National Women's Annual Clinical Report 2010

9.4 Care and complications
9.4.1 Infection (all admissions)
In 2010 there were 7 early-onset culture proven septicaemias compared with 10 in 2009 and
6 in both 2008 and 2007. The major organisms were Group B Streptococcus (4) and E Coli
(3). There were 27 episodes of late-onset septicaemia, which compared very favourably with
33, 31 and 34 episodes in the three previous years. For late onset sepsis the most common
organism was Staphylococcus epidermidis / coagulase negative Staphylococcus, which
made up about 37%.
9.4.2 Hypoxic ischaemic encephalopathy (all admissions)
Five inborn babies developed significant stage 2 or 3 hypoxic ischaemic encephalopathy
(HIE) in 2010, giving an incidence of 0.65/1000 term live births. The incidences were 0.5, 0.6,
1.6, 0.5, 0.9, 1 and 0.4/1000 term live births for the years between 2003 and 2009. In
previous years there have been infants from planned home births who had significant HIE
but in 2010 there were none.
Table 77: Details of Hypoxic Ischaemic Encephalopathy Stages 2 or 3.
Born at Gestation
Birth
Weight
HIE
stage
Apgar
1/5
Comment
Northland 39 3305g 2 2 / 4 Em C. section for fetal bradycardia
ACH 39 3560g 3 0 /2 Placental abruption, forceps
ACH 37 3480g 3 0 / 0 Em C. section for placental abruption
Waitakere 40 3900g 2 0 / 3 Meconium liquor, nuchal cord
Waitakere 36 2200g 2 0 / 4 Cord prolapse
ACH 38 3280g 3 0 / 0 Em C. section for fetal distress
ACH 40 4240g 2 2 / 4 Ventouse for fetal distress
ACH 31 1830g 3 1 / 3 Em C. section for fetal distress
North Shore 39 2850g 2 0 / 0 Em C. section for placental abruption
North Shore 38 3030g 2 5 / 6 Maternal fever, fetal distress, forceps
Waitakere 40 3500g 3 0 / 0 Fetal distress
Waitakere 39 3920g 3 1/ 2 Em C. section for fetal distress
North Shore 37 2740g 3 2 / 4 Fetal bradycardia, ventouse, forceps
North Shore 40 3340g 2 3 / 3 Fetal distress
Em C= Emergency Caesarean
The care of all babies with significant HIE is reviewed confidentially to try to identify factors
that may have contributed to the poor outcome and to attempt to improve care. Educational
feedback is given to individual clinicians and to the units involved, as appropriate.
132