Quality standard

Quality statement 9: Monitoring for postoperative complications following caesarean birth

Quality statement

Women who have had a caesarean birth are monitored for postoperative complications.

Rationale

Postoperative monitoring with regular observations in the immediate post-surgical period by someone with expertise in postoperative care is a key part of managing potential complications associated with surgery, including caesarean birth. This needs to happen alongside the core postnatal care all women receive in hospital immediately after giving birth.

Quality measures

Structure

Evidence of local arrangements to ensure that women who have had a caesarean birth are monitored for immediate postoperative complications.

Data source: Local data collection.

Process

The proportion of women who have had a caesarean birth who were monitored for immediate postoperative complications.

Numerator – the number of women in the denominator who are monitored for immediate postoperative complications.

Denominator – the number of women who have a caesarean birth.

Data source: Local data collection.

Outcome

Rates of complications in women who have had a caesarean birth.

Data source: Local data collection.

What the quality statement means for different audiences

Services providers ensure that systems are in place for women who have had a caesarean birth to be monitored for postoperative complications.

Healthcare professionals ensure that women who have had a caesarean birth are monitored for postoperative complications.

Commissioners ensure that they commission services in which women who have had a caesarean birth are monitored for postoperative complications.

Women who have had a caesarean birth are monitored for complications following the operation.

Source guidance

Caesarean birth. NICE guideline NG192 (2021), recommendations 1.6.1 to 1.6.8, 1.7.4 and 1.7.7

Definitions of terms used in this quality statement

Monitoring complications

See the section on monitoring after caesarean birth in NICE's guideline on caesarean birth.

MMBRACE-UK's report Saving lives, improving mothers care (2020) states that NHS England and NHS Improvement are rapidly developing a chart for an early warning score for pregnant and postpartum women, and a clear response pathway. The report provides an example tool called the modified early obstetric warning score (MEOWS) to support monitoring.