The Dutch Perinatal Audit Project: a feasibility study for nationwide perinatal audit in the Netherlands

Abstract

In the Netherlands, perinatal audit is well supported by all groups of caregivers. It reveals usable facts and findings for the quality assessment of perinatal care. This audit showed that in 9% of the cases perinatal death was related to SSF and potentially avoidable. However, immediate reporting of cases of perinatal death apart from regular registration in the perinatal database proved to be inaccurate. Once a nationwide audit program is realized, in which data from the different caregivers will be collected in a single database instead of collection by linkage afterwards, this problem should be solved. Local audits will start from 2009. These audits will assess mortality cases within their respective areas and may initiate adjustments for perinatal care and optimize the quality of care and inter-professional collaboration. Yearly nationwide audits will focus on specific items (e.g. term or post-term deliveries) and may well offer an opportunity for the development or adjustment of national guidelines.

Case review of perinatal deaths at hospitals in Kigali, Rwanda: perinatal audit with application of a three-delays analysis

“…This proportion is similar to that (80%) found by authors in Tanzania during a perinatal audit performed at a tertiary referral hospital [29]. These figures are higher than those reported from studies in 10 European countries, the Netherlands, and Uganda, where the factors contributing to mortality were assessed to be found in 46, 32 and 20% of deaths, respectively [4, 27, 30]. However, the latter three studies had applied different methodologies and definitions as compared to our study.…”

“…Recently, a study carried out in one regional hospital in Tanzania employed the same approach but the study population was restricted to perinatal deaths weighing 2000 g or more [9]. Many other investigators in low-, middle- and high-income countries have limited the audit either to suboptimal care factors occurring at a health facility [26, 27] or to specific groups of perinatal deaths based on gestational age or birth weight [23, 28–30]. …”

Caesarean section rates in subgroups of women and perinatal outcomes

“…6 A more recent study 12 showed that 7.1% of late perinatal deaths were not reported in the PRN. Although only 48-68% of paediatric practices participated in PRN, 100% of academic paediatric practices are included (www.perinatreg.nl).…”

“Every case of asphyxia can be used as a learning example”. Conclusions from an analysis of substandard obstetrical care

“…The aim is to initiate adjustments for perinatal care, optimize the quality of care, and inter-professional collaboration. For example, perinatal audits have been used in the Netherlands where perinatal mortality was assessed to be the highest in the 25 countries of the European Union in 1999 (11.4/1000) [32,60] . In one rural region in the Netherlands, it was found that 31 % of perinatal deaths could have been prevented [31] .…”

“…In one rural region in the Netherlands, it was found that 31 % of perinatal deaths could have been prevented [31] . In another recently published nationwide Dutch study, it was found that 9 % of the 228 cases of perinatal deaths during 1 year in the Netherlands were related to substandard care and were assessed to be potentially avoidable [32] .…”