Documente Academic
Documente Profesional
Documente Cultură
Project Team
Acknowledgements
Reproduction of material
The Womens Health Service (WHS), Capital and
Coast District Health Board (C&C DHB), permits the
reproduction of material from this publication without
prior notification, provided that the WHS C&C DHB is
acknowledged as the source and any information used
must not be distorted or changed.
Disclaimer
The purpose of this publication is to promote, discuss
and audit outcomes. The opinions expressed in this
publication do not necessarily reflect the official views
of the WHS and C&C DHB.
It is my pleasure to present the 2012 Womens Health Service Annual Clinical Report. This is our 10th report.
In 2012 the focus was on the implementation of the Ministry of Health (MOH) Maternity Quality and Safety
Programme. This is a national framework for DHB quality and safety improvement and reporting and provided us
with guidance for the revised format for this years annual clinical report.
Our primary purpose for producing these reports is to identify and acknowledge our achievements. It is also an
opportunity to identify where improvements can be made to the care provided to women and their babies. This
then allow us to improve the quality and safety of our service.
Thank you to all that have contributed to this report but special thanks must go to Carolyn Coles and Keith Fisher
who have spent many hours in the production of this report.
Justine Plunkett
Operations Manager
Womens Health Service
| 3
4 |
Contents
1 Introduction
15
1.1
15
1.2
Report structure
15
1.3
Clinical indicators
17
1.4
17
1.5
Data sources
18
1.6
Data quality
18
1.7
Data analysis
19
Service provision
21
2.1
Maternity Services
21
2.2
25
2.3
25
2.4
Gynaecology Services
26
2.5
27
2.6
28
2.7
University of Otago
29
2.8
29
2.9
Otago Polytechnic
30
31
3.1
31
3.2
Reportable events
35
3.3
35
3.4
36
3.5
36
3.6
37
3.7 Audits
37
3.8
38
39
4.1
Quality forum
39
4.2
39
4.3
Midwife educators
40
4.4
41
Controlled documents
| 5
43
5.1
Place of birth
43
5.2
45
5.3
Neonatal outcomes
47
5.4
49
5.5
Gynaecology outcomes
51
5.6
52
53
6.1
55
6.2
Anaesthesia clinics
56
6.3
56
57
7.1 Domicile
57
7.2 Age
58
7.3 Ethnicity
61
7.4 Parity
64
7.5 Smoking
65
7.6
67
7.7
68
7.8
70
Antenatal complications
71
8.1
Preterm birth
71
8.2
Multiple pregnancy
74
8.3
Diabetes in pregnancy
76
8.4
78
8.5
Maternal cardiac
81
83
9.1
Mode of birth
84
9.2
87
9.3
Various rates
93
9.4
Induction of labour
95
9.5
97
9.6
99
9.7
Obstetric anaesthesia
100
9.8
104
9.8.1
104
9.8.2
105
10
107
10.1
Perineal trauma
107
10.2
Postpartum haemorrhage
108
10.3
109
10.4
Neonatal outcomes
110
10.4.1 Gender
110
10.4.2 Plurality
110
10.4.3
111
6 |
Birth weight
10.4.4
Gestational age
114
10.4.5
Apgar score
115
11
Postnatal care
117
11.1
117
11.2
Infant feeding
118
11.3
121
11.4
122
12
Perinatal mortality
123
12.1
123
12.2
125
12.3
127
13
131
13.1
Maternal mortality
131
13.2
132
13.3
132
14
Gynaecology Clinics
133
14.1
133
14.2
Colposcopy service
135
14.3
Te Mahoe unit
137
15
Gynaecology Services
141
15.1
141
15.2
Endometriosis service
145
15.3
Urogynaecology service
146
15.4
147
15.5
149
15.6
150
16 Appendices
153
16.1
153
16.2 Abbreviations
165
16.3 References
166
16.4
167
| 7
8 |
tables
Table 1:
37
Table 2:
Place of birth for the Capital & Coast DHB region for 2012
43
Table 3:
45
Table 4:
46
Table 5:
46
Table 6:
46
Table 7:
47
Table 8:
48
Table 9:
50
Table 10:
51
Table 11:
52
Table 12:
Obstetric outpatient clinic attendances and DNA rates for years 2009 to 2012
54
Table 13:
55
Table 14:
Domicile by District Health Board (DHB) area and by gestation at birth for 2012
57
Table 15:
58
Table 16:
59
Table 17:
61
Table 18:
62
Table 19:
62
Table 20:
64
Table 21:
64
Table 22:
Rates of smoking at booking time by ethnicity and age groups for 2012
65
Table 23:
Rates of smoking at booking time by ethnicity group for years 2005 to 2012
66
Table 24:
Body mass index (BMI) categories at booking by age group for 2012
67
Table 25:
Body mass index (BMI) categories at booking by ethnicity group for 2012
67
Table 26:
LMC bookings by trimester at time of first visit, for years 2008 to 2012
68
Table 27:
69
Table 28:
69
Table 29:
69
Table 30:
70
Table 31:
Parity by ethnicity for women booked with Hospital Midwifery Primary Care for 2012
70
Table 32:
72
| 9
Table 33:
72
Table 34:
73
Table 35:
74
Table 36:
Ethnicity of women with GDM and Type 2 diabetes giving birth in 2012
76
Table 37:
Ethnicity distribution within diabetes type for women attending clinic in 2012
76
Table 38:
Mode of birth by diabetes type for births in 2012 within C&C DHB
77
Table 39:
78
Table 40:
79
Table 41:
80
Table 42:
Outcomes after amniocentesis and CVS for 2011 and 2012 (Jan-Sep)
81
Table 43:
84
Table 44:
86
Table 45:
86
Table 46:
93
Table 47:
94
Table 48:
Primary indication for induction of labour by parity and CS history group for 2012
95
Table 49:
Mode of birth after induction of labour for main primary indication groups for 2012
96
Table 50:
Peer group comparison for ACHS obstetric clinical indicators 1.1 to 1.4
99
Table 51:
100
Table 52:
100
Table 53:
101
Table 54:
101
Table 55:
102
Table 56:
103
Table 57:
Age and ethnicity distribution for the women who gave birth at KMU in 2012
104
Table 58:
Age and ethnicity distribution for the women who gave birth at PMU in 2012
105
Table 59:
Peer group comparison for ACHS obstetric clinical indicators 3.1 to 3.6
107
Table 60:
Peer group comparison for ACHS obstetric clinical indicators 7.1 and 7.2
108
Table 61:
108
Table 62:
109
Table 63:
110
Table 64:
110
Table 65:
111
Table 66:
111
Table 67:
112
Table 68:
113
Table 69:
114
Table 70:
Gestational age groups for liveborn babies for years 2005 to 2012
115
Table 71:
115
Table 72:
Apgar score at 5 minutes for liveborn babies by maternal age group for 2012
116
Table 73:
Apgar score at 5 minutes for liveborn babies by maternal ethnicity group for 2012
116
Table 74:
Apgar scores at 5 minutes for liveborn babies for years 2005 to 2012
116
10 |
Table 75:
118
Table 76:
119
Table 77:
119
Table 78:
120
Table 79:
121
Table 80:
NICU admissions and outcomes for liveborn babies, by gestation group for 2012
122
Table 81:
122
Table 82:
124
Table 83:
Perinatal mortality rate by maternal age groups for years 2005 to 2012
125
Table 84:
Adjusted perinatal mortality rate by maternal age groups for years 2005 to 2012
125
Table 85:
Perinatal mortality rate by maternal ethnicity groups for years 2005 to 2012
126
Table 86:
Adjusted perinatal mortality rate by maternal ethnicity groups for years 2005 to 2012 126
Table 87:
127
Table 88:
128
Table 89:
Summary of factors related to the 7 early neonatal deaths < 7 days in 2012
129
Table 90:
Early neonatal deaths by perinatal death classification for the years 2006 to 2012
130
Table 91:
Incidence of AMOSS reportable severe maternal morbidities for 2011 and 2012
132
Table 92:
Gynaecology outpatient clinic attendances and DNA rates for years 2009 to 2012
134
Table 93:
135
Table 94:
Colposcopy outpatient clinic attendances and DNA rates for years 2009 to 2012
136
Table 95:
136
Table 96:
137
Table 97:
139
Table 98:
142
Table 99:
142
Table 100: Elective gynaecology surgery volumes and breakdown of surgical procedures for 2012 143
Table 101: Acute gynaecology surgery volumes for 2012
144
144
145
146
147
Table 106: Gynaecology oncology referral numbers by DHB for years 2009 to 2012
147
Table 107: Histological confirmed gynaecology oncology cases for newly referred women in 2012 148
Table 108: Gynaecology oncology surgery procedures for 2012
148
149
Table 110: Group comparison for ACHS gynaecology clinical indicators for years 2010 to 2012
151
Table 111: Place of birth for the C&C DHB region for the years 2003 to 2012
154
Table 112: Place of birth by C&C DHB birthing facility for the years 2003 to 2012
155
Table 113: Ethnicity group distribution within each age group for 2012
155
156
156
Table 116: Maternal ethnicities within the six ethnicity groups for years 2005 to 2012
157
| 11
Table 117: Mode of birth group percentages for years 1997 to 2012
158
Table 118: Mode of birth group by age group for all women in 2012
158
Table 119: Mode of birth group by age group for primiparous women in 2012
158
Table 120: Mode of birth group by age group for multiparous women without previous CS in 2012 159
Table 121: Mode of birth group by age group for multiparous women with previous CS in 2012 159
Table 122: ACHS obstetric clinical indicators (Jan-Jun, Jul-Dec 2012) and table notes
160
Table 123: ACHS infection control clinical Indicators (Jan-Jun, Jul-Dec 2012) and table notes
162
Table 124: ACHS gynaecology clinical indicators (Jan-Jun, Jul-Dec 2012) and table notes
163
12 |
figures
Figure 1:
28
Figure 2:
32
Figure 3:
Number of reportable events by month for 2012, with a linear trend line
35
Figure 4:
59
Figure 5:
Ethnicity group distribution within each maternal age group for 2012
60
Figure 6:
Age group distribution within each maternal ethnicity group for 2012
63
Figure 7:
Labour and birth branch diagram for all women with multiple pregnancies for 2012
75
Figure 8:
Mode of birth group rates for years 1997 to 2012, for all C&C DHB facilities combined 85
Figure 9:
Labour and birth branch diagram for all women for 2012
Figure 10: Labour and birth branch diagram for primiparous women for 2012
87
88
Figure 11: Labour and birth branch diagram for multiparous women without previous CS for 2012 89
Figure 12: Labour and birth branch diagram for multiparous women with previous CS for 2012
90
Figure 13: Mode of birth group by age group for all women for 2012
91
Figure 14: Mode of birth group by age group for primiparous women for 2012
91
Figure 15: Mode of birth group by age group for multiparous women without previous
CS for 2012
92
Figure 16: Mode of birth group by age group for multiparous women with previous CS for 2012
92
Figure 17: Labour and birth branch diagram for singleton breech presentations for 2012
97
Figure 18: Perinatal mortality rates (perinatal and adjusted) for years 2005 to 2012
124
| 13
14 |
1. Introduction
| 15
16 |
The clinical indicator results for the WHS for 2012 are
presented in chapter 5 Summary Statistics for 2012,
| 17
18 |
| 19
20 |
2. Service provision
REGIONAL SERVICES
Maternal
NATIONAL SERVICES
The Maternal Fetal Medicine (MFM) unit at Wellington
is part of the New Zealand MFM Network and provides
nationwide care for high risk obstetric and fetal
medicine, in concert with Christchurch and Auckland.
Maternal
The WHS is a tertiary level facility that accepts referrals
from around New Zealand if capacity is exceeded in
other tertiary units.
Fetal / Neonatal
| 21
Multifetal reduction
Newborn
The Neonatal Intensive Care Unit (NICU) is located on
Level 4 of the Wellington Regional Hospital adjacent to
the Delivery Suite and Ward 4 North. NICU provides
heath care services to premature and sick newborns.
NICU works closely with the WHS.
NICU is contracted to provide:
22 |
DISTRICT SERVICES
The maternity service is comprised of:
Delivery Suite
>
>
Diabetic antenatal
>
VBAC / OASIS
>
>
MFM clinic
>
Midwifery Teams
The limited availability of midwife LMCs has meant that
C&C DHB have been providing primary maternity care
to some women. The Primary Care team is a group of
midwives who provides antenatal and postnatal care to
these women. Antenatal clinics are held at Wellington
and Kenepuru Hospitals (Monday to Friday). Labour
| 23
COMMUNITY SERVICES
Antenatal education
Free pregnancy and parenting education classes are
provided at Wellington and Kenepuru Hospitals to
women who are not currently accessing antenatal
education. These classes were set up to address
inequities of access to antenatal education
programmes for Mori, Pacific People, women from
ethnic minorities and those on a low income. The
objective is to improve health outcomes for these
women and their families and to increase the number
of first-time pregnant women accessing C&C DHB
funded antenatal education.
Breastfeeding education and support
Free breastfeeding classes are provided by the Clinical
Midwife Specialist Lactation, at Wellington and
Kenepuru Hospitals on a monthly basis. The classes
are run over two days.
Chinese breastfeeding classes are run in conjunction
with Hutt Valley DHB at Petone every two months and
are run over two days.
The Community Breastfeeding Team is comprised of
the community lactation coordinator, Pacific lactation
consultant and two Pacific breastfeeding support
workers who provide lactation consultancy support in
the homes of women and at the Breastfeeding Centre.
A particular focus of the Community Breastfeeding
Team is Mori and Pacific women and those with
complex needs. The Breastfeeding Centre is situated
in the Whanau Centre in Cannons Creek, Porirua, and
is a drop in centre open on Thursdays and Fridays from
10am to 2pm.
24 |
Obstetrician LMCs
There are two obstetric LMCs in the Wellington area.
They provide antenatal care in community clinics and
employ midwives to provide antenatal and postnatal
midwifery care. Labour care is provided by core
midwives. LMC obstetricians are also funded via
Section 88 but there is an additional charge to the
woman for this private service.
| 25
REGIONAL SERVICES
C&C DHBs gynaecology service provides:
DISTRICT SERVICES
The gynaecology service is comprised of:
> Urogynaecology
Pre-decision counselling
26 |
> Colposcopy
> Infertility (non-tertiary)
> Endometriosis.
Wellington Regional Hospital - Ward 4 North
Inpatient Gynaecology
Ward 4 North Pod A provides the inpatient
gynaecology acute and elective services for C&C DHB.
The service has provision for 14 beds with twelve beds
in Pod A and two in Pod B. There are also two flexibeds in Pod B for use as and when required.
Pod A downsizes to ten beds on weekends and public
holidays. The gynaecology pod also provides an acute
after hours assessment service for women requiring
urgent attention.
Admissions to Pod A include acute non-surgical
gynaecology (including women with chronic pain),
elective gynaecology surgery, urogynaecology surgery,
tertiary gynaecology oncology services, and acute
early pregnancy care for women who are less than
20 weeks pregnant, readmissions greater than 10
days postpartum and after hours Te Mahoe inpatient
admissions.
| 27
28 |
| 29
30 |
OBJECTIVES
| 31
GOVERNANCE STRUCTURE
The WHS has a governance structure that has
been in existence and working effectively for a
number of years. The structure consists of monthly
multidisciplinary meetings that focus on quality and risk
review, clinical audit and research and overall clinical
governance.
The MQSP is governed by a Maternity Quality
and Safety Programme Governance group, who
report to the WHS Clinical Governance group. This
multidisciplinary governance group includes the WHS
32 |
| 33
MQSP DELIVERABLES TO BE
UNDERTAKEN 2013
34 |
25
20
15
10
0
Jan 12
Feb 12
Mar 12
Apr 12
May 12
Jun 12
Jul 12
Aug 12
Sep 12
Oct 12
Nov 12
Dec 12
| 35
36 |
3.7 Audits
In 2012, 8 audits were approved by the clinical audit
and research committee. Clinicians who submit a
proposal to the committee do so on the understanding
that they will be required to submit a copy of their final
report to the committee upon completion and present
their audit findings at a quality forum.
Author
1.
How many babies born between 35 and 37 weeks gestation are admitted
directly to the postnatal ward and cared for as per policy Management of
babies 35-37 weeks gestation or 2.0-2.5 kg on the postnatal ward?
2.
Jennifer Petrovich
Midwife
3.
Sam Lepine
Obstetric Senior House Officer
4.
Is the daily baby check for babies on the postnatal pods being completed
once every 24 hours during their postnatal stay?
Pip Penhey
Midwife
5.
Laura Neuss
Ultrasonographer
6.
Are safe sleep and sudden unexpected death in infancy (SUDI) education
conversations with parents being undertaken and documented in hospital
records?
Carol McCord
Midwife
7.
How many patients failed to complete a successful trial of void in 2011 and
what factors contributed to this?
Kerri Gunn
Registered Nurse
8.
Jeremy Tuohy
Obstetrician
| 37
38 |
4. Learning development
and research
| 39
PROMPT Course
Three PROMPT (Practical Obstetric Multi-Professional
Training) days were run by the clinical midwife
specialist, the clinical leader obstetrics and the clinical
leader obstetric anaesthesia. The course is designed
to improve teamwork and communication during an
obstetric emergency. Emergencies are simulated with
the use of actors. The emergencies take place in the
unit, using real equipment, ensuring that the simulation
occurs in real time. The midwives and doctors
practise in their normal clinical roles. Five courses
were run in 2012. For the first time, two courses were
delivered at the primary maternity units. Paramedics
and call takers from Wellington Free Ambulance also
participated at the days run in the primary maternity
facilities.
