Intrapartum monitoring in late still births in Lautoka Hospital Fiji 2011

to 2014 – A retrospective study.Update since BRACCAP workshop

MMED 2 trainee Tapa Fidow

Literature Review

5 commonest causes of still births (SB)•IUGR•Maternal infections•PET/EC•Delivery complications•Chromosomal anomalies

•Lancet Series, WHO, UNICEF

Some findings in the Lautoka Hospital labour ward 2011.

• Total of 47 still births that meet the PSANZ classifications. • Late still births (fresh or unmacerated) – intrapartum

monitoring and care are audited. • 60% of still births > 2kg • 72% of SBs > 32 weeks gestation• Importance of data extraction• PSANZ (introduced to Lautoka in 2012)• The need for post mortems and placental histopathology

services.• Collaborating with some of the ongoing researches – Tonga

(Dr. Ela) Fiji (Dr. Josephine Poulter)and Samoa (myself)

Maternal ages for mother’s of SBs

Ethnicity

Marital status

Weights of the SBs

Gestations of SBs

Genders of the SBs

Using PSANZ form

Any APH

What is now happening?• All SBs are using PSANZ• CSM presentation (using this preliminary data for

some resources allocation)• Getting resources for intrapartum monitoring

(IPM)• Lautoka Hospital just received infusion pumps,

incubators, neonatal resuscitation equipment.• Some new activities on the ground initiated by

Professor Gyaneshwar and Lautoka Hospital consultatnts – CMEs and EmOC workshops for the peripheral hospitals weekly.

Where to from here?

• To use a comparison standard of monitoring (eg. RCOG IMP guidelines) for the auditing of IPM in Lautoka Hospital.

• Modify any areas of IPM in Lautoka Hospital for improvements

• Hopefully see improvements in the SB rates during the course of this audit

• Provide assistance to the administrators of Lautoka Hospital for optimising resource management concerning IPM.