Key Assurances:

Proper documentation in the antepartum, intrapartum and postpartum periods

Good folic acid nutritional supplementation

Compliant with antenatal screening for the women

Screening for prenatal complications such as gestational diabetes was good

Good intrapartum and multidisciplinary care of maternal foetal and neonatal outcome in morbidly obese women

Excellent postpartum support for breastfeeding and contraception

Key Areas for development:

Easy access to Medway Maternity for data collection but significant delay in note retrieval for data collection

Key issues arising from the analysis that negatively affects patient care:

Some missing notes and missing sheets inpatient case notes

Weight and BMI not recorded in some notes

Some of the patients were not offered Vit D nutritional supplementation

None compliance in the referral of some of the women to the anaesthetist for review antepartum.

Recommendations:

To improve preconception care and counselling for weight reduction to improve pregnancy outcome

To appropriately corroborate and timely referrals to other specialities such as endocrinology and anaesthetist

To properly file patients note and sheets as this will improve patient safety

To offer recommended nutritional supplements

To keep up with the level and standard of care for morbidly obese women as per national guidelines

For a reaudit in one year