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Could a multidisciplinary regional audit identify avoidable factors and delays that contribute to stillbirths? A retrospective cohort study

BMC pregnancy and childbirth, 2020-11, Vol.20 (1), p.700-700, Article 700 [Peer Reviewed Journal]

2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2020 ;ISSN: 1471-2393 ;EISSN: 1471-2393 ;DOI: 10.1186/s12884-020-03402-z ;PMID: 33198695

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  • Title:
    Could a multidisciplinary regional audit identify avoidable factors and delays that contribute to stillbirths? A retrospective cohort study
  • Author: Sterpu, I ; Bolk, J ; Perers Öberg, S ; Hulthén Varli, I ; Wiberg Itzel, E
  • Subjects: Adult ; Audit ; Audits ; Births ; Cause of Death ; Causes of death ; Classification ; Clinical Audit ; Data collection ; Female ; Fetal Death - prevention & control ; Gestational age ; Health care ; Health Services Needs and Demand - organization & administration ; Humans ; Medical records ; Medicin och hälsovetenskap ; Midwifery ; Obstetrics ; Patient compliance ; Population ; Postpartum period ; Pregnancy ; Prenatal care ; Preventable stillbirth ; Preventive Health Services - methods ; Quality of care ; Quality of Health Care - organization & administration ; Retrospective Studies ; Risk Factors ; Stillbirth ; Stillbirth - epidemiology ; Sweden ; Ultrasonic imaging ; Womens health
  • Is Part Of: BMC pregnancy and childbirth, 2020-11, Vol.20 (1), p.700-700, Article 700
  • Description: The annual rate of stillbirth in Sweden has remained largely unchanged for the past 30 years. In Sweden, there is no national audit system for stillbirths. The aim of the study was to determine if a regional multidisciplinary audit could help in identifying avoidable factors and delays associated with stillbirths. Population-based retrospective cohort study. Six labour wards in Stockholm County. Women delivering a stillbirth > 22 weeks of gestation in Stockholm during 2017. A multidisciplinary team was convened. Each team member independently assessed the medical chart of each case of stillbirth regarding causes and preventability, level of delay, the standard of healthcare provided, the investigation of maternal/foetal diseases and if any recommendations were given for the next pregnancy. A decision was based on the agreement of all five members. If no agreement was reached, a reassessment of the case was done and the medical record was scrutinized again until a mutual decision was made. Primary outcomes: The frequency of probably/possibly preventable factors associated with a stillbirth and the level of delay (patient/caregiver). The causes of death, the standard of antenatal/intrapartum/postpartum care, whether a summary of possible causes of the stillbirth was made and if any plans for future pregnancies were noted. Thirty percent of the stillbirths were assessed as probably/possibly preventable. More frequent ultrasound/clinical check-ups, earlier induction of labour and earlier interventions in line with current guidelines were identified as possibly preventable factors. A possibly preventable stillbirth was more common among non-Swedish-speaking women (p = 0.03). In 15% of the cases, a delay by the healthcare system was identified. Having multiple caregivers, absence of continuity in terms of attending the antenatal clinic and not following the basic monitoring program for antenatal care were also identified as risk factors for a delay. A national/regional multidisciplinary audit group retrospectively identified factors associated with stillbirth. Access to good translation services or a more innovative approach to the problem regarding communication with mothers could be an important factor to decrease possible patient delays contributing to stillbirths. NCT04281368 .
  • Publisher: England: BioMed Central
  • Language: English
  • Identifier: ISSN: 1471-2393
    EISSN: 1471-2393
    DOI: 10.1186/s12884-020-03402-z
    PMID: 33198695
  • Source: Geneva Foundation Free Medical Journals at publisher websites
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    PubMed Central
    SWEPUB Freely available online
    ROAD: Directory of Open Access Scholarly Resources
    ProQuest Central
    DOAJ Directory of Open Access Journals
    Springer Nature OA Free Journals
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