One of the advantages of these days, is that systems
that do not work when trialled are examined and
rectified if at all feasible.
40 |
Midwifery Forums
| 41
42 |
Table 2: Place of Birth for the Capital & Coast DHB region for 2012
Mothers
Place of Birth
Babies
No.
3450
89.6
240
Place of Birth
No.
3520
89.8
6.2
240
6.1
132
3.4
132
3.4
28
0.7
28
0.7
3850
100
3920
100
Total
| 43
See Table 111 for the place of birth numbers for the
last 10 years 2003 to 2012. Table 112 has the number
of births by birthing facility for 2003 to 2012, with the
births before arrival included in the birthing facility to
which they were admitted.
44 |
Category
Ethnicity *
NZ European
Age
Lead Maternity
Carer (at booking)
Parity **
Smoking rates
by ethnicity (at
booking)
Number
Of Total
1912
49.7
Other European
461
12.0
Mori
481
12.5
Pacific Peoples
359
9.3
Asian
535
Other
102
13.9
< 20 years
172
4.5
20 24
498
12.9
25 29
826
21.5
30 34
1205
31.3
35 39
904
23.5
40
245
31.3
29.6
Midwife LMC
2835
73.6
320
8.3
144
3.7
229
5.9
322
3850
3850
3850
2.6
6.4
8.4
Primiparous
1741
45.2
1541
40.0
465
12.1
103
3850
2.7
NZ European
119
1912
6.2
11
461
2.4
197
481
41.0
67
359
18.7
Asian
535
1.3
Other
102
1.0
402
3850
10.4
Other European
Mori
Pacific Peoples
Total
* The ethnicity groups used in this report contain the following ethnicities. The method by which ethnicity is determined is explained in section
7.3.
NZ European: New Zealand European/Pakeha.
Other European: Other European, European not further defined.
Mori: New Zealand Mori.
Pacific Peoples: Cook Island Mori, Fijian, Niuean, Samoan, Tokelauan, Tongan, Pacific Island not further defined, Other Pacific Island.
Asian: Chinese, Indian, Southeast Asian, Asian not further defined, Other Asian.
Other: African, Latin American/Hispanic, Middle Eastern, Other, Not stated.
** Parity:
Primiparous: A woman who has not previously given birth from 20 completed weeks gestation. (Also called nulliparous or Para 0)
Multiparous: A woman who has previously given birth from 20 completed weeks gestation.
| 45
Primiparous
Labour
No.
Multiparous, no
previous CS
No.
Multiparous, with
previous CS
No.
Total
No.
Spontaneous
954
54.8
1030
66.8
171
30.1
2155
56.0
Induced
631
36.2
412
26.7
50
8.8
1093
28.4
Pre-labour CS
156
9.0
99
6.4
347
61.1
602
15.6
1741
100
1541
100
568
100
3850
100
Total
Primiparous
No.
Multiparous, no
previous CS
No.
Multiparous, with
previous CS
No.
Total
No.
Vaginal
Normal
810
46.5
1317
85.5
97
17.1
2224
57.8
Forceps
179
10.3
25
1.6
11
1.9
215
5.6
Ventouse
153
8.8
15
1.0
24
4.2
192
5.0
0.0
0.1
0.0
0.0
Manual rotation
Breech
10
0.6
12
0.8
0.9
27
0.7
1152
66.2
1370
88.9
137
24.1
2659
69.1
502
28.8
116
7.5
140
24.6
758
19.7
Caesarean
Emergency
Elective
Total
87
5.0
55
3.6
291
51.2
433
11.2
589
33.8
171
11.1
431
75.9
1191
30.9
1741
100
1541
100
568
100
3850
100
Number
Of Total
1532
3850
39.8
241
433
55.7
522
758
68.9
760
3282
23.2
Episiotomy
522
3850
13.6
86
2659
3.2
117
1191
9.8
Normal birth (at term and spontaneous labour and normal birth)
46 |
Category
Gender
Female
1889
Male
2031
Single
3782
96.5
Twins
132
3.4
Plurality
Triplets
Gestation
3920
3920
51.8
0.2
24 27 weeks
57
1.5
28 31 weeks
84
2.1
32 36 weeks
294
7.5
All preterm
466
11.9
3407
86.9
+6
+6
+6
+6
47
3920
1.2
0.1
500g-999g
53
1.4
1000g-1499g
46
1.2
1500g-1999g
84
2.2
2000g-2499g
158
4.1
2500g-2999g
476
12.3
3000g-3499g
1192
30.7
3500g-3999g
1266
32.7
4000g-4499g
517
13.3
4500g-4999g
76
2.0
5000g
Breastfeeding at discharge
(excludes discharges from NICU)
48.2
0.8
+0
31
+0
Of Total
20 23 weeks
+0
+0
Number
Average weight
3375g
Maximum weight
5415g
3877
0.2
Preterm
31
427
7.3
Term
41
3450
1.2
Total
72
3877
1.9
Preterm
355
427
83.1
Term
389
3450
11.3
Total
744
3877
19.2
Exclusive
2728
79.6
Full
116
3.4
Partial
483
14.1
Artificial
102
3429
3.0
* Apgar: Numerical score used to evaluate the infants condition at one and five minutes after birth. Five variables are scored: heart rate,
breathing, muscle tone, reactivity to stimulation and colour. Values of 0, 1 or 2 are assigned to each variable, with 10 being the maximum Apgar
score.
| 47
Number
Total babies
3920
Liveborn babies
3877
Rate
43
Stillbirths
23
10
50
30
53
48 |
| 49
2012
Numerator
Denominator
Rate (%)
Jan-Jun
217
516
42.05
Jul-Dec
213
544
39.15
Jan-Jun
161
516
31.20
Jul-Dec
155
544
28.49
Jan-Jun
104
516
20.16
Jul-Dec
126
544
23.16
Jan-Jun
128
516
24.81
Jul-Dec
153
544
28.13
1.1
1.2
1.3
1.4
2.1
Jan-Jun
35
176
19.89
Jul-Dec
49
177
27.68
3.1
Jan-Jun
67
388
17.27
Jul-Dec
63
391
16.11
3.2
Jan-Jun
108
388
27.84
Jul-Dec
120
391
30.69
3.3
Jan-Jun
161
388
41.49
Jul-Dec
166
391
42.46
3.4
Jan-Jun
52
388
13.40
Jul-Dec
42
391
10.74
3.5
Jan-Jun
22
388
5.67
Jul-Dec
28
391
7.16
3.6
Jan-Jun
388
0.00
Jul-Dec
391
0.77
4.1
Jan-Jun
40
590
6.78
Jul-Dec
31
598
5.18
7.1
Jan-Jun
25
1295
1.93
Jul-Dec
28
1336
2.10
7.2
Jan-Jun
22
590
3.73
Jul-Dec
18
598
3.01
8.1
Jan-Jun
10
793
1.26
Jul-Dec
789
0.76
9.1
Jan-Jun
28
1685
1.66
Jul-Dec
15
1742
0.86
Jan-Jun
137
1644
8.33
Jul-Dec
188
1700
11.06
(L) A low rate is desirable (H) A high rate is desirable (N) Desirable rate is unspecified
Rates in italic / greyed highlight results that require attention.
Rates in bold highlight results where the aggregate rate is outside the 99% confidence interval.
50 |
2012
Numerator
Denominator
Rate (%)
Jan-Jun
586
0.68
Jul-Dec
598
1.00
| 51
2012
Numerator
Denominator
Rate (%)
1.1
Jan-Jun
10
390
2.56
Jul-Dec
429
1.86
1.2
Jan-Jun
57
8.77
Jul-Dec
61
8.20
2.1
Jan-Jun
412
1.70
Jul-Dec
455
0.44
Jan-Jun
245
0.00
3.1
Jul-Dec
271
0.74
Jan-Jun
15
0.00
Jul-Dec
12
0.00
Jan-Jun
15
0.00
Jul-Dec
12
0.00
Jan-Jun
15
16
93.75
Jul-Dec
12
14
85.71
3.2
3.3
4.1
5.1
Jan-Jun
51
0.00
Jul-Dec
70
0.00
5.2
Jan-Jun
51
0.00
Jul-Dec
70
0.00
5.3
Jan-Jun
51
0.00
Jul-Dec
70
0.00
52 |
6. Antenatal and
postnatal clinics
| 53
2009
2010
2011
2012
2009
2010
2011
2012
No.
No.
No.
No.
Antenatal
1889
2154
2306
2484
9.3
10.3
9.0
7.3
Diabetic
1038
1714
1845
1555
12.5
11.0
12.3
6.8
High risk
1075
939
1109
1297
8.7
7.3
12.7
11.3
MFM counselling
985
1156
1013
907
5.3
3.3
2.4
1.8
Acute assessment
1904
3059
2738
2564
0.2
Preassessment
394
466
540
581
12.2
12.0
11.1
11.4
Pre-20 weeks
533
857
877
185
11.4
8.3
8.1
7.0
Medical
VBAC antenatal
65
3.1
Virtual MFM
Virtual - Obstetric
Total - Medical
0.3
7818
10345
10432
52
9695
7.2
6.2
7.1
5.5
Midwifery
MFM antenatal
MFM postnatal
15
227
175
108
128
430
413
373
473
190
139
138
122
1050
1163
1383
1353
0.3
0.2
Primary antenatal
2820
2520
2368
2232
8.7
13.4
341
224
13
43
37
663
175
166
613
2064
2910
2491
1959
0.1
0.0
430
564
481
389
9.8
9.6
8.9
22
34
1004
835
847
802
0.2
0.2
259
181
149
203
2062
1678
1618
1717
Total - Midwifery
11245
10807
10516
10275
2.6
3.7
3.4
3.3
19063
21152
20948
19970
4.5
4.9
5.2
4.4
54 |
0.1
9.6
10.4
24.6
33.5
0.2
4.9
Other
European
Pacific
Peoples
No.
No.
No.
No.
No.
No.
No.
GDM
72
64.9
16
88.9
13
56.5
23
59.0
59
80.8
87.5
190
69.9
Type 1
18
16.2
5.6
4.3
5.1
1.4
0.0
23
8.5
Type 2
4.5
0.0
30.4
10
25.6
8.2
0.0
28
10.3
14
12.6
5.6
4.3
5.1
8.2
12.5
25
9.2
Other
1.8
0.0
4.3
5.1
1.4
0.0
2.2
Total
111
100
18
100
23
100
39
100
73
100
100
272
100
Mori
Asian
Other
Total
Diabetes
Other
Thyroid
| 55
Wellington Hospital
Antenatal Assessment and
Education Class
These education classes are structured to run alongside
antenatal assessments so enabling the majority of
women attending to have their antenatal assessment
prior to the education class commencing. 66 women
and their families attended.
56 |
7.1 Domicile
93% of all births were to women from the local catchment
area. 275 women were from other DHBs with most being
from the Hutt Valley and Mid-Central DHBs.
< 28 weeks
28+0 31+6
32+0 36+6
No.
No.
No.
35
44.3
29
40.3
211
80.5
Hutt Valley
7.6
14
19.4
16
Hawkes Bay
12
15.2
5.6
Wairarapa
3.8
Whanganui
6.3
Mid Central
Nelson Marlborough
Term
37+0 40+6
Total
No.
2655
96.0
645
96.3
3575
92.9
6.1
67
2.4
15
2.2
118
3.1
1.5
0.3
0.0
27
0.7
5.6
2.7
0.2
0.1
20
0.5
6.9
1.1
0.1
0.0
16
0.4
11.4
2.8
2.7
22
0.8
1.3
49
1.3
6.3
11.1
1.1
0.2
0.0
21
0.5
5.1
8.3
10
3.8
0.1
0.0
23
0.6
0.0
0.0
0.4
0.0
0.0
0.0
79
100
72
100
262
100
100
670
100
3850
100
Total
No.
Post term
41+0
2767
No.
| 57
7.2 Age
The median age of New Zealand women giving birth in
2012 is 30 years (Statistics New Zealand, 2013) whereas
C&C DHBs median age was 31.9 years.
The proportion of women (40 years of age and over)
giving birth at C&C DHB is 6.4% compared with
4.1% of the New Zealand birthing population. The
proportion of women (35 years of age and over) giving
birth at C&C DHB is almost 29.8% compared with
21.5% of the New Zealand birthing population. In
2012 the MoH published the Report on Maternity
Wellington
Kenepuru
Age
No.
No.
No.
No.
No.
< 20
132
3.8
28
11.4
12
8.9
172
4.5
4582
7.1
20 24
401
11.6
69
28.2
28
20.7
498
12.9
12121
18.8
25 29
718
20.7
72
29.4
36
26.7
826
21.5
16113
25.0
30 34
1128
32.5
43
17.6
34
25.2
1205
31.3
17782
27.6
35 39
857
24.7
26
10.6
21
15.6
904
23.5
11190
17.4
40
234
6.7
2.9
3.0
245
6.4
2669
4.1
0.0
0.0
0.0
0.0
28
0.0
3470
100
245
100
135
100
3850
100
Not stated
Total
Paraparaumu
C&C DHB
Average age
31.7
27.5
29.0
31.3
Median age
32.3
27.2
28.7
31.9
The average age for all women and for first time
mothers has remained fairly constant over the last eight
years since 2005 (see next table).
58 |
2010 (NZ)
64485
30.0 *
100
Table 16: Maternal age group distribution for years 2005 to 2012
Mothers
2005
Age
No.
2006
183
%
4.6
No.
219
2008
%
5.4
No.
212
2009
No.
5.3
2010
216
No.
5.4
187
2011
No.
4.8
172
2012
No.
4.4
< 20
202
20 24
427 11.4
484 12.2
508 12.6
531 13.3
492 12.3
512 13.2
487 12.4
498 12.9
25 29
768 20.5
730 18.4
783 19.3
811 20.3
832 20.8
762 19.6
823 21.0
826 21.5
30 34
5.4
No.
2007
172
4.5
1288 34.3 1435 36.2 1342 33.2 1238 31.0 1292 32.3 1263 32.5 1285 32.8 1205 31.3
35 39
893 23.8
928 23.4
959 23.7
997 24.9
967 24.2
959 24.6
937 23.9
904 23.5
40
176
207
236
210
196
208
213
245
Total
4.7
5.2
5.8
5.3
4.9
5.3
5.4
6.4
3754 100 3967 100 4047 100 3999 100 3995 100 3891 100 3917 100 3850 100
Average age
All mothers
31.2
31.4
31.2
31.1
31.2
31.3
31.3
31.3
29.4
29.8
29.5
29.2
29.4
29.6
29.8
29.6
40.0 %
20-24
25-29
30-34
35-39
>=40
35.0 %
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
2005
2006
2007
2008
2009
2010
2011
2012
| 59
60.0 %
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
< 20 yrs
20 - 24 yrs
NZ European
60 |
25 - 29 yrs
Other European
30 - 34 yrs
Mori
35 - 39 yrs
Pacific Peoples
40 yrs
Asian
Total
Other
7.3 Ethnicity
Reporting of ethnicity is complex and different systems
are used in various reports. The New Zealand Ministry
of Health uses a prioritised ethnicity classification
system. The prioritised ethnicity classification system
works by an individual choosing multiple ethnicities
based on their preferences or self-concept. The
classification system then determines the ethnicity
group value for multiple ethnicities using a hierarchical
system of 21 ethnicity descriptions. This is based on
the following priority: Mori, Pacific peoples, Asian,
other groups except NZ European, NZ European.
Thus, any person who selects Mori as one of their
three ethnicities will be recorded as Mori. (Hospital
based Maternity events 2006, NZ Ministry of Health,
Wellington
Kenepuru
Ethnicity
No.
NZ European
1749
50.4
73
29.8
Other European
432
12.4
12
Mori
384
11.1
Pacific Peoples
293
Asian
No.
Paraparaumu
No.
C&C DHB
2010 (NZ)
No.
No.
90
66.7
1912
49.7
26184
40.6
4.9
17
12.6
461
12.0
6138
9.5
77
31.4
20
14.8
481
12.5
16348
25.4
8.4
65
26.5
0.7
359
9.3
7536
11.7
512
14.8
17
6.9
4.4
535
13.9
6966
10.8
Other
100
2.9
0.4
0.7
102
2.6
1313
2.0
Total
3470
100
245
100
135
100
3850
100
64485
100
| 61
2005
2006
2007
2008
2009
2010
2011
2012
Ethnicity
No.
No.
No.
No.
No.
No.
No.
No.
NZ
European
2069
55.1
2169
54.7
2089
51.6
2059
51.5
2058
51.5
1946
50.0
1954
49.9
1912
49.7
Other
European
331
8.8
401
10.1
440
10.9
440
11.0
462
11.6
456
11.7
497
12.7
461
12.0
Mori
519
13.8
543
13.7
553
13.7
562
14.1
531
13.3
525
13.5
488
12.5
481
12.5
Pacific
Peoples
370
9.9
393
9.9
394
9.7
389
9.7
407
10.2
387
9.9
385
9.8
359
9.3
Asian
343
9.1
373
9.4
400
9.9
405
10.1
412
10.3
440
11.3
486
12.4
535
13.9
Other
122
3.2
88
2.2
171
4.2
144
3.6
125
3.1
137
3.5
107
2.7
102
2.6
Total
3754
100
3967
100
4047
100
3999
100
3995
100
3891
100
3917
100
3850
100
NZ
European
Other
European
Age
No.
