Clinical Audit: Postnatal Maternal Readmission (Rate, Indications, & Contributing Factors) 

Iqra Yasin 1, Raisham Saleem 1, Munawar Hussain 2

 1 ST3 Clinical Fellow Obstetrics & Gynaecology , 2 Consultant Obstetrician & Gynaecologist [Southend University Hospital, Mid and South Essex NHS Foundation Trust]

 

INTRODUCTION / RATIONALE

National Maternity and Perinatal Audit Clinical Report 2022:
• Postnatal readmission rates were higher following a caesarean birth compared with a vaginal birth in both England (4.3 % vs 2 .9 %) and Wales (4.7 % vs 3.3
• Recommendation: Review all cases of postnatal maternal readmission to understand common indications and identify changes in p rac tice thar may decrease the chance of readmission, especially among those having a caesarean birth.

 

METHODOLOGY

• Retrospective review of electronic and paper medical records to retrieve the data.
• Inclusion Criteria: Postnatal patients (37 42 weeks) delivered by Caesarean section or vaginal
birth (Singleton). Unplanned overnight readmission within 42 days of birth.
• Study Duration: February 01, 2024 May 31, 2024.

 

RECOMMENDATIONS:

• Optimisation of comorbidities in the antenatal time to reduce the infection rate and hence re admission including weight opti miz ation by identifying the right cases and referral to Lifestyle clinics appropriately, optimal glycaemic control by referral to diabetes clinic, correction of anaemia ant enatally and smoking caseation counselling.
• Strategies to improve BP control and hence reduction in preventable re admission i.e., medication optimisation before discharge, if two readings of borderline blood pressure >/= 140/90 mmHg, keep low threshold to start antihypertensive medication, and timely follow up.

ACTION PLAN:

• Referral to the Lifestyle clinic in accordance with the National and Local guidelines.
• Smoking cessation Counselling followed by appropriate referral to smoking cessation services.