National Women's Annual Clinical Report 2010

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Table 109: Surgical details of hysterectomies (excluding gynaecologic oncology) 2008- 2010 2008 2009 2010 N=150 N=162 N=173 n % n % n % Approach Laparotomy 86 57 104 63 90 52.0 Total laparoscopic hysterectomy 5 3 9 6 20 11.6 Laparoscopic assisted vaginal 12 8 7 4 15 8.7 Laparoscopic converted to laparotomy 2 1 5 3 2 1.2 Vaginal Timing of surgery 45 30 37 23 46 26.6 Elective 145 97 155 96 170 98.3 Acute Primary indication for surgery 5 3 7 4 3 1.7 Abnormal bleeding, non pregnant 64 43 72 44 76 43.9 Cancer /pelvic mass 37 25 40 24 37 21.4 Urogynaecology / prolapse 35 23 24 15 41 23.7 Pain, cause unknown 5 3 4 2 2 1.2 Endometriosis 3 2 6 4 9 5.2 Ovarian cyst 2 1 9 6 3 1.7 Post operative complication 1 1 0 0 Other ASA rating 3 2 7 4 5 2.9 0 20 13 9 6 0 1 45 30 51 31 58 33.5 2 67 45 71 44 72 41.6 3 17 11 9 6 24 13.9 5 1 1 0 0 Missing 22 14 19 11.0 Length of stay Median (IQR) Median (IQR) Median (IQR) All hysterectomies By approach: 4 (3-5) 4 (3-5) 4 (3-5) Laparotomy 4 (4-5) 4 (4-5) 4 (3-5) Laparoscopy 3 (3-3) 3 (2-3) 3 (2-4) Vaginal 3 (3-4) 3 (3-4) 3 (3-4) Table 110: Route of hysterectomy among non-malignant hysterectomies (2001-2010) 2001 2002 2003 2005 2006 2007 2008 2009 2010 N=170 N=208 N=187 N=161 N=131 N=189 N=150 N=162 N=173 n % n % n % n % n % n % n % n % Abdominal 90 52.9 113 54.3 100 53.5 86 53 81 61.8 109 57.7 88 58.7 109 67 92 53.2 Vaginal 65 38.2 72 34.6 63 33.7 54 34 36 27.5 67 35.4 45 30.0 37 23 46 26.6 Laparoscopic 15 8.8 23 11.1 24 12.8 21 13.0 14 10.7 13 6.9 17 11.3 16 10 35 20.2 184
% 80 70 60 50 40 30 20 10 0 Abdominal Vaginal Laparoscopic 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Figure 134: Route of hysterectomy among non malignant hysterectomies (2000-2010) ACHS Gynaecology Indicators: Injury to URETER ACHS ACHS ACHS NW NW NW during a LAPAROSCOPIC HYSTERECTOMY 2007 2008 2009 2008 2009 2010 Indicator Definition Injury to ureter during a laparoscopic % % % % % Numerator hysterectomy, with repair, during or up to 2 weeks post operation 0.17 0.57 0.23 0/17 0/16 0 Denominator Laparoscopic hysterectomy procedures ACHS Gynaecology Indicators: Injury to BLADDER ACHS ACHS ACHS NW NW NW during a LAPAROSCOPIC HYSTERECTOMY 2007 2008 2009 2008 2009 2010 Indicator Definition Injury to bladder during a laparoscopic % % % % % Numerator hysterectomy, with repair, during or up to 2 weeks post operation 1.13 0.48 0.78 0/17 0/16 0 Denominator Laparoscopic hysterectomy procedures 185
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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
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Table 39: Maternal demographic char
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Table 40: Gestation at birth among
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Women given syntocinon prior to 3 c
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70 60 50 40 30 20 10 0 % NZ Europea
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6.5 Caesarean section WHA Maternity
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Caesarean section rate 60 50 40 30
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Sixty percent of para 1 women with
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6.6 Instrumental vaginal birth WHA
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Table 52: Neonatal outcomes followi
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6.10 Obstetric analgesia WHA Matern
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Table 56: GA use and mode of birth
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Table 58: Interventions and outcome
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Chaptern 7 LABOUR and BIRTH OUTCOME
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7 LABOUR and BIRTH OUTCOMES This ch
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7.2 Third stage management Methods:
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Table 61: Postpartum haemorrhage ra
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7.4 Emergency peripartum hysterecto
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Chaptern 8 POSTNATAL CARE 113
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8 POSTNATAL CARE This chapter provi
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% 90 85 80 75 70 65 60 55 50 45 40
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8.2 Postnatal admissions Methods Pr
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Table 70: Reason for admission to N
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Chaptern 9 NEWBORN SERVICES 123
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9 NEWBORN SERVICES This chapter pro
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9.2 NICU occupancy For 2010 the ver
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Number 700 600 500 400 300 200 100
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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
Page 175 and 176: 10.5 Causes of perinatal-related de
Page 177 and 178: Chapter 11 SEVERE MATERNAL MORBIDIT
Page 179 and 180: 11 SEVERE MATERNAL MORBIDITY This c
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
Page 195 and 196: 12.5 Gynaecologic laparoscopic proc
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Page 201 and 202: 12.7 Urogynaecology Methods As in p
Page 203 and 204: Table 113: Complications of surgery
Page 205 and 206: 12.8 Colposcopy Methods: The data p
Page 207 and 208: Referral smear cytology Table 117:
Page 209 and 210: The number of treatments and percen
Page 211 and 212: Number of patients 4.5 4 3.5 3 2.5
Page 213 and 214: 12.9 Gynaecologic oncology surgical
Page 215 and 216: 11.9.2 Gynaecologic oncology surger
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Page 219 and 220: Antenatal Summary screen; Reason fo
Page 221 and 222: Postnatal Mothers Destination to Wa
Page 223 and 224: APPENDIX 2. SUMMARY STATISTICS Tabl
Page 225 and 226: Table 135: Time trends in nullipari
Page 227 and 228: Table 141: Rates of smoking at book
Page 229 and 230: Table 149: LMC at birth and materna
Page 231 and 232: APPENDIX 4. ANTENATAL COMPLICATIONS
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Page 235 and 236: 4.4 Hypertensive disease Table 160:
Page 237 and 238: Table 164: LMC at birth and BMI (20
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Page 241 and 242: 5.2 Outcomes following induction Ta
Page 243 and 244: Table 180: Mode of birth by LMC at
Page 245 and 246: 5.5 Operative births Table 189: Pri
Page 247 and 248: 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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