No.
< 20
52
2.7
0.7
76
15.8
35
9.7
0.4
20 24
196
10.3
17
3.7
140
29.1
85
23.7
47
25 29
352
18.4
55
11.9
116
24.1
107
29.8
30 34
640
33.5
186
40.3
70
14.6
75
35 39
540
28.2
159
34.5
62
12.9
40
132
6.9
41
8.9
17
Total
1912
100
461
100
481
Average
32.3
62 |
34.0
Mori
No.
27.1
Pacific
Peoples
No.
No.
Other
No.
3.9
172
4.5
8.8
13
12.7
498
12.9
169
31.6
27
26.5
826
21.5
20.9
206
38.5
28
27.5
1205
31.3
39
10.9
81
15.1
23
22.5
904
23.5
3.5
18
5.0
30
5.6
6.9
245
6.4
100
359
100
535
100
102
100
3850
100
31.4
No.
Total
28.2
Asian
31.0
31.3
< 20 yrs
Other
European
20 - 24 yrs
Mori
Pacific Peoples
25 - 29 yrs
Asian
30 - 34 yrs
Other
35 - 39 yrs
Total
40 yrs
| 63
7.4 Parity
The parity rates for all women have remained
consistent for the last 8 years. Tables for 2012 of parity
by age group and parity by ethnicity group are listed in
the Appendices (Table 114 and Table 115).
2005
2006
No.
No.
44.8 1813
45.7 1844
45.6 1854
46.4 1828
45.8 1717
44.1 1787
45.6 1741
45.2
1249
33.3 1321
33.3 1372
33.9 1273
31.8 1299
32.5 1285
33.0 1327
33.9 1294
33.6
513
13.7
503
12.7
524
12.9
528
13.2
533
13.3
574
14.8
491
12.5
528
13.7
182
4.8
183
4.6
167
4.1
200
5.0
189
4.7
183
4.7
178
4.5
163
4.2
73
1.9
88
2.2
82
2.0
66
1.7
73
1.8
83
2.1
64
1.6
79
2.1
>4
57
1.5
59
1.5
58
1.4
78
2.0
73
1.8
49
1.3
70
1.8
45
1.2
100 3850
100
100 3995
No.
100 3891
No.
2012
1680
100 3999
2011
100 4047
2010
100 3967
No.
2009
No.
3754
2008
Parity
Total
No.
2007
100 3917
No.
2005
2006
2007
2008
2009
2010
2011
2012
Parity
grouping
No.
Primipara
1680
44.8 1813
45.7 1844
45.6 1854
46.4 1828
45.8 1717
44.1 1787
45.6 1741
45.2
42.3 1616
40.7 1641
40.5 1562
39.1 1635
40.9 1589
40.8 1578
40.3 1541
40.0
No.
No.
No.
No.
No.
No.
No.
Multipara, with :
0 previous
CS
1588
1 previous
CS
391
10.4
456
11.5
477
11.8
471
11.8
431
10.8
464
11.9
460
11.7
465
12.1
95
2.5
82
2.1
85
2.1
112
2.8
101
2.5
121
3.1
92
2.3
103
2.7
100 3850
100
>1
previous
CS
Total
64 |
3754
100 3967
100 4047
100 3999
100 3995
100 3891
100 3917
7.5 Smoking
The Ministry of Health have defined a 90% target for
women who identify as smokers at the time of their
pregnancy confirmation. These women should be
offered advice and support to quit smoking when
booking with their LMC or visiting their general
practitioner.
The smoking rate for all women in 2012 was 10.4%, but
Mori women had a rate of 41% and Pacific women a
rate of 18.7%. In 2011 National Womens reported an
overall rate of 6.6% at booking and rates of 34.5% for
Mori women and 13.5% for Pacific women (Auckland
District Health Board 2012).
Young women under 25 years had high smoking rates
with a combined rate of 30.3%. National Womens
reported a rate of 19.8% in 2011 for all women 25
years and younger.
< 20
20 24
25 29
30 34
35 39
40
Total
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
NZ
European
14
26.9
48
24.5
24
6.8
18
2.8
11
2.0
3.0
119
6.2
Other
European
Ethnicity
Mori
Pacific
Peoples
Asian
Other
Total
52
196
0.0
3
41
53.9
22.9
50.0
172
23
0.0
27.1
139
498
45
20
2.1
38.8
18.7
97
826
21
12
1.8
30.0
16.0
56
1205
15
1.0
24.2
7.7
33
904
0.0
47.1
5.6
13
245
197
41.0
67
18.7
359
0.0
1.3
535
0.0
7
3.7
2.4
481
30
0.0
11
461
18
23
4.6
0.0
17
81
0.0
1912
41
39
28
11.7
2.5
62
206
3.7
132
159
75
27
27.9
1.6
70
169
0.0
540
186
107
13
37.2
7.3
116
47
4
64
47.9
85
2
0
67
640
55
140
35
1
0.0
17
76
8
352
1.0
102
5.3
402
10.4
3850
| 65
Other
Total
66 |
2005
2006
2007
2008
2009
2010
2011
2012
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
Num
Den
Rate
%
185
8.9
196
9.0
201
9.6
169
8.2
158
7.7
154
7.9
141
7.2
119
6.2
2069
12
2169
3.6
331
238
45.9
27.3
2.0
3754
81
4.9
20.6
550
3967
243
103
2.1
43.9
26.1
581
4047
248
89
2.0
11
44.1
22.9
536
3999
236
92
2.7
44.4
22.6
510
3995
236
83
2.2
45.0
21.4
492
3891
193
87
0.9
39.5
22.8
448
3917
197
41.0
67
18.7
359
1.0
1.3
535
1.9
107
12.6
2.4
481
486
3.6
11
461
385
137
12.8
4.0
488
440
4.0
20
1912
497
387
125
13.4
2.2
525
412
3.5
10
1954
456
407
144
14.4
2.2
531
405
4.1
10
1946
462
389
171
13.9
3.2
562
400
2.3
14
2058
440
394
88
14.6
4.3
553
373
122
549
44.6
393
343
6
242
19
2059
440
543
370
7
5.2
401
519
101
21
2089
1.0
102
11.4
402
3850
10.4
< 20
No.
20 24
%
No.
25 29
No.
30 34
No.
35 39
No.
40
No.
Total
%
No.
4.6
18
3.9
39
4.9
41
3.5
17
1.9
1.7
126
3.4
19 25
76
50.3
201
43.4
384
48.6
669
56.8
476
53.8
115
48.9
1921
51.9
26 30
47
31.1
127
27.4
199
25.2
298
25.3
245
27.7
76
32.3
992
26.8
31 35
14
9.3
64
13.8
89
11.3
106
9.0
86
9.7
24
10.2
383
10.3
36 40
2.6
34
7.3
47
5.9
42
3.6
28
3.2
3.8
164
4.4
41 45
1.3
14
3.0
17
2.2
10
0.8
24
2.7
1.7
71
1.9
> 45
0.7
1.1
15
1.9
12
1.0
1.0
1.3
45
1.2
151
100
463
100
790
100
1178
100
885
100
235
100
3702
100
Total
* BMI = Weight (kg) / Height (m ). BMI calculated from booking weights and heights. Missing data is excluded from the table
(3.9% of the total women for 2012)
2
NZ
European
Other
European
BMI *
No.
No.
< 19
Pacific
Peoples
Mori
No.
No.
Asian
No.
Other
No.
Total
No.
49
2.6
17
3.8
1.4
0.3
49
9.4
4.0
126
3.4
19 25
1045
56.1
272
60.7
151
34.7
51
15.2
347
66.9
55
54.5
1921
51.9
26 30
492
26.4
113
25.2
147
33.8
106
31.6
100
19.3
34
33.7
992
26.8
31 35
170
9.1
31
6.9
70
16.1
87
26.0
19
3.7
5.9
383
10.3
36 40
61
3.3
2.0
35
8.0
57
17.0
0.4
0.0
164
4.4
41 45
28
1.5
1.1
15
3.4
21
6.3
0.2
1.0
71
1.9
> 45
Total
19
1.0
0.2
11
2.5
12
3.6
0.2
1.0
45
1.2
1864
100
448
100
435
100
335
100
519
100
101
100
3702
100
* BMI = Weight (kg) / Height2 (m2). BMI calculated from booking weights and heights. Missing data is excluded from the table (3.9% of the
total women for 2012)
| 67
2008
2009
2010
2011
2012
Trimester at booking
No.
No.
No.
No.
No.
2122
53.1
2267
56.7
2256
58.0
2339
59.7
2444
63.5
1282
32.1
1184
29.6
1126
28.9
1124
28.7
931
24.2
274
6.9
232
5.8
222
5.7
186
4.7
195
5.1
321
8.0
312
7.8
287
7.4
268
6.8
280
7.3
3999
100
3995
100
3891
100
3917
100
3850
100
+0
Total
68 |
Wellington
LMC at booking
No.
No.
No.
No.
2455
70.7
245
100.0
135
100.0
2835
73.6
320
9.2
320
8.3
144
4.1
144
3.7
229
6.6
229
5.9
322
9.3
322
8.4
3470
100
3850
100
Midwife LMC
Total
Kenepuru
245
Paraparaumu
100
135
100
C&C DHB
2008
LMC at Booking
2009
2010
2011
2012
No.
No.
No.
No.
No.
2812
70.3
2813
70.4
2683
68.9
2660
67.9
2835
73.6
264
6.6
371
9.3
396
10.2
361
9.2
320
8.3
404
10.1
300
7.5
300
7.7
261
6.7
144
3.7
219
5.5
165
4.1
159
4.1
253
6.5
229
5.9
Hospital Secondary/Tertiary
300
7.5
346
8.7
353
9.1
382
9.8
322
8.4
3999
100
3995
100
3891
100
3917
100
3850
100
Midwife LMC
Total
Midwife LMC
Hospital
Midwifery
Primary Care
Obstetrician
& Midwife
LMC
Obstetrician
& Hospital
Midwifery
Shared Care
Ethnicity
No.
NZ European
1397
49.3
108
33.8
101
70.1
159
69.4
Other European
334
11.8
40
12.5
19
13.2
36
Mori
371
13.1
29
9.1
0.7
Pacific Peoples
280
9.9
46
14.4
Asian
384
13.5
83
25.9
Other
69
2.4
14
Total
2835
100
320
No.
No.
No.
Hospital
Secondary /
Tertiary
No.
Total
No.
147
45.7
1912
49.7
15.7
32
9.9
461
12.0
2.2
75
23.3
481
12.5
0.7
0.0
32
9.9
359
9.3
17
11.8
23
10.0
28
8.7
535
13.9
4.4
3.5
2.6
2.5
102
2.6
100
144
100
229
100
322
100
3850
100
| 69
Midwife
LMC
Mothers
Parity
No.
Primiparous
1284
45.3
160
50.0
66
45.8
105
45.9
Multip. & no CS
1173
41.4
109
34.1
53
36.8
87
38.0
378
13.3
51
15.9
25
17.4
37
2835
100
320
100
144
100
229
Multip. prev. CS
Total
No.
Obstetrician
& Hospital
Midwifery
Shared Care
Obstetrician
& Midwife
LMC
No.
No.
Hospital
Secondary /
Tertiary
No.
Total
No.
126
39.1
1741
45.2
119
37.0
1541
40.0
16.2
77
23.9
568
14.8
100
322
100
3850
100
NZ
European
Other
European
Parity
No.
No.
Mori
No.
Pacific
Peoples
No.
Asian
No.
Other
No.
Total
No.
52
48.1
20
50.0
11
37.9
23
50.0
46
55.4
57.1
160
50.0
40
37.0
14
35.0
27.6
19.6
28
33.7
14.3
101
31.6
13
12.0
10.0
20.7
15.2
9.6
14.3
40
12.5
0.9
5.0
3.4
8.7
1.2
0.0
2.8
1.9
0.0
3.4
6.5
0.0
7.1
2.2
>4
0.0
0.0
6.9
0.0
0.0
7.1
0.9
108
100
40
100
29
100
46
100
83
100
14
100
320
100
Total
70 |
8. Antenatal complications
| 71
< 20
20 24
25 29
30 34
35 39
40
Total
No.
No.
No.
No.
No.
No.
No.
< 24 weeks
1.7
0.6
0.8
11
0.9
0.7
0.0
30
0.8
24 27
1.2
1.6
10
1.2
13
1.1
1.0
2.9
49
1.3
28 31
4.1
13
2.6
16
1.9
15
1.2
14
1.5
2.9
72
1.9
+6
32 35
3.5
16
3.2
33
4.0
39
3.2
32
3.5
12
4.9
138
3.6
36+0 36+6
2.3
20
4.0
29
3.5
28
2.3
34
3.8
3.7
124
3.2
12
7.0
24
4.8
33
4.0
39
3.2
29
3.2
14
5.7
151
3.9
22
12.8
60
12.0
95
11.5
106
8.8
95
10.5
35
14.3
413
10.7
+0
+0
+0
+6
+6
NZ
European
Other
European
Gestation
No.
No.
No.
No.
No.
No.
No.
< 24 weeks
13
0.7
0.2
1.9
0.6
0.9
0.0
30
0.8
24+0 27+6
26
1.4
1.3
12
2.5
0.6
0.6
0.0
49
1.3
28+0 31+6
31
1.6
10
2.2
15
3.1
1.9
1.1
2.9
72
1.9
32+0 35+6
71
3.7
11
2.4
18
3.7
15
4.2
17
3.2
5.9
138
3.6
36 36
58
3.0
1.3
16
3.3
12
3.3
28
5.2
3.9
124
3.2
70
3.7
17
3.7
36
7.5
11
3.1
14
2.6
2.9
151
3.9
199
10.4
34
7.4
70
14.6
38
10.6
59
11.0
13
12.7
413
10.7
+0
72 |
+6
Pacific
Peoples
Mori
Asian
Other
Total
Total
births
Fetal
deaths
Live
births
% Live births
of Total
Neonatal deaths
< 28 days
% of live births
surviving 28 days
20
0.0
0.0
21
0.0
0.0
22
12
11
8.3
0.0
23
44.4
75.0
24
11
72.7
100.0
25
11
81.8
100.0
26
21
17
91.0
100.0
27
14
13
92.9
92.3
28
17
17
100.0
88.2
29
13
13
100.0
100.0
30
27
26
96.3
96.2
31
27
27
100.0
96.3
32
19
18
94.7
100.0
33
32
32
100.0
100.0
34
43
42
97.7
97.6
35
66
66
100.0
100.0
36
134
134
100.0
100.0
Total
466
39
427
91.6
98.1
| 73
2003
No.
2004
%
No.
2005
%
No.
2006
%
No.
2007
%
No.
2008
%
No.
2009
%
No.
2010
%
No.
2011
%
No.
2012
%
No.
84 2.14
91 2.46
81 2.16
72 1.81
93 2.30
88 2.20
81 2.03
88 2.26
78 1.99
66 1.71
Triplet
4 0.10
3 0.08
1 0.03
1 0.03
2 0.05
2 0.05
4 0.10
3 0.08
3 0.08
2 0.05
Total
88 2.24
94 2.54
82 2.18
73 1.84
95 2.35
90 2.25
85 2.13
91 2.34
81 2.07
68 1.77
74 |
Figure 7: Labour and birth branch diagram for all women with
multiple pregnancies for 2012
Pre-labour CS
31 / 51 = 60.8%
CS
Pre-term
51 / 68 = 75.0%
NVB
AVB
CS
31
Spontaneous Labour
41 / 51 = 27.5%
5
9
9.8%
17.6%
NVB
AVB
37
72.5%
CS
51 100%
100.0%
45.6
% of
Total No.
4
7
26.8%
50.0%
5.9
10.3
21.4%
4.4
20.6
14 100%
% of
Total No.
Induced Labour
6 / 51 = 11.8%
% of
Total No.
NVB
1
16.7%
AVB
2
33.3%
CS
3
50.0%
6 100%
1.5
2.9
4.4
8.8
Pre-labour CS
6 / 17 = 35.3%
% of
Total No.
8.8
CS 47 69.1%
68 100%
CS
Term
17 / 68 = 25.0%
NVB
AVB
CS
2 11.8%
5
29.4%
10
58.8%
17 100%
100%
Spontaneous Labour
0 / 17 = 0.0%
% of
Total No.
NVB 0 0.0%
AVB
0
0.0%
0.0
0.0
CS
0 0%
0.0
0.0
0.0%
Induced Labour
11 / 17 = 64.7%
NVB
AVB
CS
% of
Total No.
2
5
18.2%
45.5%
2.9
7.4
36.4%
5.9
16.2
11 100%
100
| 75
Type 2
Number
Of total births
Number
Of total births
NZ European
58
1912
3.0
1912
0.1
Other European
15
461
3.3
461
0.0
Mori
10
481
2.1
481
1.0
Pacific Peoples
18
359
5.0
359
1.4
Asian
51
535
9.5
535
0.6
Other
102
5.9
102
0.0
Total
158
3850
4.1
15
3850
0.4
Type 1
Type 2
Total
No.
No.
No.
No.
