National Women's Annual Clinical Report 2010

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Table 64: Blood transfusion (1995-2010) 1995 1996 1997 1998 1999 2000 2004 2005 2006 2007 2008 2009 2010 Antenatal 9 4 2 4 4 0 10 12 11 6 6 18 12 Antenatal & intrapartum 1 0 0 0 1 0 0 1 0 0 0 Antenatal & postpartum 1 0 3 0 0 2 2 0 Intrapartum 11 7 3 3 3 4 2 2 6 1 4 3 1 Intrapartum & postpartum 1 3 6 3 4 4 3 3 4 1 2 1 Postpartum 152 90 94 110 100 96 128 133 150 165 212 228 189 Total transfusions 172 103 102 123 110 105 145 153 170 177 225 253 203 Total transfusion rate 2.0 1.1 1.3 1.6 1.5 1.3 1.9 2.1 2.4 2.3 3.0 3.3 2.6 110
7.4 Emergency peripartum hysterectomy WHA Maternity Indicator for Peripartum Hysterectomy WHA mean 07-08 WHA mean 09-10 NW 2007 NW 2008 NW 2009 NW 2010 Maternal indicator Definition % % % % % % Peripartum hysterectomy Hysterectomy at birth admission/Mothers giving birth 0.102 0.117 0.184 0.155* 0.91 *WHA definition includes only peripartum hysterectomy during birth admission (excludes 2 cases in 2009) Methods Emergency peripartum hysterectomy is defined as hysterectomy performed for complications related to pregnancy within 6 weeks of birth, when that pregnancy resulted in birth at NW at or beyond 20 weeks gestation. Semi-elective cases are excluded. Rate/1000 births 3 2.5 2 1.5 1 0.5 0 1992 1993 1994 1995 1996 1997 1998 rate/1000 median 1999 2000 2001 2002 Figure 68: Emergency peripartum hysterectomy rates/1000 births (1992-2010) (horizontal dotted line represents median rate for 1992-2010) Findings There were 7 emergency peripartum hysterectomies in 2010. This includes two semi-elective caesarean hysterectomies (despite the definition above) as these were prophylactic or intraoperative decisions for placental implantation abnormalities that had been diagnosed prior to birth. This is a rate of 0.91/1000 births, which is consistent with rates before and following the period from 1998-2000, and is consistent with international rates. There is no significant difference from the median rate (represented by the dotted line) over this time period. 111 2003 2004 2005 2006 2007 2008 2009 2010
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National Women’s Annual Clinical
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It is my pleasure to present the 20
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7 LABOUR AND BIRTH OUTCOMES .......
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Table 50: Neonatal outcomes followi
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Table 153: Preterm birth and matern
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Table 258: Perinatal mortality rate
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Figure 53: Mode of birth (1991-2010
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Chapter 1 INTRODUCTION 1
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Chapter 8: Postnatal care This chap
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1.5.3 Gynaecologic data quality As
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2 SERVICE PROVISION 2.1 Maternity s
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2.2.4 Antenatal and Postnatal Wards
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The service has access to the ACH L
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2.5.3 University Links There are cl
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Reportable events All incidents (mi
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Chaptern 3 SUMMARY STATISTICS 19
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3.2 Summary of maternal outcomes 20
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Rate Table 7: Perinatal related mor
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Maternal indicator Caesarean sectio
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50 45 40 35 30 25 20 15 10 5 0 % Ep
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4 MATERNAL DEMOGRAPHY This chapter
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4.2.2 Maternal ethnicity When more
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% 60 50 40 30 20 10 0 NZ European M
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4.5 Body mass index Thirty five per
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% 100 80 60 40 20 0 European Maori
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Women booked with a private obstetr
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5 ANTENATAL COMPLICATIONS This chap
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Ethnic differences in rates of pret
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of women under 20 with SGA babies s
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Perinatal deaths in term SGA infant
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The rate of multiple pregnancy rema
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Summary / Implications Multiple pre
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5.4.1 Demographic characteristics o
Page 73 and 74: 5.4.5 Perinatal losses Diabetes Per
Page 75 and 76: A confirmed placental abruption is
Page 77 and 78: 70 60 50 40 30 20 10 0 % Gestationa
Page 79 and 80: 5.7 Body Mass Index Methods BMI is
Page 81 and 82: % European Maori Pacific Other Asia
Page 83 and 84: 50 45 40 35 30 25 20 15 10 5 0 % Eu
Page 85 and 86: 16 % 40 14 12 10 8 6 4 2 0 Iatrogen
Page 87: Table 38: Mothers with babies diagn
Page 91 and 92: 6 LABOUR AND BIRTH This chapter inc
Page 93 and 94: Table 39: Maternal demographic char
Page 95 and 96: Table 40: Gestation at birth among
Page 97 and 98: Women given syntocinon prior to 3 c
Page 99 and 100: 70 60 50 40 30 20 10 0 % NZ Europea
Page 101 and 102: 6.5 Caesarean section WHA Maternity
Page 103 and 104: Caesarean section rate 60 50 40 30
Page 105 and 106: Sixty percent of para 1 women with
Page 107 and 108: 6.6 Instrumental vaginal birth WHA
Page 109 and 110: Table 52: Neonatal outcomes followi
Page 111 and 112: 6.10 Obstetric analgesia WHA Matern
Page 113 and 114: Table 56: GA use and mode of birth
Page 115 and 116: Table 58: Interventions and outcome
Page 117 and 118: Chaptern 7 LABOUR and BIRTH OUTCOME
