Saturday, November 21, 2009

Improve quality of care for post-partum period, docs urged

Star: PETALING JAYA: Doctors need to improve the quality of care for the post-partum period, said Health director-general Tan Sri Dr Ismail Merican.
He said 60% of the deaths occurred during post-natal period and the rate was higher among women over 40 and those who had given birth more than five times, he said.
“Patient factors such as unbooked cases (where mothers did not receive antenatal care and did not register with a health facility for child delivery) and non-compliance to doctors’ advice, admission and therapy were identified as contributory factors to maternal deaths.”
Common remediable clinical factors included failure in communication and lack of technical knowledge and skill that resulted in failure to recognise early warnings, he added.
Dr Ismail said for every maternal death there were many “near misses” and this might provide doctors with more information on areas for improvement than mortality figures.
The implementation of inquiry recommendations and guidelines had shown to improve maternal health policies, procedures and practices and save the lives of mothers and their babies, he said.
He pointed out there was a steep rise in Caesarean section rates over the world with patients not fully understanding the risks involved. Since they might suffer complicated subsequent operative procedures, he urged senior doctors to be more actively involved in the management of high risk cases.
He added that the risks involved must be discussed and informed consent obtained and documented.

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