2005 - National Women's Hospital - Auckland District Health Board

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Check ‘Delivered by’ is not missing. Check that admission to Labour & Birth Suite/Operating Theatre/WAU is before birth time (unless is recorded as BBA). If birth location is BBA, then birth time is before admission. If indication for induction is SROM then rupture of membrane time should be before induction start time which in turn is before onset of contraction time. Onset of contraction time is before full dilatation which is in turn before Birth time (sometimes there is no onset of contraction time because of pre-labour caesarean). There should be NO onset of contraction time if method of Birth is Elective Caesarean not in labour or Emergency Caesarean not in labour. Onset of contraction time should not be missing if method of Birth is Caesarean (elective or emergency) in labour. Check all Classical Caesareans to ensure they are authentic. If Delivery Method is a SVD or Spontaneous Breech Delivery, check there is NO reason for operative delivery. Full Dilatation Time should not be null if Delivery Method is a vaginal delivery. If Delivery Method is 'Elective CS' then Dilatation at Syntocinon should be null. Syntocinon Time is before Delivery Time. Membranes Ruptured Time is null. Membranes ruptured time is before delivery time. Membrane method is SRM but has indication for ARM, check. If indication for induction is SRM then rupture of membrane time should be before induction start time which in turn is before onset of contraction time. If ARM check there is an indication for ARM. Placenta Delivery Time is not null. Delivery Presentation is null. If had an epidural, then dilatation at last VE is not missing and time of epidural is not missing. A Caesarean Section (CS) must have an option from the expanded tree to describe what type of CS. Cannot be just Lower Segment Caesarean Section or Classical Caesarean Section. If indication for caesarean is breech or malpresentation, then presentation is NOT cephalic. Delivery Method is anything other than SVD or Spontaneous Breech Delivery, check there is a reason for Operative Delivery. If Delivery Presentation is Breech, should not be a Spontaneous Vertex Delivery. If Indication for Operative Delivery Is Repeat Caesarean Section then Women is not a Primipara & has a CS in her Obstetric History. Indication for Operative Delivery Is Other Please Specify + Comment fields - for checking. 170
If indication for operative delivery is fetal distress, then fetal distress variable (in 802) is yes or meconium was present. Check Birth Methods fields 1 & 2 are consistent. Birth time is always before delivery of placenta time. If Birth method is breech, then presentation is breech. Time of epidural insertion is before birth time. If caesarean is mode of birth, anaesthesia is not missing. If there is postpartum transfusion and blood loss is < 1000 mls, check blood loss. Blood Loss is not out of range ie: 1500 or is null. Blood Loss >=1500 & Blood Transfusion = No. Blood Loss 35 weeks, check birth weight if 44 wks. If indication for induction is post term, check gestation if gestation is < 40 weeks. Days in NICU/PIN/Paed care on Ward are not null or check if >30. Derived Gestation to Neonatal Gestation (Immediate Newborn Assessment screen) >2 weeks difference. Gestational Age (Immediate Newborn Assessment) Is Null. Missing Apgars. Live birth with Apgars 1min or Apgars 5 min of 0. 171
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Cover artwork: Chris Charteris, 200
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Reproduction of material National W
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TABLE of CONTENTS 1 INTRODUCTION ..
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10 GYNAECOLOGY ....................
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Table 36: Blood transfusion……
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Table 108: Induction rate by indica
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Table 173: Chronic lung disease by
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Figure 34: Caesarean section rate a
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Figure 104: ROP at 28-31 weeks.....
