National Women's Annual Clinical Report 2010

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Table 111: Complications of surgery among women undergoing hysterectomy (excluding gynaecologic oncology) during 2010 2009 2010 N=162 N=173 n % n % Any complication 46 28 45 26.0 Blood transfusion 20 12 18 10.4 Intraoperative injury 4 2 2 1.2 Anaesthetic complications 2 1 2 1.2 Significant postoperative infection 7 4 5 2.9 Other significant complications 5 3 11 6.4 Unplanned return to theatre 5 3 7 4.1 Admission to DCCM 2 1 2 1.2 Readmission to hospital 29 18 19 11.0 Failed to complete planned surgery 3 2 1 0.6 There were 18 (10%) peri-operative blood transfusions for benign hysterectomy in the service in 2010. The rate was similar in each of vaginal, laparoscopic and abdominal hysterectomy. All of the transfusions in abdominal hysterectomy were in women having surgery for complex multi-fibroid disease. In two of the abdominal hysterectomy group, the pre-operative Haemoglobin was
12.7 Urogynaecology Methods As in previous annual clinical reports, the section on urogynaecology will concentrate on operative procedures, rather than clinic throughput or urodynamic investigations. From the gynaecology surgical database, urogynaecological procedures have been identified using the surgical audit forms submitted for each operative case. Developments in data coding have enabled us to further categorise operative urogynaecological procedures. Sub-categories available are: procedures including hysterectomy; incontinence tape procedures; prolapse repairs using synthetic mesh augmentation; ‘other’ prolapse repairs. The data for this year’s report, however, were collated using the previous system which grouped all urogynaecology procedures together. As with general gynaecology the service is piloting direct data entry by surgeon at the time of procedure. If successful this will be introduced fully during 2011 and should improve data accuracy. Table 112: Demography of women undergoing inpatient urogynaecology surgery during 2010 2010 N=209 n % Age < 30 3 1.5 31-40 15 7.2 41-50 50 23.9 51-60 45 21.5 >60 Ethnicity 96 45.9 NZ European 120 57.4 Maori 12 5.7 Pacific 11 5.3 Other Asian 11 5.3 Indian 12 5.7 Other European 32 15.3 Other 9 4.3 Not stated District Health Board of residence 2 1.0 Auckland 167 79.9 Counties Manukau 6 2.9 Waitemata 21 10.1 Other BMI 15 7.2 35 25 12.0 Missing 4 1.9 187
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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
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9.4.3 Intraventricular haemorrhage
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Page 151 and 152: 9.4.8 Trends in the use of assisted
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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
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Page 163 and 164: express milk for many weeks before
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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
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Page 177 and 178: Chapter 11 SEVERE MATERNAL MORBIDIT
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Page 181 and 182: Chapter 12 GYNAECOLOGY 167
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Page 185 and 186: 12.2 Termination of pregnancy Epsom
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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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Page 197 and 198: 12.6 Hysterectomy Methods See Gynae
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Page 205 and 206: 12.8 Colposcopy Methods: The data p
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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
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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
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Page 235 and 236: 4.4 Hypertensive disease Table 160:
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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 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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