Page 119 and 120: 7 LABOUR and BIRTH OUTCOMES This ch
Page 121 and 122: 7.2 Third stage management Methods:
Page 123: Table 61: Postpartum haemorrhage ra
Page 127 and 128: Chaptern 8 POSTNATAL CARE 113
Page 129 and 130: 8 POSTNATAL CARE This chapter provi
Page 131 and 132: % 90 85 80 75 70 65 60 55 50 45 40
Page 133 and 134: 8.2 Postnatal admissions Methods Pr
Page 135 and 136: Table 70: Reason for admission to N
Page 137 and 138: Chaptern 9 NEWBORN SERVICES 123
Page 139 and 140: 9 NEWBORN SERVICES This chapter pro
Page 141 and 142: 9.2 NICU occupancy For 2010 the ver
Page 143 and 144: Number 700 600 500 400 300 200 100
Page 145 and 146: 9.3.4 Reasons for admission to NICU
Page 147 and 148: 9.4.3 Intraventricular haemorrhage
Page 149 and 150: 246 for 2010. This number is higher
Page 151 and 152: 9.4.8 Trends in the use of assisted
Page 153 and 154: 9.4.10 Positive pressure ventilatio
Page 155 and 156: 9.4.12 Term/post-term infants on as
Page 157 and 158: 9.5.2 Survival of inborn babies (23
Page 159 and 160: 20% 18% 16% 14% 12% 10% 8% 6% 4% AN
Page 161 and 162: 9.5.10 Postnatal corticosteroids (A
Page 163 and 164: express milk for many weeks before
Page 165 and 166: 9.9 Child Development Unit 9.9.1 Fo
Page 167 and 168: 9.9.2 Development at 4 years of chi
Page 169 and 170: Chapter 10 PERINATAL MORTALITY 155
Page 171 and 172: 10 PERINATAL MORTALITY This chapter
Page 173 and 174: Table 87: Perinatal related loss an
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10.5 Causes of perinatal-related de
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Chapter 11 SEVERE MATERNAL MORBIDIT
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11 SEVERE MATERNAL MORBIDITY This c
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Chapter 12 GYNAECOLOGY 167
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12 GYNAECOLOGY This chapter provide
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12.2 Termination of pregnancy Epsom
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12.3 Second trimester Termination o
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12.4 Gynaecology inpatient surgery
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Table 101: Demographic details of w
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ACHS Gynaecology Indicators: Injury
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12.5 Gynaecologic laparoscopic proc
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12.6 Hysterectomy Methods See Gynae
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% 80 70 60 50 40 30 20 10 0 Abdomin
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12.7 Urogynaecology Methods As in p
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Table 113: Complications of surgery
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12.8 Colposcopy Methods: The data p
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Referral smear cytology Table 117:
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The number of treatments and percen
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Number of patients 4.5 4 3.5 3 2.5
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12.9 Gynaecologic oncology surgical
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11.9.2 Gynaecologic oncology surger
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203
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Antenatal Summary screen; Reason fo
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Postnatal Mothers Destination to Wa
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APPENDIX 2. SUMMARY STATISTICS Tabl
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Table 135: Time trends in nullipari
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Table 141: Rates of smoking at book
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Table 149: LMC at birth and materna
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APPENDIX 4. ANTENATAL COMPLICATIONS
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Table 157: Demographic characterist
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4.4 Hypertensive disease Table 160:
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Table 164: LMC at birth and BMI (20
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APPENDIX 5. LABOUR AND BIRTH 5.1 In
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5.2 Outcomes following induction Ta
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Table 180: Mode of birth by LMC at
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5.5 Operative births Table 189: Pri
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Table 196: Referral for ECV (women
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APPENDIX 6. LABOUR and BIRTH OUTCOM
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APPENDIX 7. POSTNATAL CARE 7.1 Infa
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Table 213: Maternal destination fol
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Table 220: Admissions of inborn bab
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Table 224: Admissions of outborn ba
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8.2.5 Antenatal corticosteroids Tab
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8.3.2 Intraventricular haemorrhage
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8.4.1 Survival Table 240: Numbers o
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8.5.4 Patent Ductus Arteriosus Tabl
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Table 252: Inborn babies receiving
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APPENDIX 9. PERINATAL MORTALITY Tab
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Table 260: Cause of perinatal-relat
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10.2 Gynaecology Inpatient Surgery
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APPENDIX 11. GLOSSARY OF ABBREVIATI
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APPENDIX 12. DEFINITIONS Antepartum
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Lead Maternity Carer (LMC) The Lead
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Standard primipara A woman with no
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