibiotics
0.42(95%CI 0.22-0.79, p=0.007) and 0.33 (95%CI 0.172-0.63, p=0.0006)
and thrombopophylaxis 8.1 (95%CI 2.80-23.23, p=0.000). Conclusion: the
results are encouraging, but suboptimal compliance was noticed mainly
among external physicians. Funding: None