National Women's Annual Clinical Report 2010

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The number of VLBW infants admitted to ACH peaked in 2001 and then fell over the next three years before a plateau over the last five years. The admissions in this group have again remained stable in 2010. Although the proportion of outborn infants is low there was a steady increase 2004-9 then a slight decrease for 2010. This group of infants includes transfers for level 3 care and those infants who are transferred from Middlemore Hospital NICU for surgical intervention. 9.3.2 Admissions to NICU by domicile of mother As expected, since 2004, there has been a decline in admissions of babies whose mothers are domiciled in the Waitemata District Health Board area. In 2008 and 2009 there was a modest increase in the number of babies admitted to NICU whose mothers were domiciled in the Auckland District Health Board region. This trend was considered due to better allocation, with a drop in unknowns, but was identified to be observed and there was a slight decrease for 2010. Number 600 500 400 300 200 100 0 ADHB CMDHB Waitemata Other Unknow n 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Figure 85: Admissions to NICU by maternal domicile 9.3.3 Admissions to NICU by ethnicity of baby The most frequent ethnicity of NICU admissions was NZ European with 41.2% overall, including 36.6% of preterm and 47.0% of term infants respectively. Due to changes in reporting infant ethnicity made in 2007 we have not reported long term changes in infant ethnicity over time. However, the difference between the rates for NZ Europeans in the two groups, with term infants having a larger representation than preterm infants is of interest. The second largest single ethnic group is Maori with an overall rate of 16.5% compared to 15.3 % for Pacific people. For both Maori and Pacific there are higher rates in the preterm group than the term group (17.4% Vs 15.4% and 15.8 % Vs 14.7% respectively). Asian and Indian were the two other major groups represented with 11.3% and 6.2% of admissions respectively. The number of Asian admissions has increased reflecting the increase in births to Chinese families in Auckland over the last 5 years. 130
9.3.4 Reasons for admission to NICU Prematurity (36.5%) and respiratory distress (26.3%) remain the commonest reasons for admission to NICU. However, 110 babies (12.2%) were admitted because of congenital anomalies. This has increased from 70 (8.8%) in 2006. Forty babies (4.4%) including 34 term infants were admitted primarily for hypoglycaemia. The full list is presented in Appendix 8. 9.3.5 Antenatal corticosteroids (benchmarked with ANZNN) Antenatal steroid use has been consistently high in the Network (ANZNN) and ACH over the last five years. In 2010 over 90% of ACH babies
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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
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5.4.5 Perinatal losses Diabetes Per
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A confirmed placental abruption is
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70 60 50 40 30 20 10 0 % Gestationa
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5.7 Body Mass Index Methods BMI is
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% European Maori Pacific Other Asia
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50 45 40 35 30 25 20 15 10 5 0 % Eu
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16 % 40 14 12 10 8 6 4 2 0 Iatrogen
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Table 38: Mothers with babies diagn
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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 and 124: Table 61: Postpartum haemorrhage ra
Page 125 and 126: 7.4 Emergency peripartum hysterecto
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: Number 700 600 500 400 300 200 100
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
Page 175 and 176: 10.5 Causes of perinatal-related de
Page 177 and 178: Chapter 11 SEVERE MATERNAL MORBIDIT
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Page 181 and 182: Chapter 12 GYNAECOLOGY 167
Page 183 and 184: 12 GYNAECOLOGY This chapter provide
Page 185 and 186: 12.2 Termination of pregnancy Epsom
Page 187 and 188: 12.3 Second trimester Termination o
Page 189 and 190: 12.4 Gynaecology inpatient surgery
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Page 193 and 194: 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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National Women's Annual Clinical Report 2010

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