Maternity unit performance index. A novel approach for evaluation of the changing obstetric practice in a single maternity unit

Objective To audit obstetric outcomes for primiparous laborers in order to provide accurate information to the population we serve. To establish a simple index by which a maternity unit's performance can be compared over time and to other units. This index is named, maternity unit performance index (MUPI). Study design A retrospective analysis of the obstetric outcome of all nulliparous singleton gestations that have been admitted to labor ward for delivery, between 37 and prior to 41, gestational weeks. The chronical periods examined were: I January 2005 to 31 December 2005, 1 January 1995 to 31 December 1995 and 1 January 1985 to 31 December 1985. To these chronical periods we have utilized the MUPI formula. Results Retrospective implementation of the MUPI formula resulted in lower mean scores as time progressed. Mean MUPI values for the years 2005, 1995 and 1985 were respectively 0.8, 1.2 and 1.4. Significant differences of MUPI between the three time periods were found (P < 0.001). Conclusion In our attempt to counsel our first time mothers, we have proposed a simple index of our unit's performance. This index overcomes the widely used cesarean birth rate. As years go by, MUPI scores decreased steadily. Interpretation of these results suggests a continuously evolving obstetric practice rather than a decrease in the quality of obstetric service provided.