NZ European
72
37.9
18
78.3
17.9
95
39.4
Other European
16
8.4
4.3
0.0
17
7.1
Mori
13
6.8
4.3
25.0
21
8.7
Pacific Peoples
23
12.1
8.7
10
35.7
35
14.5
Asian
59
31.1
4.3
21.4
66
27.4
Other
3.7
0.0
0.0
2.9
Total
190
100
23
100
28
100
241
100
76 |
Gestational
Type 1
No.
Type 2
No.
Normal
71
44.9
16.7
Forceps
5.7
Ventouse
3.2
Manual rotation
Breech
No.
Total
%
No.
40.0
79
42.7
0.0
0.0
4.9
0.0
0.0
2.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
85
53.8
16.7
40.0
93
50.3
Emergency
45
28.5
25.0
26.7
52
28.1
Elective
28
17.7
58.3
33.3
40
21.6
73
46.2
10
83.3
60.0
92
49.7
158
100
12
100
15
100
185
100
Vaginal
Caesarean
Total
| 77
2011
Category
No.
Screening
153
29.4
Multiple pregnancy
22
No.
93
17.7
104
21.7
4.2
38
7.2
15
3.1
13
2.5
15
2.9
1.3
21
4.0
27
5.1
29
6.1
New (Others)
312
59.9
322
61.2
294
61.4
Telemedicine
0.0
31
5.9
31
6.5
521
100
526
100
479
100
Follow up visits
737
718
695
3.1
2.4
3.0
78 |
No.
2012
2009
2010
2011
2012
Scan or procedure
No.
No.
No.
No.
No.
863
20.5
750
18.8
460
13.3
410
12.1
507
14.0
2707
64.3
2578
64.5
2461
71.4
2483
73.3
2555
70.9
Morphology scan
643
15.3
668
16.7
528
15.3
496
14.6
544
15.1
Total Obstetrics
4213
100
3996
100
3449
100
3389
100
3606
100
MFM scan
1081
76.8
1426
83.5
1327
83.8
1354
87.4
1151
86.2
186
13.2
172
10.1
133
8.4
102
6.6
105
7.9
89
6.3
77
4.5
55
3.5
45
2.9
52
3.9
0.3
0.1
0.4
0.1
0.1
0.6
0.5
21
1.3
13
0.8
0.3
Amnio drainage
0.5
0.5
19
1.2
13
0.8
0.5
Amnio infusion
0.0
0.1
0.1
0.0
0.0
Platelet transfusion
0.1
0.1
0.3
0.0
0.1
Shunt
0.1
0.0
0.1
0.1
0.0
Embryo reduction/fetocide
0.6
0.4
10
0.6
12
0.8
11
0.8
20
1.4
0.2
0.4
0.5
0.2
Total MFM
1407
100
1708
100
1584
100
1549
100
1335
100
Gynaecology
1475
Amniocentesis
Chorionic villus sampling
Other sampling
1485
1547
1451
1456
| 79
No.
2009
%
No.
2010
%
No.
2011
%
No.
2012
%
No.
1.5
2.4
42
22.3
58
39.5
57
36.3
117
42.5
91
36.5
32
17.0
16
10.9
17
10.8
0.7
26
10.4
31
16.5
2.7
10
6.4
123
44.7
123
49.4
105
55.9
78
53.1
84
53.5
Previous chromosomally
abnormal child
2.9
14
5.6
3.2
6.1
5.7
50
18.2
18
7.2
2.7
1.4
1.9
Maternal anxiety
11
4.0
10
4.0
3.7
2.7
2.5
Subtotal
69
25.1
42
16.9
18
9.6
15
10.2
16
10.2
13
4.7
13
5.3
4.3
12
8.2
5.7
1.1
0.4
2.1
1.4
0.6
Subtotal
16
5.8
14
5.6
12
6.4
14
9.5
10
6.4
Fetal abnormality
39
14.2
34
13.7
30
16.0
13
8.8
17
10.8
Abnormalities on 20 week
scan
15
5.5
19
7.6
16
8.5
10
6.8
13
8.3
1.1
2.0
3.7
12
8.2
13
8.3
57
20.7
58
23.3
53
28.2
35
23.8
43
27.4
3.4
2.5
188
100
147
100
157
100
Increased risk on NT
Increased risk on maternal
serum screen
Subtotal
Carrier of balanced
translocation
Abnormalities on
subsequent scan
Subtotal
Other or not specified
Total
10
3.6
12
4.8
275
100
249
100
80 |
Table 42: Outcomes after Amniocentesis and CVS for 2011 and
2012 (Jan-Sep)
Outcome
2011
2012
No.
No.
0.5
0.0
TOP
42
22.2
34
21.9
Trisomy 21
10
5.3
14
9.0
Trisomy 18
4.2
5.2
Trisomy 13
1.1
1.9
Turners
2.1
0.0
Other
0.5
3.2
Stillbirth
1.6
2.6
Livebirth
113
59.8
79
51.0
2.6
5.2
189
100
155
100
Miscarriage
Not known
Total
| 81
82 |
All women
Primiparous women
| 83
2003
No.
2004
No.
2005
No.
2006
No.
2007
No.
2008
No.
2009
No.
2010
No.
2011
No.
2012
No.
Vaginal
Normal
2420 61.6 2270 61.3 2278 60.7 2338 58.9 2413 59.6 2438 61.0 2442 61.1 2300 59.1 2226 56.8 2224 57.8
Forceps
238
6.1
191
5.2
200
5.3
243
6.1
232
5.7
222
5.6
187
4.7
227
5.8
259
6.6
215
5.6
Ventouse
173
4.4
166
4.5
212
5.6
164
4.1
199
4.9
205
5.1
245
6.1
174
4.5
198
5.1
192
5.0
Manual
Rotation
0.1
0.0
0.0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
Breech
25
0.6
20
0.5
19
0.5
33
0.8
26
0.6
19
0.5
28
0.7
38
1.0
25
0.6
27
0.7
Total
Vaginal
2860 72.8 2648 71.5 2710 72.2 2780 70.1 2870 70.9 2885 72.1 2902 72.6 2739 70.4 2709 69.2 2659 69.1
Caesarean
Emergency
707 18.0
743 20.1
722 19.2
787 19.8
790 19.5
735 18.4
686 17.2
717 18.4
780 19.9
758 19.7
Elective
360
312
322
400 10.1
387
379
407 10.2
435 11.2
428 10.9
433 11.2
9.2
8.4
8.6
9.6
9.5
Total
1067 27.2 1055 28.5 1044 27.8 1187 29.9 1177 29.1 1114 27.9 1093 27.4 1152 29.6 1208 30.8 1191 30.9
Caesarean
Total
84 |
3927
100 3703
100 3754
100 3967
100 4047
100 3999
100 3995
100 3891
100 3917
100 3850
100
Figure 8: Mode of birth group rates for years 1997 to 2012, for
all C&C DHB facilities combined
Normal
80.0 %
CS
Assisted
70.0 %
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
1997
1998
1999
2007
2008
2009
2010 2011
2012
| 85
< 20
20 24
25 29
30 34
40
35 39
Total
No.
No.
No.
No.
No.
No.
No.
Normal
116
67.4
330
66.3
494
59.8
692
57.4
481
53.2
111
45.3
2224
57.8
Forceps
11
6.4
25
5.0
44
5.3
73
6.1
51
5.6
11
4.5
215
5.6
Ventouse
5.2
25
5.0
49
5.9
73
6.1
31
3.4
2.0
192
5.0
Manual rotation
0.0
0.0
0.0
0.1
0.0
0.0
0.0
Breech
0.6
0.2
0.8
0.7
0.8
0.8
27
0.7
137
79.7
381
76.5
594
71.9
848
70.4
570
63.1
129
52.7
2659
69.1
32
18.6
89
17.9
158
19.1
218
18.1
191
21.1
70
28.6
758
19.7
1.7
28
5.6
74
9.0
139
11.5
143
15.8
46
18.8
433
11.2
35
20.3
117
23.5
232
28.1
357
29.6
334
36.9
116
47.3
1191
30.9
172
100
498
100
826
100
1205
100
904
100
245
100
3850
100
Vaginal
Caesarean
Emergency
Elective
Total
NZ
European
Other
European
Mode
No.
No.
No.
No.
No.
Normal
1091
57.1
238
51.6
309
64.2
243
67.7
294
55.0
Forceps
110
5.8
34
7.4
18
3.7
11
3.1
32
Ventouse
99
5.2
31
6.7
17
3.5
10
2.8
0.0
0.2
0.0
14
0.7
0.7
1.5
1314
68.7
307
66.6
351
Emergency
378
19.8
96
20.8
Elective
220
11.5
58
598
31.3
1912
100
Mori
Pacific
Peoples
Asian
Other
No.
Total
No.
49
48.0
2224
57.8
6.0
10
9.8
215
5.6
29
5.4
5.9
192
5.0
0.0
0.0
0.0
0.0
0.0
0.6
0.0
27
0.7
73.0
264
73.5
358
66.9
65
63.7
2659
69.1
85
17.7
61
17.0
112
20.9
26
25.5
758
19.7
12.6
45
9.4
34
9.5
65
12.1
11
10.8
433
11.2
154
33.4
130
27.0
95
26.5
177
33.1
37
36.3
1191
30.9
461
100
481
100
359
100
535
100
102
100
3850
100
Vaginal
Manual rotation
Breech
Caesarean
Total
86 |
Figure 9: Labour and birth branch diagram for all women for
2012
Pre-labour CS
154 / 413 = 37.3%
CS
Pre-term
413 / 3850 = 10.7%
155
42
37.5%
10.2%
NVB
AVB
CS
216
52.3%
CS
All Women
Total No. = 3850
NVB 2224 57.8%
AVB
435
11.3%
100.0%
Spontaneous Labour
144 / 413 = 34.9%
NVB
AVB
413 100%
154
4.0
% of
Total No.
92
22
63.9%
15.3%
2.4
0.6
30
20.8%
0.8
3.7
144 100%
% of
Total No.
Induced Labour
115 / 413 = 27.8%
% of
Total No.
NVB
63
54.8%
AVB
20
17.4%
CS
32
27.8%
115 100%
1.6
0.5
0.8
3.0
Pre-labour CS
448 / 3437 = 13.0%
% of
Total No.
CS 1191 30.9%
3850 100%
CS
Term
3437 / 3850 = 89.3%
448
100%
Spontaneous Labour
2011 / 3437 = 58.5%
11.6
% of
Total No.
NVB 1532
AVB
225
76.2%
11.2%
39.8
5.8
CS
CS
12.6%
6.6
52.2
975
28.4%
3437 100%
254
2011 100%
Induced Labour
978 / 3437 = 28.5%
NVB
AVB
% of
Total No.
537
168
54.9%
17.2%
13.9
4.4
CS
273
27.9%
978 100%
7.1
25.4
100
Labour
No.
Spontaneous
Induced
2155
1093
56.0
28.4
Pre-labour CS
Total
602
3850
15.6
100
| 87
56
Spontaneous Labour
72 / 181 = 39.8%
NVB
AVB
69
22
38.1%
12.2%
NVB
AVB
CS
90
49.7%
181 100%
Primiparous
No. = 1741
NVB 810 46.5%
AVB
342
19.6%
100.0%
% of
Primip No.
3.2
% of
Primip No.
46
12
63.9%
16.7%
2.6
0.7
CS
14
19.4%
72 100%
0.8
4.1
Induced Labour
53 / 181 = 29.3%
% of
Primip No.
NVB
23
43.4%
AVB
10
18.9%
CS
20
37.7%
53 100%
1.3
0.6
1.1
3.0
Pre-labour CS
100 / 1560 = 6.4%
% of
Primip No.
CS 589 33.8%
1741 100%
CS
100
100%
5.7
Term
1560 / 1741 = 89.6%
Spontaneous Labour
882 / 1560 = 56.5%
% of
Primip No.
30.4
10.5
CS
CS
171
882 100%
9.8
50.7
499
32.0%
1560 100%
19.4%
Induced Labour
578 / 1560 = 37.1%
NVB
AVB
% of
Primip No.
212
138
36.7%
23.9%
12.2
7.9
CS
228
39.4%
578 100%
13.1
33.2
100
Labour
No.
Spontaneous
Induced
954
631
54.8
36.2
Pre-labour CS
Total
156
1741
9.0
100
88 |
50
Spontaneous Labour
56 / 161 = 34.8%
NVB
AVB
78
14
48.4%
8.7%
NVB
AVB
CS
69
42.9%
CS
161 100%
Multiparous without
previous CS No. = 1541
NVB 1317 85.5%
AVB
53
3.4%
100%
3.2
% of
Multip No.
41
6
73.2%
10.7%
2.7
0.4
16.1%
0.6
3.6
56 100%
% of
Multip No.
Induced Labour
55 / 161 = 34.2%
% of
Multip No.
NVB
37
67.3%
AVB
8
14.5%
CS
10
18.2%
55 100%
2.4
0.5
0.6
3.6
Pre-labour CS
49 / 1380 = 3.6%
% of
Multip No.
CS 171 11.1%
1541 100%
CS
49
100%
3.2
Term
1380 / 1541 = 89.6%
Spontaneous Labour
974 / 1380 = 70.6%
% of
Multip No.
60.2
1.2
CS
CS
1.8
63.2
102
7.4%
1380 100%
27
2.8%
974 100%
Induced Labour
357 / 1380 = 25.9%
NVB
AVB
CS
% of
Multip No.
311
20
87.1%
5.6%
20.2
1.3
26
7.3%
1.7
23.2
357 100%
100
Labour
No.
Spontaneous
Induced
1030
412
66.8
26.7
Pre-labour CS
Total
99
1541
6.4
100
| 89
48
Spontaneous Labour
16 / 71 = 22.5%
8
6
11.3%
8.5%
NVB
AVB
57
80.3%
CS
71 100%
Multiparous with
previous CS No. = 568
NVB 97 17.1%
AVB
40
7.0%
100%
8.5
% of
Multip No.
5
4
31.3%
25.0%
0.9
0.7
43.8%
1.2
2.8
16 100%
% of
Multip No.
Induced Labour
7 / 71 = 9.9%
% of
Multip No.
NVB
AVB
3
2
42.9%
28.6%
0.5
0.4
CS
28.6%
7 100%
0.4
1.2
Pre-labour CS
299 / 497 = 60.2%
% of
Multip No.
CS 431 75.9%
568 100%
CS
299
100%
52.6
Term
497 / 568 = 87.5%
Spontaneous Labour
155 / 497 = 31.2%
% of
Multip No.
NVB 89 17.9%
AVB
34
6.8%
NVB 75 48.4%
AVB
24
15.5%
13.2
4.2
CS
CS
9.9
27.3
374
75.3%
497 100%
56
36.1%
155 100%
Induced Labour
43 / 497 = 8.7%
NVB
AVB
% of
Multip No.
14
10
32.6%
23.3%
2.5
1.8
CS
19
44.2%
43 100%
3.3
7.6
100
Labour
No.
Spontaneous
Induced
171
50
30.1
8.8
Pre-labour CS
Total
347
568
61.1
100
90 |
Figure 13: Mode of birth group by age group for all women
for 2012
80.0 %
Normal
CS
Assisted
70.0 %
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
< 20 yrs
20 - 24 yrs
25 - 29 yrs
30 - 34 yrs
35 - 39 yrs
40 yrs
(The numbers and percentages for this figure are in Table 118 in the Appendices).
70.0 %
CS
Assisted
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
< 20 yrs
20 - 24 yrs
25 - 29 yrs
30 - 34 yrs
35 - 39 yrs
40 yrs
(The numbers and percentages for this figure are in Table 119 in the Appendices).
| 91
100.0 %
CS
Assisted
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
< 20 yrs
20 - 24 yrs
25 - 29 yrs
30 - 34 yrs
35 - 39 yrs
40 yrs
(The numbers and percentages for this figure are in Table 120 in the Appendices).
100.0 %
CS
Assisted
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
< 20 yrs
20 - 24 yrs
25 - 29 yrs
30 - 34 yrs
35 - 39 yrs
(The numbers and percentages for this figure are in Table 121 in the Appendices).
NB The 100% CS rate for the < 20 years group is for 3 women who have had one or more previous CS.
92 |
40 yrs
2.1
C&C
2011
C&C
2012
ACHS
2010
ACHS
2011
ACHS
2012
Clinical Indicator
Period
Rate (%) Rate (%) Rate (%) Rate (%) Rate (%) Rate (%)
Jan-Jun
26.67
20.69
19.89
20.11
19.27
18.55
Jul-Dec
21.74
22.95
27.68
21.87
18.29
19.43
| 93
Normal
birth
Elective CS
for previous
CS
Emergency
CS in
established
labour
2005
2006
2007
2008
2009
2010
2011
2012
Num.
Den.
Rate Num.
% Den.
Rate Num.
% Den.
Rate Num.
% Den.
Rate Num.
% Den.
Rate Num.
% Den.
Rate Num.
% Den.
Rate Num.
% Den.
Rate
%
1625
43.3
41.2
42.2
44.1
41.6
40.8
38.7
39.8
3754
155
3967
48.1
322
503
189
69.7
561
47.3
784
198
71.3
555
51.2
774
190
70.3
535
50.1
710
227
72.8
473
55.8
688
257
69.0
486
59.1
720
217
67.8
540
50.7
790
241
55.7
433
69.2
780
21.8
1532
3850
428
717
19.9
1517
3917
435
686
20.8
1586
3891
407
735
22.2
1661
3995
379
790
22.9
1765
3999
387
787
21.1
1709
4047
400
722
688
1634
522
68.9
758
23.5
760
23.2
Primary CS
3268
477
3429
12.7
473
3485
11.9
493
3416
12.2
459
3463
11.5
514
3306
12.9
551
3365
14.2
550
3282
14.0
522
13.6
Episiotomy
3754
3967
4047
3999
3995
3891
3917
3850
* Definitions:
Normal birth - defined as women who went to term and had a spontaneous labour and had a normal vaginal birth (see branch diagrams in
Labour and Birth section).
