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MORBIDITY AUDIT
Starting on:
Oct 29, 2026
Ending on:
Oct 29, 2026
Moderator(s):
Dr. JOSEPH OKWARO
MEDICAL OFFICER IN-CHARGE
Venue:
EXECUTIVE CLINIC
Max Credits:
3 Points

Provider:
SILOAM HOSPITAL
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MORBIDITY AUDIT

Starting on:
Oct 29, 2026
Ending on:
Oct 29, 2026
Venue:
EXECUTIVE CLINIC

Description

A 33-year-old female was admitted with cervical incompetence and underwent a cervical cerclage (McDonald/MAC stitch) procedure. On the following day, she developed per vaginal (P.V.) bleeding and subsequently expelled the pregnancy. On the 25th, a manual vacuum aspiration (MVA) was performed due to retained products of conception. The patient later developed deranged urea, electrolytes and creatinine (UECs), necessitating admission to the High Dependency Unit (HDU) for close monitoring and further management. The case is presented for morbidity audit to review the clinical management, identify possible contributing factors to the pregnancy loss and subsequent renal/electrolyte abnormalities, and establish opportunities for improving patient safety and quality of care.

Objectives

Review clinical management: Assess the appropriateness of the diagnosis, decision to perform cervical cerclage, and subsequent management of pregnancy loss. Assess timeliness of interventions: Evaluate the recognition and management of P.V. bleeding, pregnancy expulsion, and retained products of conception. Evaluate post-procedure care: Review the indication, timing, and safety of MVA and the monitoring provided following the procedure. Investigate deranged UECs: Establish the nature and possible causes of the renal and electrolyte abnormalities and assess whether they were identified and managed promptly. Review escalation of care: Assess the timeliness and appropriateness of referral to HDU and the effectiveness of subsequent monitoring and treatment. Identify gaps in care: Determine any delays, complications, deviations from clinical protocols, or deficiencies in documentation that may have contributed to the patient's deterioration.

Presenters

  1. Dr. MWITA MATIKO
    RESIDENT MEDICAL OFFICER
    SILOAM HOSPITAL

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