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Appendix 6 — Induction of Labour Audit Induction of Labour Audit January - March 2014

Objectives

Method

To determine whether the criteria for induction of labour (IOL) at Counties Manukau Health were in accordance with the Draft Auckland Consensus Guideline on Induction of Labour 2014

All IDL from 1st January - 31st March 2014 documented in the IOL booking diary in Birthing and Assessment were reviewed by three practitioners (one specialist obstetrician, one house officer, and one charge midwife). The indications were then grouped into 20 main categories (diabetes, pre-eclampsia, slowed growth/ IUGR, post-dates, reduced fetal movements, spontaneous rupture of membranes/+ meconium liquor, advanced maternal age > 40 years, oligo-hydramnios, fetal demise, abnormal dopplers, hypertension, positive antibodies, antepartum haemorrhage, termination of pregnancy for fetal abnormalities, cholestasis of pregnancy, twins, poly-hydramnios, previous intrauterine death, large for gestational

Background/Rationale As part of the Maternity Quality and Safety Programme, the Ministry of Health requested each DHB to review and critique their indications for induction of labour. Middlemore Birthing and Assessment is resourced to perform a total of five inductions of labour per day, two in the morning (9am) and two in the evening (7.30pm) with an emergency slot available at midday.

age, unstable lie, IVF pregnancy, and others). To ensure inter-rater reliability, all three health practitioners undertaking the audit cross checked the data. Findings A total of 538 IOLs were performed over the 3 month period. On average six IOLs were performed per day, 20% more a day than planned. The maximum booked on one day was 10, double the number planned. Of the 90 days audited, on 55 days (61%), B & A carried out more IOL’s than the planned 5 per day.

It was identified that 70% of the IOLs were due to the following categories: INDICATION

NUMBER

Diabetes

106

Slowed growth/IUGR

105

Postdates (41.4 + weeks gestation)

99

Spontaneous rupture of membranes (SROM)

66

Meconium liquor

1

Total

377

2014 2015 maternity quality and safety programme  

This Annual Report (2014-2015) covers the continued progress and initiatives undertaken over the last 12 months as part of the Maternity Qua...

2014 2015 maternity quality and safety programme  

This Annual Report (2014-2015) covers the continued progress and initiatives undertaken over the last 12 months as part of the Maternity Qua...