Elective CS for previous CS - Proportion of total elective CS performed when the primary documented indication is an obstetric history of one
or more previous CS.
Emergency CS in established labour - Proportion of total emergency CS performed in established labour
Primary CS - Number of women having their first CS, divided by total number of women without a previous CS.
94 |
Primiparous
Multiparous, no
previous CS
Multiparous,
with previous
CS
Total
Primary indication
No.
No.
No.
No.
Postdates
168
26.6
104
25.2
14
28.0
286
26.2
Prelabour SRM
101
16.0
55
13.3
10
20.0
166
15.2
Hypertension
63
10.0
20
4.9
2.0
84
7.7
Diabetes
53
8.4
28
6.8
4.0
83
7.6
Maternal disease
30
4.8
25
6.1
2.0
56
5.1
Maternal request
0.3
16
3.9
2.0
19
1.7
Antepartum haemorrhage
1.0
0.5
2.0
0.8
Multiple gestation
10
1.6
1.2
0.0
15
1.4
IUGR
42
6.7
34
8.3
2.0
77
7.0
61
9.7
34
8.3
6.0
98
9.0
Fetal abnormality
10
1.6
1.5
2.0
17
1.6
0.6
10
2.4
0.0
14
1.3
81
12.8
73
17.7
15
30.0
169
15.5
631
100
412
100
50
100
1093
100
36.2
412
1541
26.7
50
568
8.8
1093
3850
28.4
631
1741
| 95
Primiparous
Postdates
Prelabour SRM
Hypertension
Abnormal fetal
monitoring
Diabetes
All Indications
96 |
Multiparous, no
previous CS
Multiparous,
with previous
CS
Total
No.
No.
No.
No.
NVB
55
32.7
92
88.5
7.1
148
51.7
AVB
36
21.4
4.8
28.6
45
15.7
CS
77
45.8
6.7
64.3
93
32.5
168
100
104
100
14
100
286
100
NVB
48
47.5
47
85.5
60.0
101
60.8
AVB
17
16.8
5.5
10.0
21
12.7
CS
36
35.6
9.1
30.0
44
26.5
101
100
55
100
10
100
166
100
NVB
21
33.3
14
70.0
0.0
35
41.7
AVB
20
31.7
10.0
0.0
22
26.2
CS
22
34.9
20.0
100.0
27
32.1
63
100
20
100
100
84
100
NVB
21
34.4
28
82.4
66.7
51
52.0
AVB
15
24.6
5.9
0.0
17
17.3
CS
25
41.0
11.8
33.3
30
30.6
61
100
34
100
100
98
100
NVB
17
32.1
28
100.0
50.0
46
55.4
AVB
11
20.8
0.0
0.0
11
13.3
CS
25
47.2
0.0
50.0
26
31.3
53
100
28
100
100
83
100
NVB
235
37.2
348
84.5
17
34.0
600
54.9
AVB
148
23.5
28
6.8
12
24.0
188
17.2
CS
248
39.3
36
8.7
21
42.0
305
27.9
631
100
412
100
50
100
1093
100
34
Spontaneous Labour
18 / 66 = 27.3%
NVB
AVB
0
20
0.0%
30.3%
NVB
AVB
CS
46
69.7%
66 100%
100%
NVB 0
AVB
24
0.0%
16.7%
CS 120
83.3%
23.6
% of
Total No.
0
7
0.0%
38.9%
0.0
4.9
CS
11
61.1%
18 100%
7.6
12.5
Induced Labour
14 / 66 = 21.2%
NVB
AVB
% of
Total No.
% of
Total No.
0
13
0.0%
92.9%
0.0
9.0
7.1%
14 100%
0.7
9.7
Pre-labour CS
62 / 78 = 79.5%
% of
Total No.
CS
144 100%
CS
62
100%
43.1
Term
78 / 144 = 54.2%
Spontaneous Labour
11 / 78 = 14.1%
% of
Total No.
NVB 0 0.0%
AVB
4
5.1%
NVB 0 0.0%
AVB
3
27.3%
0.0
2.1
CS
CS
5.6
7.6
74
94.9%
78 100%
72.7%
11 100%
Induced Labour
5 / 78 = 6.4%
% of
Total No.
0
1
0.0%
20.0%
0.0
0.7
CS
80.0%
5 100%
2.8
3.5
NVB
AVB
100
| 97
98 |
singleton pregnancy
cephalic presentation
C&C
2011
C&C
2012
ACHS
2010
ACHS
2011
ACHS
2012
Clinical Indicator
Period
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
1.1
Jan-Jun
42.26
39.92
42.05
51.63
48.90
48.28
Jul-Dec
41.34
39.74
39.15
50.16
48.45
47.62
1.2
Jan-Jun
29.64
29.75
31.20
30.32
31.48
31.22
Jul-Dec
29.12
25.82
28.49
30.06
32.30
31.95
1.3
Jan-Jun
20.84
20.54
20.16
24.29
25.25
22.44
Jul-Dec
24.64
24.18
23.16
24.84
25.12
22.28
1.4
Jan-Jun
24.67
27.83
24.81
21.85
24.12
21.54
Jul-Dec
23.22
26.37
28.13
23.51
24.49
22.45
| 99
Table 51: Summary of neuraxial blocks for years 2011 and 2012
2011
2012
No.
No.
1329
33.9
1270
33.0
736
18.8
732
19.0
2098
53.6
2080
54.0
3917
Labour analgesia
Caesarean section 1
3850
Includes only new blocks for caesarean section and does not include epidurals topped up for caesarean section
Epidural
Spinal
(SAB)
Combined
spinal epidural
(CSE)
Total
neuraxial
blocks
General
anaesthesia
Total
requiring
intervention
No.
No.
No.
No.
No.
No.
1215
23
57
1295
33.6
1295
33.6
12
195
525
732
19.0
85
817
21.2
13
21
0.5
21
0.5
1228
231
589
2048
53.2
85
2133
55.4
0.1
Other
Cerclage
0.1
Postpartum
procedure
79
81
16
97
2.5
1228
314
591
2133
106
2239
Total
C&C DHB women
3850
55.4
58.2
WRH women
3470
61.5
64.5
100 |
2012
No.
499
43.1
Forceps
150
13.0
Ventouse
105
9.1
Caesarean section
403
34.8
1157
100
Total
2012
No.
CSE
525
45.1
Spinal
195
16.7
Epidural top up
348
29.9
12
1.0
General anaesthesia
85
7.3
1165
100
Total
| 101
Table 55: Urgency of caesarean section for years 2011 and 2012
CS urgency category
2011
No.
2012
%
No.
85
7.6
103
9.0
474
42.2
436
38.1
112
10.0
130
11.4
333
29.6
298
26.0
No category
120
10.7
177
15.5
1124
100
1144
100
Complications
Accidental dural puncture remains a rare complication
of epidural analgesia with 8 documented cases (0.8%).
One woman had postdural puncture headache (PDPH)
with spinal alone. Twelve epidural blood patches were
performed as treatment for PDPH, of which 3 failed in
the first 48 hours, requiring repeat blood patch.
Numbness or weakness lasting longer than expected
was reported on 0.1% (1 in 1000) of women receiving
neuraxial blocks, while backache requiring analgesia
occurred in 1.1% of women. Side effects from spinal
102 |
Satisfaction
Postnatal follow up on the wards, or a phone call
at home are an important part of anaesthesia
care. Follow up rates are high with 94% of women
documented as giving a response. There has been an
improvement in satisfaction scores, and a decrease in
those reporting intra-operative pain during caesarean
section. Fewer women report poor pain relief during
second stage (4.8% compared with 6.0% in 2011). It
is important to continue use of patient-controlled
epidural analgesia (PCEA) throughout labour and
the low concentrations used mean women can push
adequately and receive adequate analgesia.
Post-caesarean pain relief has continued to be an
important focus, and we now provide leaflets on
postoperative analgesia to all women having caesarean
section, emphasising the use of regular simple
analgesics.
Conclusions
The anaesthesia department continues to provide
an essential service for all women delivering in the
Wellington area. As in the past, 58% of women require
some form of anaesthesia assistance, so antenatal
review is helpful in providing the best service we can.
Clinical Indicator
4.1
Women having a
general anaesthetic for a
caesarean section (L)
C&C
2010
C&C
2011
C&C
2012
ACHS
2010
ACHS
2011
ACHS
2012
Period
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Jan-Jun
7.82
4.82
6.78
7.23
8.64
8.93
Jul-Dec
8.16
6.50
5.18
8.43
7.74
7.97
| 103
Table 57: Age and ethnicity distribution for the women who
gave birth at KMU in 2012
Mothers
NZ
European
Other
European
Age
No.
No.
No.
No.
No.
No.
No.
< 20
6.8
0.0
17
22.1
7.7
5.9
0.0
28
11.4
20 24
13
17.8
8.3
33
42.9
16
24.6
29.4
100.0
69
28.2
25 29
19
26.0
25.0
18
23.4
24
36.9
47.1
0.0
72
29.4
30 34
20
27.4
25.0
7.8
12
18.5
11.8
0.0
43
17.6
35 39
14
19.2
33.3
3.9
6.2
5.9
0.0
26
10.6
2.7
8.3
0.0
6.2
0.0
0.0
2.9
73
100
12
100
77
100
65
100
17
100
100
245
100
No.
Yrs
No.
Yrs
No.
Yrs
No.
Yrs
No.
Yrs
No.
Yrs
No.
Yrs
Primips
18
27.1
32.2
22
19.8
14
23.3
23.8
60
23.5
Multips
55
30.8
10
33.9
55
25.7
51
29.1
13
28.5
24.9
185
28.8
Total
73
29.9
12
33.6
77
24.0
65
27.9
17
27.4
24.9
245
27.5
40
Total
Average age
Pacific
Peoples
Mori
104 |
Asian
Other
Total
The largest age group for all C&C DHB women in 2012
was the 30 to 34 year age group (31% of all ethnicities),
Table 58: Age and ethnicity distribution for the women who
gave birth at PMU in 2012
Mothers
NZ
European
Other
European
Age
No.
No.
< 20
6.7
0.0
25.0
100.0
0.0
0.0
12
8.9
20 24
19
21.1
23.5
20.0
0.0
16.7
0.0
28
20.7
25 29
26
28.9
23.5
25.0
0.0
16.7
0.0
36
26.7
30 34
22
24.4
35.3
15.0
0.0
50.0
0.0
34
25.2
35 39
15
16.7
17.6
5.0
0.0
16.7
100.0
21
15.6
40
Mori
No.
Pacific
Peoples
No.
Asian
No.
Other
No.
Total
No.
2.2
0.0
10.0
0.0
0.0
0.0
3.0
90
100
17
100
20
100
100
100
100
135
100
No.
Yrs
No.
Yrs
No.
Yrs
No.
Yrs
No.
Yrs
No.
Yrs
No.
Yrs
Primips
25
24.0
21.2
21.3
18.5
31.9
36
23.4
Multips
65
31.0
13
32.9
15
28.9
30.7
37.4
99
31.0
Total
90
29.1
17
30.1
20
27.0
30.9
37.4
135
29.0
Total
Average age
18.5
| 105
106 |
Clinical Indicator
Period
C&C
2010
C&C
2011
C&C
2012
ACHS
2010
ACHS
2011
ACHS
2012
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
3.1
Jan-Jun
17.51
20.74
17.27
13.61
15.15
18.12
Jul-Dec
13.26
17.41
16.11
12.54
14.30
16.09
3.2
Jan-Jun
29.44
29.79
27.84
24.33
26.25
25.50
Jul-Dec
34.75
30.60
30.69
25.30
27.76
26.76
3.3
Jan-Jun
44.92
40.96
41.49
53.45
51.24
50.01
Jul-Dec
42.18
41.04
42.46
51.06
49.26
46.69
3.4
Jan-Jun
7.36
8.51
13.40
7.14
7.93
8.15
Jul-Dec
8.49
10.95
10.74
8.45
8.42
9.25
3.5
Jan-Jun
3.05
3.72
5.67
5.55
7.15
7.45
Jul-Dec
4.51
5.22
7.16
6.70
7.33
6.98
3.6
Jan-Jun
0.25
0.53
0.00
0.43
0.36
0.36
Jul-Dec
0.27
0.50
0.77
0.42
0.33
0.43
| 107
Clinical Indicator
7.1
7.2
C&C
2010
C&C
2011
C&C
2012
ACHS
2010
ACHS
2011
ACHS
2012
Period
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Jan-Jun
2.16
1.99
1.93
1.67
1.66
1.86
Jul-Dec
1.99
0.91
2.10
1.75
1.56
1.60
Jan-Jun
5.33
2.25
3.73
2.93
2.69
2.97
Jul-Dec
4.25
2.05
3.01
2.73
2.91
2.16
Table 61: Primary postpartum blood loss for years 2005 to 2012
Mothers
Total blood loss
1000ml
500ml and
< 1000ml
< 500ml
Not stated
Total
108 |
2005
No.
95
%
2.5
757 20.2
2006
No.
137
%
3.5
862 21.7
2007
No.
127
%
3.1
865 21.4
2008
No.
104
%
2.6
790 19.8
2009
No.
139
%
3.5
682 17.1
2010
No.
158
%
4.1
743 19.1
2011
No.
171
%
4.4
905 23.1
2012
No.
203
%
5.3
876 22.8
2790 74.3 2812 70.9 2890 71.4 2946 73.7 3033 75.9 2888 74.2 2765 70.6 2716 70.5
112
3754
3.0
156
100 3967
3.9
165
100 4047
4.1
159
100 3999
4.0
141
100 3995
3.5
102
100 3891
2.6
76
100 3917
1.9
55
1.4
100 3850
100
Clinical Indicator
1.16
Deep incisional/organ/
space surgical site
infection (SSI) in lower
segment caesarean section
procedures (L)
C&C
2010
C&C
2011
C&C
2012
ACHS
2010
ACHS
2011
ACHS
2012
Rate (%)
Rate (%)
Rate (%)
Rate (%)
Rate (%)
Rate (%)
Jan-Jun
1.29
0.68
0.36
0.21
Jul-Dec
1.55
1.00
1.15
0.50
Period
| 109
10.4.1 Gender
Table 63: Gender for years 2005 to 2012
Babies
2005
2006
1894 49.4 2032 50.3 1991 48.0 2032 49.7 2016 49.4 1937 48.6 2013 50.3 1889 48.2
Total
3837
100 4041
No.
0.1
100 4144
No.
0.1
100 4091
No.
0.0
No.
0.0
2012
Female
0.0
2011
1940 50.6 2008 49.7 2150 51.9 2057 50.3 2068 50.6 2048 51.4 1988 49.7 2031 51.8
No.
2010
Male
0.1
2009
No.
No.
2008
Gender
Indeterminate
2007
100 4001
0.0
No.
0.0
10.4.2 Plurality
Table 64: Plurality for years 2005 to 2012
Babies
2005
No.
No.
2009
No.
2010
No.
2011
No.
2012
Singletons
3672 95.7 3894 96.4 3952 95.4 3909 95.6 3910 95.7 3800 95.4 3836 95.9 3782 96.5
Total
2008
No.
Triplets *
No.
2007
Plurality
Twins *
2006
No.
162
4.2
144
3.6
186
4.5
176
4.3
162
4.0
176
4.4
156
3.9
132
3.4
0.1
0.1
0.1
0.1
12
0.3
0.2
0.2
0.2
100 3920
100
3837
100 4041
100 4144
100 4091
100 4084
100 3985
100 4001
110 |
8.1
C&C
2011
C&C
2012
ACHS
2010
ACHS
2011
ACHS
2012
Period
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Jan-Jun
1.50
1.07
1.26
2.00
1.78
1.75
Jul-Dec
1.10
1.23
0.76
1.89
1.67
1.63
< 20
No.
20 24
%
No.
25 29
No.
30 34
No.
35 39
No.
40
No.
Total
%
No.
< 500
1.2
0.6
0.7
0.7
0.9
0.4
28
0.7
500 999
2.9
1.6
14
1.7
16
1.3
11
1.2
3.6
63
1.6
1000 1499
3.5
1.8
11
1.3
12
1.0
0.8
1.2
48
1.2
1500 1999
1.2
13
2.6
20
2.4
25
2.0
20
2.2
2.0
85
2.2
2000 2499
2.9
30
5.9
30
3.6
43
3.5
36
3.9
15
6.0
159
4.1
2500 2999
20
11.6
65
12.8
123
14.6
147
12.0
90
9.8
33
13.1
478
12.2
3000 3499
55
31.8
149
29.4
263
31.2
356
29.0
302
32.9
68
27.1
1193
30.4
3500 3999
58
33.5
158
31.2
255
30.3
431
35.1
293
31.9
71
28.3
1266
32.3
4000 4499
19
11.0
62
12.2
106
12.6
162
13.2
127
13.8
41
16.3
517
13.2
4500 4999
0.6
10
2.0
13
1.5
26
2.1
21
2.3
2.0
76
1.9
5000
0.0
0.0
0.1
0.2
0.4
0.0
0.2
Total
173
100
507
100
842
100
1228
100
919
100
251
100
3920
100
Average
3235
3295
3305
3390
3390
3295
3345
Median
3440
3420
3420
3500
3480
3440
3460
Maximum
4780
4950
5220
5415
5080
4860
5415
| 111
NZ
European
Other
European
Weight (g)
No.
