National Women's Annual Clinical Report 2010

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Table 199: Analgesic use and ethnicity (prioritised) among labouring nulliparous women (2010) Total Epidural Entonox Pethidine TENS Water N n % n % n % n % n % NZ European 1160 870 75.0 637 54.9 246 21.2 38 3.3 171 14.7 Maori 196 117 59.7 133 67.9 55 28.1 1 0.5 29 14.8 Pacific 309 158 51.1 173 56.0 74 24.0 1 0.3 25 8.1 Other Asian 749 450 60.1 416 55.5 216 28.8 5 0.7 38 5.1 Indian 246 169 68.7 129 52.4 64 26.0 3 1.2 15 6.1 Other European 396 290 73.2 191 48.2 79 20.0 14 3.5 59 14.9 Other 94 68 72.3 51 54.3 28 29.8 2 2.1 14 14.9 Table 200: Analgesic use and maternal age among labouring nulliparous women (2010) Maternal age Total Epidural Entonox Pethidine TENS Water (years) N n % n % n % n % n % 40 52 44 84.6 22 42.3 12 23.1 0 3 5.8 234
APPENDIX 6. LABOUR and BIRTH OUTCOMES 6.1 Perineal trauma Table 201: Perineal trauma by mode of birth, parity and LMC at birth among all vaginal births (2010) Total Episiotomy 3 rd /4 th tear Vaginal wall tear N n % n % n % Total vaginal births 5218 1252 24.0 120 2.3 297 5.7 Mode of birth Normal vaginal 4217 621 14.7 63 1.5 250 5.9 Vaginal breech 59 3 5.1 0 0.0 0 0.0 Ventouse 587 343 58.4 34 5.8 26 4.4 Forceps 355 285 80.3 23 6.5 21 5.9 Parity Nulliparous 2427 953 39.3 95 3.9 210 8.7 Multiparous 2791 299 10.7 25 0.9 87 3.1 LMC at birth Independent Midwife 2737 673 24.6 70 2.6 162 5.9 Private Obstetrician 862 325 37.7 17 2.0 26 3.0 General Practitioner 66 23 34.9 1 1.5 7 10.6 NW Community 1060 161 15.2 26 2.5 83 7.8 NW Diabetes 186 24 12.9 2 1.1 7 3.8 NW Medical 223 42 18.8 4 1.8 10 4.5 Other DHB 34 0 0.0 0 0.0 0 0.0 Unbooked 50 4 8.0 0 0.0 2 4.0 Table 202: Episiotomy rates in vaginal births, all gestations by LMC at birth and parity (2010) Nullipara Multipara Total n % Total n % Total 2427 953 39.3 2791 299 10.7 Independent Midwife 1353 530 39.2 1384 143 10.3 Private Obstetrician 424 229 54.0 438 96 21.9 General Practitioner 28 17 60.7 38 6 15.8 National Women’s 622 177 28.5 931 54 5.8 Table 203: Episiotomy rates in spontaneous (non operative) vertex (not breech) birth, all gestations by LMC at birth and parity (2010) Nullipara Multipara Total n % Total n % Total 1650 417 25.3 2567 204 8.0 Independent Midwife 948 244 25.7 1297 101 7.8 Private Obstetrician 223 86 38.6 381 71 18.6 General Practitioner 20 9 45.0 36 4 11.1 National Women’s 459 78 17.0 853 28 3.3 235
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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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246 for 2010. This number is higher
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9.4.8 Trends in the use of assisted
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9.4.10 Positive pressure ventilatio
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9.4.12 Term/post-term infants on as
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9.5.2 Survival of inborn babies (23
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20% 18% 16% 14% 12% 10% 8% 6% 4% AN
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9.5.10 Postnatal corticosteroids (A
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express milk for many weeks before
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9.9 Child Development Unit 9.9.1 Fo
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9.9.2 Development at 4 years of chi
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Chapter 10 PERINATAL MORTALITY 155
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10 PERINATAL MORTALITY This chapter
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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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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
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Page 229 and 230: Table 149: LMC at birth and materna
Page 231 and 232: APPENDIX 4. ANTENATAL COMPLICATIONS
Page 233 and 234: Table 157: Demographic characterist
Page 235 and 236: 4.4 Hypertensive disease Table 160:
Page 237 and 238: Table 164: LMC at birth and BMI (20
Page 239 and 240: APPENDIX 5. LABOUR AND BIRTH 5.1 In
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: Table 196: Referral for ECV (women
Page 251 and 252: APPENDIX 7. POSTNATAL CARE 7.1 Infa
Page 253 and 254: Table 213: Maternal destination fol
Page 255 and 256: Table 220: Admissions of inborn bab
Page 257 and 258: Table 224: Admissions of outborn ba
Page 259 and 260: 8.2.5 Antenatal corticosteroids Tab
Page 261 and 262: 8.3.2 Intraventricular haemorrhage
Page 263 and 264: 8.4.1 Survival Table 240: Numbers o
Page 265 and 266: 8.5.4 Patent Ductus Arteriosus Tabl
Page 267 and 268: Table 252: Inborn babies receiving
Page 269 and 270: APPENDIX 9. PERINATAL MORTALITY Tab
Page 271 and 272: Table 260: Cause of perinatal-relat
Page 273 and 274: 10.2 Gynaecology Inpatient Surgery
Page 275 and 276: APPENDIX 11. GLOSSARY OF ABBREVIATI
Page 277 and 278: APPENDIX 12. DEFINITIONS Antepartum
Page 279 and 280: Lead Maternity Carer (LMC) The Lead
Page 281: Standard primipara A woman with no
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