VALUE OF PERINATAL AUDIT IN OBSTETRIC CARE IN THE DEVELOPING-WORLD - A 10-YEAR EXPERIENCE OF THE MAPUTO MODEL

A decade of perinatal audit in the Maputo Central Hospital is reviewed with the objective of addressing the potential value of the audit pro cess in monitoring the different constituents of morbidity and mortali ty in the perinatal period. The perinatal mortality showed a significa nt but transient change during the observation period 1982-1991, while intrapartum fetal mortality was significantly reduced from 10.9 to 3. 9 per thousand (p < 0.0005). Staff members were sensitized towards imm ediate and long-term effects of implemented surveillance routines by r egular feedback of perinatal data on visible wall charts and by weekly conferences. The advantages of a comprehensive audit approach in peri natal medicine comprising both maternal and fetal/infant aspect are un derscored. An ethical commitment to nonconfidential straight-forwardne ss and openmindedness in critical discussions regarding mismanagement is emphasized for a successful audit strategy.