No.
Mori
No.
Pacific
Peoples
No.
Asian
No.
Other
No.
Total
No.
< 500
15
0.8
0.4
1.0
0.3
0.9
0.0
28
0.7
500 999
27
1.4
1.9
17
3.5
1.4
0.7
1.0
63
1.6
1000 1499
29
1.5
0.8
1.8
0.5
0.6
1.0
48
1.2
1500 1999
49
2.5
1.7
12
2.5
2.2
0.9
2.9
85
2.2
2000 2499
72
3.7
15
3.2
19
3.9
11
3.0
32
5.9
10
9.5
159
4.1
2500 2999
192
9.8
52
11.0
65
13.3
44
12.1
115
21.3
10
9.5
478
12.2
3000 3499
564
28.9
137
29.0
149
30.6
106
29.0
197
36.5
40
38.1
1193
30.4
3500 3999
670
34.3
164
34.7
139
28.5
126
34.5
135
25.0
32
30.5
1266
32.3
4000 4499
293
15.0
69
14.6
56
11.5
53
14.5
38
7.0
7.6
517
13.2
4500 4999
37
1.9
11
2.3
15
3.1
1.9
1.1
0.0
76
1.9
0.2
0.2
0.2
0.5
0.0
0.0
0.2
Total
1951
100
472
100
487
100
365
100
540
100
105
100
3920
100
Average
3385
3405
3245
3430
3215
3255
3345
Median
3520
3520
3390
3530
3260
3360
3460
Maximum
5415
5120
5030
5220
4910
4460
5415
5000
112 |
Table 68: Birth weights for liveborn babies for years 2005 to
2012
Babies
Weight (g)
< 500
2005
No.
2006
No.
2007
No.
2008
No.
2009
No.
2010
No.
2011
No.
2012
No.
0.0
0.1
0.1
0.0
0.1
0.1
0.1
0.1
500 999
35
0.9
34
0.9
44
1.1
33
0.8
44
1.1
42
1.1
40
1.0
53
1.4
1000 1499
54
1.4
49
1.2
50
1.2
60
1.5
64
1.6
58
1.5
51
1.3
46
1.2
1500 1999
62
1.6
46
1.2
62
1.5
72
1.8
58
1.4
68
1.7
92
2.3
84
2.2
2000 2499
134
3.5
126
3.2
153
3.7
169
4.2
149
3.7
179
4.5
179
4.5
158
4.1
2500 2999
498
13.1
548
13.7
528
12.9
527
13.0
493
12.2
522
13.2
516
13.0
476
12.3
3000 3499
1214
32.0 1272
31.9 1270
31.0 1316
32.5 1290
32.0 1254
31.7 1297
32.7 1192
30.7
3500 3999
1223
32.2 1318
33.1 1345
32.9 1272
31.4 1315
32.6 1279
32.4 1234
31.2 1266
32.7
4000 4499
492
13.0
487
12.2
519
12.7
502
12.4
511
12.7
465
11.8
464
11.7
517
13.3
4500 4999
71
1.9
95
2.4
105
2.6
88
2.2
90
2.2
75
1.9
77
1.9
76
2.0
5000
14
0.4
0.2
12
0.3
11
0.3
0.2
0.1
0.2
0.2
100
Total
3799
100 3987
100 4093
100 4052
100 4028
100 3951
100 3961
100 3877
Average
3385
3400
3395
3375
3390
3350
3350
3375
Median
3460
3460
3470
3440
3460
3440
3430
3470
Maximum
5650
5180
5880
5520
5370
5680
5300
5415
NB This table includes a few extremely small babies who were neonatal deaths in Delivery Suite soon after birth.
| 113
2005
No.
2006
No.
2007
No.
2008
No.
2009
No.
2010
No.
2011
No.
2012
No.
20
21
0.0
0.0
0.1
22
0.1
0.0
0.0
23
0.1
0.1
0.2
0.1
0.1
24
0.1
0.2
10
0.2
0.1
10
0.2
25
10
0.3
10
0.3
0.2
11
0.3
26
0.1
11
0.3
12
0.3
0.2
27
15
0.4
0.1
10
0.2
14
28
12
0.3
0.1
16
0.4
29
15
0.4
17
0.4
10
30
22
0.6
19
0.5
31
21
0.6
14
32
26
0.7
33
23
34
0.0
1
0.0
0.0
0.2
0.1
0.1
12
0.3
0.1
0.2
0.1
0.2
0.2
0.2
14
0.3
15
0.4
0.2
17
0.4
0.3
15
0.4
0.2
12
0.3
13
0.3
13
0.3
20
0.5
16
0.4
14
0.4
17
0.4
0.2
21
0.5
15
0.4
11
0.3
16
0.4
13
0.3
15
0.4
11
0.3
23
0.6
23
0.6
24
0.6
26
0.7
0.4
25
0.6
19
0.5
18
0.4
29
0.7
25
0.6
27
0.7
12
0.3
18
0.4
29
0.7
17
0.4
31
0.8
29
0.7
18
0.5
0.6
29
0.7
24
0.6
27
0.7
27
0.7
24
0.6
31
0.8
32
0.8
43
1.1
40
1.0
43
1.1
45
1.1
47
1.2
37
0.9
61
1.5
42
1.1
35
64
1.7
69
1.7
61
1.5
90
2.2
70
1.7
91
2.3
80
2.0
66
1.7
36
111
2.9
104
2.6
110
2.7
113
2.8
119
3.0
121
3.1
132
3.3
134
3.5
37
226
5.9
244
6.1
290
7.1
258
6.4
248
6.2
302
7.6
279
7.0
267
6.9
38
616
16.2
659
16.5
633
15.5
655
16.2
595
14.8
647
16.4
604
15.2
583
15.0
39
881
23.2
961
24.1
959
23.4
953
23.5
994
24.7
939
23.8
966
24.4
1008 26.0
40
999
26.3
991
24.9
1035 25.3
1037 25.6
1018 25.3
941
23.8
996
25.1
923
23.8
41
641
16.9
710
17.8
754
18.4
674
16.6
707
17.6
638
16.1
627
15.8
622
16.0
42
60
1.6
73
1.8
50
1.2
59
1.5
55
1.4
47
1.2
40
1.0
46
1.2
0.0
0.1
0.1
0.1
0.1
0.1
0.0
43
Total
3799 100
3987 100
4093 100
4052 100
4028 100
3951 100
NB This table includes a few extremely small babies who were neonatal deaths in Delivery Suite soon after birth.
114 |
3961 100
3877 100
Table 70: Gestational age groups for liveborn babies for years
2005 to 2012
Babies
2005
Gestation
No.
2006
No.
2007
No.
2008
No.
2009
No.
2010
No.
2011
No.
2012
No.
20 23 weeks
0.2
0.1
0.2
0.1
0.2
0.2
0.1
0.1
24 27 weeks
32
0.8
32
0.8
39
0.9
38
0.9
43
1.1
42
1.1
32
0.8
47
1.2
28 31 weeks
70
1.8
55
1.4
66
1.6
64
1.6
76
1.9
79
2.0
79
2.0
83
2.1
32 36 weeks
267
7.0
254
6.4
256
6.3
304
7.5
280
7.0
304
7.7
333
8.4
292
7.5
All preterm
376
9.9
346
8.7
369
9.0
412 10.2
+0
+0
+0
+0
+6
+6
+6
+6
408 10.1
433 11.0
449 11.3
427 11.0
37 41 weeks 3363 88.5 3565 89.4 3671 89.7 3577 88.3 3562 88.4 3467 87.7 3472 87.7 3403 87.8
+0
+6
42+0 weeks
Total
60
1.6
76
1.9
53
1.3
63
1.6
58
1.4
51
1.3
40
1.0
47
1.2
3799 100 3987 100 4093 100 4052 100 4028 100 3951 100 3961 100 3877
100
Clinical Indicator
9.1
C&C
2010
C&C
2011
C&C
2012
ACHS
2010
ACHS
2011
ACHS
2012
Period
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Jan-Jun
0.92
1.64
1.66
1.59
1.62
1.82
Jul-Dec
1.60
1.69
0.86
1.58
1.44
1.66
| 115
< 20
20 24
25 29
30 34
40
35 39
Total
No.
No.
No.
No.
No.
No.
No.
<5
0.0
0.0
0.2
0.2
0.3
0.8
10
0.3
5 or 6
1.2
15
3.0
10
1.2
11
0.9
16
1.8
3.2
62
1.6
7 or 8
14
8.2
34
6.8
58
6.9
92
7.6
69
7.6
19
7.7
286
7.4
9 or 10
154
90.6
454
90.3
767
91.6
1107
91.3
818
90.3
219
88.3
3519
90.8
Total
170
100
503
100
837
100
1213
100
906
100
248
100
3877
100
NZ
European
Other
European
Apgar score
No.
No.
No.
No.
No.
No.
No.
0.3
0.0
0.4
0.3
0.0
1.0
10
0.3
5 or 6
32
1.7
0.6
13
2.7
1.4
0.9
3.8
62
1.6
7 or 8
149
7.7
28
6.0
40
8.3
26
7.2
32
6.0
11
10.5
286
7.4
9 or 10
1745
90.3
436
93.4
425
88.5
328
91.1
496
93.1
89
84.8
3519
90.8
Total
1932
100
467
100
480
100
360
100
533
100
105
100
3877
100
<5
Pacific
Peoples
Mori
Asian
Other
Total
2005
2006
%
No.
2007
%
No.
2008
%
No.
2009
%
No.
2010
%
No.
2011
%
No.
2012
Apgar score
No.
No.
<5
24
0.6
26
0.7
19
0.5
15
0.4
18
0.4
13
0.3
21
0.5
10
0.3
5 or 6
40
1.1
42
1.1
31
0.8
35
0.9
42
1.0
63
1.6
59
1.5
62
1.6
7 or 8
184
4.8
194
4.9
159
3.9
201
5.0
245
6.1
251
6.4
209
5.3
286
7.4
9 or 10
3551 93.5
3725 93.4
3884 94.9
3801 93.8
3723 92.4
3624 91.7
3672 92.7
3519 90.8
Total
3799 100
3987 100
4093 100
4052 100
4028 100
3951 100
3961 100
3877 100
116 |
baby bathing
breastfeeding
immunisations.
| 117
Wellington
Kenepuru
Paraparaumu
C&C DHB
Feeding *
No.
No.
No.
No.
Exclusive
2396
78.6
204
83.3
128
94.8
2728
79.6
Full
114
3.7
0.8
0.0
116
3.4
Partial
456
15.0
22
9.0
3.7
483
14.1
83
2.7
17
6.9
1.5
102
3.0
3049
100
245
100
135
100
3429
100
Artificial
Total
* Numbers are for babies discharged from Delivery Suite, Ward 4 North, Kenepuru Maternity and Paraparaumu Maternity.
118 |
Normal
Forceps
Ventouse
Breech
Emerg. CS
Elect. CS
Total
Feeding *
No.
No.
No.
No.
No.
No.
No.
Exclusive
1810
87.1
137
71.7
152
86.4
42.9
378
64.0
248
64.1
2728
79.6
41
2.0
10
5.2
2.8
0.0
35
5.9
25
6.5
116
3.4
167
8.0
39
20.4
16
9.1
42.9
163
27.6
95
24.5
483
14.1
59
2.8
2.6
1.7
14.3
15
2.5
19
4.9
102
3.0
2077
100
191
100
176
100
100
591
100
387
100
3429
100
Full
Partial
Artificial
Total
* Numbers are for babies discharged from Delivery Suite, Ward 4 North, Kenepuru Maternity and Paraparaumu Maternity.
< 20
20 24
25 29
30 34
40
35 39
Total
Feeding *
No.
No.
No.
No.
No.
No.
No.
Exclusive
112
76.2
355
81.1
603
81.3
878
80.0
629
78.6
151
73.7
2728
79.6
2.7
2.1
26
3.5
38
3.5
31
3.9
3.9
116
3.4
Partial
18
12.2
54
12.3
95
12.8
157
14.3
120
15.0
39
19.0
483
14.1
Artificial
13
8.8
20
4.6
18
2.4
24
2.2
20
2.5
3.4
102
3.0
147
100
438
100
742
100
1097
100
800
100
205
100
3429
100
Full
Total
* Numbers are for babies discharged from Delivery Suite, Ward 4 North, Kenepuru Maternity and Paraparaumu Maternity.
NZ
European
Other
European
Feeding *
No.
No.
No.
No.
No.
No.
No.
Exclusive
1428
84.5
339
81.7
332
80.8
255
77.0
300
61.2
74
80.4
2728
79.6
44
2.6
10
2.4
12
2.9
12
3.6
36
7.3
2.2
116
3.4
185
10.9
52
12.5
39
9.5
46
13.9
146
29.8
15
16.3
483
14.1
33
2.0
14
3.4
28
6.8
18
5.4
1.6
1.1
102
3.0
1690
100
415
100
411
100
331
100
490
100
92
100
3429
100
Full
Partial
Artificial
Total
Pacific
Peoples
Mori
Asian
Other
* Numbers are for babies discharged from Delivery Suite, Ward 4 North, Kenepuru Maternity and Paraparaumu Maternity.
120 |
Total
2010
2011
2012
No.
No.
No.
3988
3882
3903
68
32
19
3779
3677
3619
52
18
15
1585
1466
1443
239
163
218
71
45
54
2-4
3-7
1-3
5-2
2-1
0-1
1-0
3-1
1-0
0-0
0-1
0-1
14 (20%)
18 (40%)
7 (13%)
0.4%
0.5%
0.2%
12
10
10
Declined screening
Screening completed by end of year
Total (% of referrals)
% diagnosed of babies screened
Early Intervention
| 121
Babies
Gestation
group
No.
20+0 23+6
NICU adms,
(No. & %
of Total
liveborn)
No.
Died in NICU
<7 days (%
of NICU
adms)
No.
Died in NICU
7, <28 days
(% of NICU
adms)
No.
Died in NICU
28 days
(% of NICU
adms)
No.
Live at
discharge
(% of NICU
adms)
No.
100.0
40.0
0.0
20.0
40.0
24 27
+6
47
47
100.0
0.0
2.1
2.1
45
95.7
28 31
+6
83
83
100.0
3.6
1.2
0.0
79
95.2
32 36
+6
292
220
75.3
0.0
0.5
0.0
219
99.5
427
355
83.1
1.4
0.8
0.6
345
97.2
2781
317
11.4
0.3
0.0
0.0
316
99.7
+0
+0
+0
All preterm
37 40
+0
41
+6
+0
669
72
10.8
1.4
0.0
0.0
71
98.6
Total
3877
744
19.2
0.9
0.4
0.3
732
98.4
Clinical Indicator
10.1
Period
C&C
2010
C&C
2011
C&C
2012
ACHS
2010
ACHS
2011
ACHS
2012
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Jan-Jun
8.55
9.03
8.33
12.05
11.59
10.62
Jul-Dec
8.32
10.77
11.06
10.69
12.17
11.60
122 |
| 123
Table 82: Perinatal mortality numbers and rates for years 2005
to 2012
2005
2006
2007
2008
2009
2010
2011
2012
20052012
No.
No.
No.
No.
No.
No.
No.
No.
No.