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1 INTRODUCTION 1.1 Purpose of this
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1.4.1 Healthware In 2001, Healthwar
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clinical record and data in Healthw
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section 2 SUMMARY STATISTICS SSSTAT
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2.2 Summary of maternal outcomes 20
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2.3 Summary of neonatal outcomes 20
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3 MATERNAL DEMOGRAPHY This chapter
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80 70 60 50 40 30 20 10 0 % Nullipa
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Significantly, more complete data h
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section 4 ANTENATAL COMPLICATIONS C
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Table 9: Rates of preterm birth
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4.2 Small for gestational age (SGA)
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4.3 Multiple pregnancy This section
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Table 16: Fetal/newborn outcomes of
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4.4 Diabetes Methods The statistics
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4.4.2 Outcomes of pregnancies compl
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Table 20: Neonatal outcomes among b
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4.5 Antepartum haemorrhage Antepart
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had had a Manchester operation for
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lower rate among Asian women may be
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section 5 LABOUR and BIRTH DEMOGRAP
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Rates of induction vary by LMC, mat
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% 35 10 9 8 7 6 5 4 3 2 1 0 Post da
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5.2 Use of Syntocinon Table 26: Use
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5.3 Mode of birth Findings Table 27
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70 60 50 40 30 20 10 0 % IMW Pvt Ob
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5.4 Caesarean section Methods In 20
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Other Failed Induction Diabetes Cor
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. % 70 60 50 40 30 20 10 0 SVB Oper
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5.7 Obstetric analgesia Methods Cur
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Younger women are less likely to ch
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There is a suggestion that third an
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Table 36: Blood transfusion 1993 19
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5.11 Neonatal outcomes by mode of b
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5.12 Labour and birth at Birthcare
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Summary • The caesarean section r
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6 POSTNATAL CARE This chapter provi
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% 80 60 40 20 0 NZ European Maori P
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increase in numbers in the Medical
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Of the 2013 women with vaginal birt
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The rate of re-admission is half th
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section 7 NEWBORN SERVICES 107
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7 NEWBORN SERVICES This chapter pro
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Number 600 500 400 300 200 100 0 AD
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7.3 Immunisation A number of babies
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7.5 Hypoxic ischaemic encephalopath
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7.6.2 Trends in use of assisted ven
Page 121 and 122: 7.6.4 Positive pressure ventilation
Page 123 and 124: 7.6.6 High frequency oscillatory ve
Page 125 and 126: 7.7 Very low birth weight infants T
Page 127 and 128: 7.8 Survival of babies from 23 to 3
Page 129 and 130: 7.10 Morbidity of inborn very low b
Page 131 and 132: 7.10.3 Intraventricular haemorrhage
Page 133 and 134: 7.10.6 Chronic lung disease The ANZ
Page 135 and 136: 7.10.9 Pneumothorax needing drainag
Page 137 and 138: 7.11 Death of babies born in or adm
Page 139 and 140: Table 53: Outcome Categories at 18
Page 141 and 142: Table 56: Outcome categories at 4 y
Page 143 and 144: section 8 PERINATAL MORTALITY 141
Page 145 and 146: 8 PERINATAL MORTALITY This chapter
Page 147 and 148: All babies born at National Women
Page 149 and 150: 8.5 Lead maternity carer (LMC) at b
Page 151 and 152: 8.8 Necropsy 80 70 60 50 40 30 20 1
Page 153 and 154: section 9 FERTILITY SERVICES 151
Page 155 and 156: 9 FERTILITY SERVICES This chapter d
Page 157 and 158: section 10 GYNAECOLOGY 155
Page 159 and 160: 10 GYNAECOLOGY 10.1 Hyperemesis Met
Page 161 and 162: 10.2 Ectopic pregnancy Methods Thes
Page 163 and 164: 10.3 Hysterectomy Methods These dat
Page 165 and 166: section 11 TERMINATION of PREGNANCY
Page 167 and 168: 11 TERMINATION OF PREGNANCY Epsom D
Page 169 and 170: section 12 APPENDICES 167
Page 171: APPENDIX 1. METHODOLOGY 1.2 Data cl
Page 175 and 176: APPENDIX 2. SUMMARY STATISTICS Tabl
Page 177 and 178: Table 79: Time trends in Nulliparit
Page 179 and 180: 3.1 Lead Maternity Carer and matern
Page 181 and 182: 3.2 Smoking Table 88: Smoking statu
Page 183 and 184: APPENDIX 4. ANTENATAL COMPLICATIONS
Page 185 and 186: 4.3 Diabetes Table 94: Women with d
Page 187 and 188: 4.4 Antepartum haemorrhage Table 98
Page 189 and 190: 4.5 Hypertensive disease Table 101:
Page 191 and 192: Table 105: Rates of indication for
Page 193 and 194: Table 108: Induction rate by indica
Page 195 and 196: Table 113: Gestation at birth among
Page 197 and 198: Table 119: Mode of birth by LMC at
Page 199 and 200: Total births (mothers) Total operat
Page 201 and 202: NZ European SVB Vaginal breech 199
Page 203 and 204: LMC type Total Epidural Entonox Pet
Page 205 and 206: Table 137: 3 rd and 4 th degree tea
Page 207 and 208: Table 141: Clinical characteristics
Page 209 and 210: Table 147: Postnatal readmission by
Page 211 and 212: Table 149: Admissions to NICU by bi
Page 213 and 214: Table 153: Domicile of mother of ba
Page 215 and 216: Table 159: Late onset serious infec
Page 217 and 218: Table 164: Inhaled Nitric Oxide (iN
Page 219 and 220: Table 170: Intraventricular haemorr
Page 221 and 222: Table 177: Patent Ductus Arteriosus
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7.7 Details of babies who died Tabl
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Table 187: Babies with lethal anoma
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Table 191: Maternal characteristics
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Perinatal necropsy rates (%) Table
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APPENDIX 10. GLOSSARY OF ABBREVIATI
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Lead Maternity Carer (LMC) The Lead
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2005 - National Women's Hospital - Auckland District Health Board

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