3837
4041
4144
4091
4084
3985
4001
3920
32102
3799
3987
4093
4052
4028
3951
3961
3877
31747
38
54
51
39
56
34
40
43
355
17
21
26
19
28
22
20
23
176
17
14
12
14
14
13
96
18
14.3
16.8
15.2
10.8
17.1
12.0
13.2
12.8
14.0
8.9
8.7
9.2
5.9
10.3
9.0
8.2
7.7
8.5
14.3
17.1
15.7
11.0
18.1
13.6
13.5
13.5
14.6
Babies
Total babies
Liveborn babies
Fetal deaths
Stillbirths
Early neonatal deaths
Late neonatal deaths
2
3
1
2
3
4
All fetal deaths (Stillbirths and terminations of pregnancy, 20 completed weeks or more, or > 400g birth weight)
Early neonatal deaths (Liveborn, died < 7 days)
Late neonatal deaths (Liveborn, died between 7 and < 28 days)
PMMRC = Perinatal & Maternal Mortality Review Committee
20.0
Adjusted
18.0
16.0
14.0
12.0
10.0
8.0
6.0
4.0
2.0
0.0
2005
124 |
2006
2007
2008
2009
2010
2011
2012
2006
2007
2008
2009
2010
2011
2012
20052012
14.6
0.0
4.5
9.2
45.5
15.9
17.2
17.3
15.8
20 24
6.9
20.4
25.3
7.4
25.8
21.1
10.1
7.9
15.7
25 29
24.2
19.0
17.5
13.3
21.3
9.0
13.0
7.1
15.5
30 34
12.1
20.5
9.5
7.9
11.4
9.3
9.2
12.2
11.6
35 39
12.0
12.6
14.2
12.7
9.1
13.2
20.8
18.5
14.1
40
16.7
9.6
32.8
18.5
24.5
9.3
9.3
19.9
17.9
Total
14.3
16.8
15.2
10.8
17.1
12.0
13.2
12.8
14.0
Maternal age
< 20
2006
2007
2008
2009
2010
2011
2012
20052012
< 20
9.8
0.0
0.0
9.2
36.4
15.9
11.5
5.8
11.3
20 24
2.3
12.2
19.5
1.9
21.9
13.4
6.1
0.0
9.7
25 29
16.6
10.8
11.3
3.6
13.0
7.7
7.1
3.6
9.1
30 34
6.8
10.2
2.9
6.3
4.5
7.7
3.1
6.5
6.0
35 39
7.7
6.3
10.1
8.8
5.0
8.1
16.6
14.1
9.6
Maternal age
40
11.1
0.0
20.5
4.6
4.9
9.3
9.3
19.9
10.4
Total
8.9
8.7
9.2
5.9
10.3
9.0
8.2
7.7
8.5
| 125
2006
2007
2008
2009
2010
2011
2012
20052012
NZ European
12.8
16.7
17.2
12.3
14.3
13.0
13.5
12.3
14.1
Other
European
14.7
19.7
4.4
11.1
8.5
8.5
11.9
10.6
11.0
9.4
10.8
16.0
5.2
30.7
20.4
20.1
16.4
16.1
Pacific Peoples
15.9
15.2
7.6
12.5
24.1
10.2
10.1
13.7
13.7
Asian
31.3
21.1
17.3
9.7
16.9
6.7
10.2
13.0
15.1
Other
8.1
32.6
27.8
6.8
15.4
0.0
9.1
9.5
13.6
Total
14.3
16.8
15.2
10.8
17.1
12.0
13.2
12.8
14.0
Maternal ethnicity
Mori
2006
2007
2008
2009
2010
2011
2012
20052012
NZ European
7.6
8.1
8.8
5.2
5.7
9.5
6.5
7.2
7.3
Other
European
2.9
4.9
4.4
8.9
4.3
4.3
6.0
6.4
5.3
Mori
5.7
5.4
10.7
5.2
23.5
16.7
18.1
8.2
11.6
Pacific Peoples
13.3
15.2
7.6
10.0
19.3
10.2
7.6
13.7
12.1
Asian
22.7
10.6
9.9
4.8
14.5
4.5
8.1
5.6
9.6
Other
8.1
21.7
22.2
0.0
7.7
0.0
9.1
9.5
9.7
Total
8.9
8.7
9.2
5.9
10.3
9.0
8.2
7.7
8.5
Maternal ethnicity
126 |
Maternal Age
No.
NZ European
39.1
Other European
13.0
Mori
13.0
Pacific Peoples
21.7
Asian
13.0
Other
0.0
23
100
< 20 years
4.3
20 24 years
0.0
25 29 years
8.7
30 34 years
34.8
35 39 years
39.1
40 years
13.0
Primiparous
Multiparous, no previous CS
Multiparous, with previous CS
Maternal Domicile
C&C DHB
Other DHBs
Maternal Smoking
Gestational Age
23
100
34.8
13
56.5
8.7
23
100
21
91.3
8.7
23
100
Yes
21.7
No
18
78.3
23
100
20 23 weeks
10
43.5
26.1
4.3
8.7
37 40 weeks
13.0
41+0 weeks
4.3
23
100
+0
+0
Birth Weight
+6
+6
<500g
12
52.2
500g-999g
21.7
1000g-1499g
4.3
1500g-1999g
4.3
2000g-2499g
4.3
2500g-2999g
8.7
3000g-3499g
4.3
23
100
| 127
2007
2008
2009
2010
2011
2012
20062012
No.
No.
No.
No.
No.
No.
No.
No.
Congenital anomaly
22
Perinatal infection
Hypertension
Antepartum haemorrhage
14
Maternal conditions
10
12
43
16
Spontaneous preterm
delivery
16
Unexplained
23
No obstetric antecedent
Total
21
26
19
28
22
20
23
159
20
13
13
12
12
88
95.2
50.0
68.4
42.9
40.9
45.0
52.2
55.3
128 |
Maternal Age
Maternal Domicile
Maternal Smoking
Gestational Age
No.
NZ European
71.4
Other European
0.0
Mori
14.3
Pacific Peoples
0.0
Asian
0.0
Other
14.3
100
< 20 years
0.0
20 24 years
0.0
25 29 years
14.3
30 34 years
0.0
35 39 years
57.1
40 years
28.6
100
Primiparous
14.3
Multiparous, no previous CS
42.9
42.9
100
C&C DHB
57.1
Other DHBs
42.9
100
Yes
14.3
No
85.7
100
20 23 weeks
28.6
24 27 weeks
0.0
28 31 weeks
42.9
32 36 weeks
0.0
14.3
41+0 weeks
14.3
100
<500g
0.0
500g-999g
42.9
1000g-1499g
0.0
1500g-1999g
28.6
2000g-2499g
0.0
2500g-2999g
0.0
3000g-3499g
28.6
100
+0
+0
+0
+0
Birth Weight
+6
+6
+6
+6
| 129
2007
2008
2009
2010
2011
2012
20062012
No.
No.
No.
No.
No.
No.
No.
No.
Congenital anomaly
18
Perinatal infection
Hypertension
Antepartum haemorrhage
12
Maternal conditions
14
16
Unexplained
No obstetric antecedent
14
12
14
14
13
79
No.
No.
No.
No.
No.
No.
No.
No.
Congenital anomaly
22
Extreme prematurity
21
Cardio-respiratory disorders
Infection
10
Neurological
17
Gastrointestinal
Other
Total
14
12
14
14
13
79
12
45
85.7
50.0
100.0
42.9
57.1
30.8
57.1
57.0
Total
Primary diagnosis (NDC*)
* Perinatal Society of Australia and New Zealand - Perinatal Death Classification & Neonatal Death Classification
130 |
The maternal mortality ratio is the number of maternalrelated deaths per 100,000 maternities and for C&C
DHB it was 10.2 per 100,000 women over the 2003 to
2012 period.
Definitions
Maternal deaths are defined according to the World
Health Organisation (WHO) definition as: Deaths
of women while pregnant or within 42 days of
birth,miscarriage or termination of pregnancy, from any
| 131
2012
No.
No.
Placenta accreta/percreta/increta
0.51
1.04
Peripartum hysterectomy
0.51
0.78
0.26
0.00
0.00
0.26
0.52
0.52
0.00
132 |
| 133
2009
2010
2011
2012
2009
2010
2011
2012
No.
No.
No.
No.
Wellington
3187
3247
3380
3846
9.2
9.1
9.8
7.8
Kenepuru
850
843
812
748
15.5
12.2
11.6
11.8
Kapiti
349
198
169
246
5.4
11.6
14.8
5.3
Gynaecology - General
Hastings
34
0.0
14.7
0.0
0.0
4388
4322
4361
4845
10.1
9.9
10.3
8.3
Acute assessment
2337
1541
1142
1214
0.5
0.1
0.5
0.6
Preassessment
1147
1299
1415
1558
5.8
3.5
3.1
3.9
56
46
50
82
7.1
15.2
8.0
1.2
Infertility
290
237
280
300
10.0
8.4
8.9
6.3
Oncology
523
667
592
461
8.0
6.1
7.4
11.1
PCC
18
29
47
59
16.7
17.2
6.4
8.5
Pelvic floor
55
64
50
27
3.6
7.8
2.0
0.0
66
116
6.1
3.4
80
84
75
4.8
5.3
Total - General
Gynaecology - Other
PMB
Skin
93
5.4
12.5
Urogynaecology
78
10.3
OASIS
15
0.0
Total - Other
4519
3968
3726
3985
3.6
3.4
3.6
4.0
8907
8290
8087
8830
6.8
6.8
7.2
6.3
134 |
Table 93: Gynaecology waiting time numbers per month for 2012
2012
Maximum waiting
time for FSA
Numbers waiting
> 6 months
Numbers waiting
< 6 months
Jan
10 months
22
847
Feb
9 months
17
851
Mar
8 months
14
894
Apr
6 months
884
May
6 months
767
Jun
8 months
644
Jul
5 months
544
Aug
6 months
471
Sep
6 months
469
Oct
5 months
492
Nov
4 months
581
Dec
4 months
574
Colposcopy Service
Monitoring
These are:
| 135
Treatment:
Colposcopy
LLETZ
Total Colposcopy
2009
2010
2011
2012
2009
2010
2011
2012
No.
No.
No.
No.
1184
1200
1144
1294
15.2
14.6
16.7
14.1
315
328
392
368
15.9
9.1
9.2
6.5
1499
1528
1536
1662
15.3
13.4
14.8
12.5
Table 95: Colposcopy waiting time numbers per month for 2012
2012
Jan
9 months
256
Feb
10 months
12
217
Mar
9 months
196
Apr
9 months
226
May
10 months
244
Jun
7 months
206
Jul
6 months
230
Aug
6 months
227
Sep
7 months
227
Oct
7 months
221
Nov
7 months
182
Dec
8 months
122
* Not available
136 |
2008
2009
2010
2011
2012
46.0
44.5
44.0
41.0
44.0
40.5
Hutt Valley
23.0
23.0
24.0
22.8
23.2
21.6
Mid-Central
19.3
20.0
19.0
19.1
19.0
19.4
Whanganui
6.8
7.4
7.0
9.0
8.4
9.2
Hawkes Bay
1.1
0.6
0.7
0.8
0.4
0.9
Wairarapa
0.4
0.5
0.7
0.8
0.7
1.5
Nelson Marlborough
0.6
0.7
0.5
0.5
0.8
0.8
0.7
0.7
0.2
1.2
0.8
0.5
Non-residents
2.1
2.5
4.0
4.7
2.7
5.7
100
100
100
100
100
100
| 137
138 |
Table 97: Numbers and rates for Te Mahoe for years 2007 to 2012
Total number of TOPs
Procedure
Local anaesthetic
2007
2008
2009
2010
2011
2012
3078
2872
2781
2691
2497
2221
88.0
86.0
90.0
89.0
89.0
91.6
General anaesthetic
5.0
5.0
5.0
5.0
4.8
3.8
6.5
7.0
5.0
6.0
6.0
4.4
Induction of labour
0.5
1.0
0.1
0.1
0.04
40.0
47.0
48.0
50.0
50.0
54.8
9 11 weeks
41.0
37.0
35.0
33.0
34.0
29.6
12 15 weeks
1.0
15.0
12.0
14.0
14.0
12.0
12.8
4.0
4.0
3.0
3.0
4.0
2.6
Repeat TOPs
None
63.0
62.0
61.0
62.0
62.0
58.8
1 prior TOP
24.0
23.0
25.0
25.0
25.0
26.4
2 prior TOPs
8.0
10.0
8.0
9.0
9.0
9.3
3 prior TOPs
3.0
4.0
4.0
3.0
3.0
3.4
4 prior TOPs
2.0
1.0
2.0
1.0
1.0
2.0
Ethnicity
NZ European
49.0
50.0
46.0
49.0
49.0
48.8
Mori
24.0
25.0
25.0
25.0
24.5
26.2
Samoan
5.0
6.0
6.0
6.0
6.5
6.4
2.4
4.4
4.0
4.0
5.0
0.2
Asian
5.0
4.4
4.0
3.0
4.5
0.1
Other
14.6
10.2
15.0
13.0
10.5
18.2
Age
< 14 years
0.2
0.4
0.0
0.0
0.0
0.0
14 15 years
2.2
1.6
2.0
1.0
1.5
1.1
16 18 years
16.2
15.0
16.0
12.0
10.2
9.9
19 24 years
37.9
40.0
40.0
40.0
44.2
40.2
25 29 years
17.3
19.3
19.0
21.0
19.5
21.8
30 35 years
15.2
14.0
14.0
15.0
14.3
15.8
36 40 years
8.7
7.6
7.0
8.0
8.0
8.3
> 40 years
2.3
2.1
2.0
3.0
2.3
2.8
RPOC
1.1
1.3
0.6
0.8
1.45
0.8
0.8
0.5
0.8
0.9
0.4
0.6
Failed TOP
0.2
0.3
0.0
0.04
Perforation
0.04
0.1
0.08
0.04
0.0
0.04
0.0
0.04
Endometritis
PPH
Ongoing pregnancy
Early MTOP complication rates
RPOC
3.9
5.3
2.0
3.1
Endometritis
1.3
0.5
0.6
1.0
2.6
3.0
2.0
5.2
1.2
1.3
2.0
0.6
1.0
Failed TOP
PPH
| 139
140 |
| 141
2010
2011
2012
Surgery location
No.
No.
No.
No.
Wellington Inpatient
866
848
777
835
358
242
270
342
470
318
393
384
1694
1408
1440
1561
2010
2011
2012
No.
No.
No.
No.
92
157
147
198
211
188
143
169
Total
303
345
290
367
Surgery location
Wellington Inpatient
142 |
Wellington
Inpatient
Wellington
day patient
Kenepuru
Total
43
12
55
13
Vaginal hysterectomy
11
16
32
36
46
19
65
Laparotomy oopherectomy/BSO
21
23
31
22
53
168
95
263
Insertion of Mirena
78
32
110
33
41
22
87
Sub-total hysterectomy
Laparoscopic sterilisation
Dilation & curettage, hysteroscopy, polypectomy
Myomectomy
65
13
15
Cone biopsy
13
17
Laparoscopic cerclage
Incision & drainage Bartholins abscess
18
20
Urogynaecology surgery *
152
32
184
Endometriosis surgery **
239
124
363
228
Total
835
Fentons procedure
228
342
384
1561
| 143
Surgical Procedure
Wellington
day patient
Total
32
32
66
37
37
Diagnostic laparoscopy
13
13
12
12
27
159
225
10
37
Cervical cerclage
Wound debridement
Total
198
169
367
* Of the 32 women with ectopic pregnancy, there were 7 ruptured ectopic and 2 corneal ectopic.
Total
6
Endometritis
23
14
Mastitis
14
Breast abscess
Unwell / sepsis
Urinary retention
15
Total
91
144 |
Total
76
14
Ovarian hyperstimulation
15
21
Genital herpes
PV bleeding / menorrhagia
37
14
53
45
Total
289
| 145
Total
267
46
Ovarian drilling
13
Ovarian endometrioma
36
Total
363
* Some women have multiple sites of disease, therefore there may be 3-4 sites excised in one procedure.
** Total volumes represent each case not each procedure.
2008
2009
2010
2011
2012
No.
No.
No.
No.
No.
16
13
50
30
29
63
85
88
78
74
23
15
20
15
27
56
49
60
58
36
Revision of mesh
Abdominal sacrocolpopexy
159
186
230
195
184
Total
* Some women have had more than one procedure at the same operative episode. The surgical numbers for 2012 were reliant on ORSOS and
surgical lists. The actual procedure may be different from proposed therefore possibly affecting accuracy of surgical procedures for 2012.
2009
2010
2011
2012
No.
No.
No.
No.
98
102
Hutt Valley *
94
120
16
19
Hawkes Bay
48
38
28
36
Taranaki
29
36
27
23
Whanganui
15
Mid Central
16
21
13
20
10
13
Nelson Marlborough
207
205
214
228
Wairarapa
Total
* Hutt Valley DHB numbers included in C&C DHB numbers for 2009 and 2010.
| 147
Total
38
44
56
31
Total
174
Total
38
44
Trachlectomy
24
EUA, staging
50
12
Biopsy of vagina
Wide local excision vulva
5
18
Radical vulvectomy
Other procedures
Total
148 |
17
231
Trend monitoring
Case review
Reportable event
Benign
Gynaecology
Gynaecology
/ Oncology
Postoperative death
20
58
23
Total Women
53
22
| 149
150 |
C&C
2011
C&C
2012
ACHS
2010
ACHS
2011
ACHS
2012
Period
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Rate
(%)
Jan-Jun
3.05
1.74
2.56
0.99
1.35
1.46
Jul-Dec
1.42
2.34
1.86
1.09
1.03
1.01
Jan-Jun
8.96
19.12
8.77
9.41
8.36
6.01
Jul-Dec
19.12
14.81
8.20
10.48
6.01
7.03
1.59
1.37
1.70
0.47
0.51
0.63
0.79
1.11
0.44
0.46
0.58
0.40
0.00
0.50
0.00
0.63
0.99
0.78
0.00
1.52
0.74
0.73
1.03
0.82
Jan-Jun
0.00
0.00
0.00
0.43
0.43
0.00
Jul-Dec
0.00
0.00
0.00
0.43
0.00
1.00
Jan-Jun
0.00
0.00
0.00
0.00
0.00
0.36
Jul-Dec
0.00
0.00
0.00
0.00
0.31
1.00
Jan-Jun
87.50
69.23
93.75
83.57
80.76
82.41
Jul-Dec
92.86
94.44
85.71
82.75
82.82
82.58
Jan-Jun
1.85
1.45
0.00
0.91
1.43
1.78
Jul-Dec
0.00
0.00
0.00
1.52
1.18
1.39
Jan-Jun
0.00
0.00
0.00
0.00
0.28
0.00
Jul-Dec
0.00
0.00
0.00
0.14
0.27
0.36
Jan-Jun
0.00
0.00
0.00
0.66
0.42
0.68
Jul-Dec
0.00
0.00
0.00
0.42
0.68
0.60
Clinical Indicator
1.1
1.2
2.1
3.1
3.2
3.3
4.1
5.1
5.2
5.3
| 151
152 |
16. Appendices
| 153
154 |
4019
100
0.6
2.5
6.5
90.4
100
0.6
2.5
6.7
3800
19
98
234
3449
No.
100
0.5
2.6
6.2
90.8
100
0.5
2.6
6.3
90.5
2004
3703
19
98
234
3352
No.
2004
3837
18
110
264
3445
No.
100
0.5
2.9
6.9
89.8
100
0.5
2.9
7.0
89.6
2005
3754
18
110
264
3362
No.
2005
4041
26
131
254
3630
No.
100
0.6
3.2
6.3
89.8
100
0.7
3.3
6.4
89.6
2006
3967
26
131
254
3556
No.
2006
4144
23
154
266
3701
No.
100
0.6
3.7
6.4
89.3
100
0.6
3.8
6.6
89.1
2007
4047
23
154
266
3604
No.
2007
4091
31
162
273
3625
No.
100
0.8
4.0
6.7
88.6
100
0.8
4.1
6.8
88.3
2008
3999
31
162
273
3533
No.
2008
4084
20
157
232
3675
No.
100
0.5
3.8
5.7
90.0
100
0.5
3.9
5.8
89.8
2009
3995
20
157
232
3586
No.
2009
3985
39
156
203
3587
No.
100
1.0
3.9
5.1
90.0
100
1.0
4.0
5.2
89.8
2010
3891
39
156
203
3493
No.
2010
4001
27
127
245
3602
No.
100
0.7
3.2
6.1
90.0
100
0.7
3.2
6.3
89.8
2011
3917
27
127
245
3518
No.
2011
3920
28
132
240
3520
No.
100
0.7
3.4
6.1
89.8
100
0.7
3.4
6.2
89.6
2012
3850
28
132
240
3450
No.
2012
Total
24
263
Kenepuru
99
3633
Wellington
Paraparaumu
No.
90.2
2003
3927
Place of birth
Babies
Total
24
263
Kenepuru
99
3541
Wellington
Paraparaumu
No.
2003
Place of birth
Mothers
Table 111: Place of birth for the C&C DHB region for the years 2003 to 2012
Table 112: Place of birth by C&C DHB birthing facility for the
years 2003 to 2012
Mothers
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Birth Facility
No.
No.
No.
No.
No.
No.
No.
No.
No.
No.
Wellington
3558
3365
3379
3574
3622
3560
3603
3520
3537
3470
Kenepuru
270
240
265
262
271
277
234
213
251
245
99
98
110
131
154
162
158
158
129
135
3927
3703
3754
3967
4047
3999
3995
3891
3917
3850
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
No.
No.
No.
No.
No.
No.
No.
No.
No.
No.
Wellington
3650
3462
3462
3648
3719
3652
3692
3614
3621
3540
Kenepuru
270
240
265
262
271
277
234
213
251
245
99
98
110
131
154
162
158
158
129
135
4019
3800
3837
4041
4144
4091
4084
3985
4001
3920
Paraparaumu
Total
Babies
Birth Facility
Paraparaumu
Total
(NB The births before arrival tabulated separately in the previous table are included in this table in the birthing facility to which they were
admitted).
< 20
25 29
30 34
35 39
40
Total
No.
No.
No.
No.
No.
No.
52
30.2
196
39.4
352
42.6
640
53.1
540
59.7
132
53.9
1912
49.7
1.7
17
3.4
55
6.7
186
15.4
159
17.6
41
16.7
461
12.0
Mori
76
44.2
140
28.1
116
14.0
70
5.8
62
6.9
17
6.9
481
12.5
Pacific Peoples
35
20.3
85
17.1
107
13.0
75
6.2
39
4.3
18
7.3
359
9.3
Asian
1.2
47
9.4
169
20.5
206
17.1
81
9.0
30
12.2
535
13.9
Other
2.3
13
2.6
27
3.3
28
2.3
23
2.5
2.9
102
2.6
Total
172
100
498
100
826
100 1205
100
904
100
245
100
3850
100
NZ European
Other European
No.
20 24
| 155
< 20
20 24
25 29
30 34
Parity
No.
No.
No.
No.
No.
143
83.1
285
57.2
420
50.8
552
45.8
272
30.1
23
13.4
160
32.1
228
27.6
437
36.3
362
3.5
44
8.8
110
13.3
137
11.4
0.0
1.0
38
4.6
52
0.0
0.8
18
2.2
>4
0.0
0.0
12
1.5
172
100
498
100
826
Total
40
35 39
No.
Total
%
No.
69
28.2
1741
45.2
40.0
84
34.3
1294
33.6
184
20.4
47
19.2
528
13.7
4.3
48
5.3
20
8.2
163
4.2
19
1.6
27
3.0
11
4.5
79
2.1
0.7
11
1.2
14
5.7
45
1.2
100 1205
100
904
100
245
100
3850
100
NZ
European
Other
European
Parity
No.
No.
No.
No.
No.
No.
No.
877
45.9
214
46.4
190
39.5
133
37.0
281
52.5
46
45.1
1741
45.2
697
36.5
172
37.3
126
26.2
88
24.5
178
33.3
33
32.4
1294
33.6
263
13.8
55
11.9
76
15.8
60
16.7
60
11.2
14
13.7
528
13.7
59
3.1
14
3.0
36
7.5
36
10.0
14
2.6
3.9
163
4.2
13
0.7
0.9
31
6.4
27
7.5
0.4
2.0
79
2.1
>4
Total
156 |
Pacific
Peoples
Mori
Asian
Other
Total
0.2
0.4
22
4.6
15
4.2
0.0
2.9
45
1.2
1912
100
461
100
481
100
359
100
535
100
102
100
3850
100
Fijian
Niuean
3754
Total
11
122
Other
Not stated
49
Middle Eastern
Other
Latin American
49
African
343
Asian
Asian nfd
32
Other Asian
114
Indian
90
103
Chinese
Southeast Asian
370
Pacific Peoples
14
16
Tongan
40
Tokelauan
221
Samoan
68
519
Mori
331
Other European
17
314
Other European
European nfd
2069
No.
2005
NZ European
Ethnicity
Mothers
| 157
100
3.2
0.3
0.1
1.3
0.2
1.3
9.1
0.1
0.9
2.4
3.0
2.7
9.9
0.4
0.0
0.2
0.1
0.4
1.1
1.8
5.9
13.8
8.8
0.5
8.4
55.1
3967
88
27
41
373
11
43
76
131
112
393
13
13
19
34
57
245
543
401
91
310
2169
No.
2006
100
2.2
0.2
0.1
0.7
0.2
1.0
9.4
0.3
1.1
1.9
3.3
2.8
9.9
0.3
0.1
0.2
0.3
0.5
0.9
1.4
6.2
13.7
10.1
2.3
7.8
54.7
4047
171
30
41
43
17
40
400
12
78
74
110
126
394
21
12
12
34
63
244
553
440
59
381
2089
No.
2007
100
4.2
0.7
1.0
1.1
0.4
1.0
9.9
0.3
1.9
1.8
2.7
3.1
9.7
0.5
0.0
0.1
0.3
0.3
0.8
1.6
6.0
13.7
10.9
1.5
9.4
51.6
3999
144
25
18
40
20
41
405
18
67
88
123
109
389
19
21
18
36
53
228
562
440
57
383
2059
No.
2008
100
3.6
0.6
0.5
1.0
0.5
1.0
10.1
0.5
1.7
2.2
3.1
2.7
9.7
0.5
0.2
0.2
0.5
0.5
0.9
1.3
5.7
14.1
11.0
1.4
9.6
51.5
3995
125
17
20
37
43
412
22
72
97
101
120
407
19
11
11
11
42
54
253
531
462
62
400
2058
No.
2009
100
3.1
0.4
0.5
0.9
0.2
1.1
10.3
0.6
1.8
2.4
2.5
3.0
10.2
0.5
0.2
0.3
0.3
0.3
1.1
1.4
6.3
13.3
11.6
1.6
10.0
51.5
3891
137
24
48
12
52
440
23
77
86
114
140
387
26
20
19
38
52
219
525
456
72
384
1946
No.
2010
100
3.5
0.6
0.0
1.2
0.3
1.3
11.3
0.6
2.0
2.2
2.9
3.6
9.9
0.7
0.2
0.1
0.5
0.5
1.0
1.3
5.6
13.5
11.7
1.9
9.9
50.0
3917
107
12
42
10
41
486
13
93
98
131
151
385
22
15
16
32
50
240
488
497
56
441
1954
No.
2011
%
100
2.7
0.3
0.1
1.1
0.3
1.0
12.4
0.3
2.4
2.5
3.3
3.9
9.8
0.6
0.1
0.2
0.4
0.4
0.8
1.3
6.1
12.5
12.7
1.4
11.3
49.9
Table 116: Maternal ethnicities within the six ethnicity groups for years 2005 to 2012
3850
102
31
23
46
535
15
62
125
151
182
359
10
17
23
33
47
223
481
461
36
425
1912
No.
2012
100
2.6
0.0
0.0
0.8
0.6
1.2
13.9
0.4
1.6
3.2
3.9
4.7
9.3
0.3
0.0
0.1
0.4
0.6
0.9
1.2
5.8
12.5
12.0
0.9
11.0
49.7
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
Normal
66.5
66.9
65.6
65.6
64.4
64.0
61.6
61.3
60.7
58.9
Caesarean section
21.0
22.0
24.2
26.6
24.0
25.1
27.2
28.5
27.8
29.9
Assisted
12.5
11.1
10.3
7.8
11.6
10.9
11.2
10.2
11.5
11.1
Total
100
100
100
100
100
100
100
100
100
100
Mothers
2007
2008
2009
2010
2011
2012
Normal
59.6
61.0
61.1
59.1
56.8
57.8
Caesarean
29.1
27.9
27.4
29.6
30.8
30.9
Assisted
11.3
11.2
11.5
11.3
12.3
11.3
Total
100
100
100
100
100
100
Table 118: Mode of birth group by age group for all women in
2012
Mothers
< 20
20 24
25 29
30 34
35 39
40
Total
Mode group
No.
No.
No.
No.
No.
No.
No.
Normal
116
67.4
330
66.3
494
59.8
692
57.4
481
53.2
111
45.3
2224
57.8
CS
35
20.3
117
23.5
232
28.1
357
29.6
334
36.9
116
47.3
1191
30.9
Assisted
21
12.2
51
10.2
100
12.1
156
12.9
89
9.8
18
7.3
435
11.3
172
100
498
100
826
100
1205
100
904
100
245
100
3850
100
Total
< 20
20 24
25 29
30 34
35 39
40
Total
No.
No.
No.
No.
No.
No.
No.
Normal
95
66.4
165
57.9
209
49.8
238
43.1
87
32.0
16
23.2
810
46.5
CS
28
19.6
75
26.3
124
29.5
192
34.8
126
46.3
44
63.8
589
33.8
Assisted
20
14.0
45
15.8
87
20.7
122
22.1
59
21.7
13.0
342
19.6
143
100
285
100
420
100
552
100
272
100
69
100
1741
100
Total
158 |
< 20
20 24
25 29
30 34
35 39
40
Total
No.
No.
No.
No.
No.
No.
No.
21
80.8
155
89.6
266
85.5
420
89.2
368
82.0
87
78.4
1317
85.5
CS
15.4
14
8.1
35
11.3
35
7.4
63
14.0
20
18.0
171
11.1
Assisted
3.8
2.3
10
3.2
16
3.4
18
4.0
3.6
53
3.4
26
100
173
100
311
100
471
100
449
100
111
100
1541
100
Normal
Total
< 20
No.
20 24
%
No.
25 29
No.
30 34
No.
35 39
No.
40
No.
Total
%
No.
Normal
0.0
10
25.0
19
20.0
34
18.7
26
14.2
12.3
97
17.1
CS
3 100.0
28
70.0
73
76.8
130
71.4
145
79.2
52
80.0
431
75.9
Assisted
0.0
5.0
3.2
18
9.9
12
6.6
7.7
40
7.0
Total
100
40
100
95
100
182
100
183
100
65
100
568
100
| 159
160 |
1.1
1.2
1.3
1.4
2.1
3.1
3.2
Your
numerator
217
213
161
155
104
126
128
153
35
49
67
63
108
120
2012
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
391
388
391
388
177
176
544
516
544
516
544
516
544
516
Your
denominator
(19.92-29.69)
(18.51-27.81)
(15.62-24.69)
(23.52-33.47)
(25.96-36.44)
30.69%
27.84%
16.11%
17.27%
27.68%
19.89%
(24.70-36.68)
(21.99-33.68)
(11.33-20.89)
(12.34-22.20)
(19.04-36.33)
(12.15-27.62)
28.13% (23.17-33.08)
24.81%
23.16%
20.16%
28.49%
31.20%
39.15% (33.78-44.53)
42.05% (34.47-47.64)
Your
rate
99%
Confidence
Interval for
your rate
105
99
63
70
34
33
122
111
121
116
174
161
259
249
Your
expected
number
of events
15
-3
15
31
17
-12
-19
-46
-32
(excess events)
Your
observed
minus
expected
Table 122: ACHS Obstetric Clinical Indicators (Jan-Jun, Jul-Dec 2012) and table notes
13
14
14
14
13
12
14
14
13
13
12
12
13
13
No. of
organisations
submitting
data
26.76%
25.50%
16.09%
18.12%
19.43%
18.55%
22.45%
21.54%
22.28%
22.44%
31.95%
31.22%
47.62%
48.28%
Aggregate
rate for these
organisations
3.5
3.6
4.1
7.1
7.2
8.1
9.1
10.1
Jul-Dec
188
137
15
Jul-Dec
Jan-Jun
28
28
Jul-Dec
Jan-Jun
25
Jan-Jun
31
Jul-Dec
Jul-Dec
40
Jan-Jun
10
Jul-Dec
Jan-Jun
Jan-Jun
18
28
Jul-Dec
Jul-Dec
22
Jan-Jun
22
42
Jul-Dec
Jan-Jun
52
166
Jul-Dec
Jan-Jun
161
Jan-Jun
1700
1644
1742
1685
789
793
598
590
1336
1295
598
590
391
388
391
388
391
388
391
388
11.06%
8.33%
0.86%
1.66%
0.76%
1.26%
3.01%
3.73%
2.10%
1.93%
5.18%
6.78%
0.77%
0.00%
7.16%
5.67%
10.74%
13.40%
42.46%
(9.10-13.01)
(6.58-10.09)
(0.29-1.43)
(0.86-2.46)
(0.00-1.56)
(0.24-2.28)
(1.21-4.81)
(1.72-5.73)
(1.09-3.10)
(0.95-2.91)
(2.85-7.51)
(4.12-9.44)
(0.00-1.90)
(0.00-0.92)
(3.81-10.51)
(2.65-8.69)
(6.72-14.77)
(8.96-17.85)
(36.03-48.88)
41.49% (35.07-47.92)
197
175
29
31
13
14
13
17
21
24
48
53
27
29
36
32
183
194
-9
-38
-14
-3
-7
-4
-17
-13
-1
-7
20
-17
-33
14
14
16
17
15
16
16
16
16
17
16
17
14
15
14
15
13
14
12
14
11.60%
10.62%
1.66%
1.82%
1.63%
1.75%
2.16%
2.97%
1.60%
1.86%
7.97%
8.93%
0.43%
0.36%
6.98%
7.45%
9.25%
8.15%
46.69%
50.01%
3.4
3.3
| 161
162 |
4
6
Jan-Jun
Jul-Dec
2012
598
586
Your
denominator
1.00%
0.68%
Your
rate
(0.00-2.05)
(0.00-1.56)
99%
Confidence
Interval for
your rate
Your
expected
number
of events
(excess events)
Your
observed
minus
expected
15
No. of
organisations
submitting
data
0.50%
0.21%
Aggregate
rate for these
organisations
1.16
Your
numerator
Table 123: ACHS Infection Control Clinical Indicators (Jan-Jun, Jul-Dec 2012) and table notes
1.1
1.2
2.1
3.1
3.2
3.3
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
2012
10
Your
numerator
12
15
12
15
271
245
455
412
61
57
429
390
Your
denominator
0.00%
0.00%
0.00%
0.00%
0.74%
0.00%
0.44%
1.70%
8.20%
8.77%
1.86%
2.56%
Your
rate
(0.00-27.46)
(0.00-22.31)
(0.00-27.46)
(0.00-22.31)
(0.00-2.07)
(0.00-1.45)
(0.00-1.24)
(0.06-3.34)
(0.00-17.22)
(0.00-18.40)
(0.19-3.54)
(0.51-4.62)
99%
Confidence
Interval for
your rate
Your
expected
number
of events
-2
(excess events)
Your
observed
minus
expected
15
15
15
17
24
25
26
25
17
15
23
22
No. of
organisations
submitting
data
Table 124: ACHS Gynaecology Clinical Indicators (Jan-Jun, Jul-Dec 2012) and table notes
1.00%
0.36%
1.00%
0.00%
0.82%
0.78%
0.40%
0.63%
7.03%
6.01%
1.01%
1.46%
Aggregate
rate for these
organisations
| 163
164 |
5.1
5.2
5.3
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
Jan-Jun
Jul-Dec
12
15
70
51
70
51
70
51
14
16
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
85.71%
93.75%
(0.00-5.03)
(0.00-6.87)
(0.00-5.03)
(0.00-6.87)
(0.00-5.03)
(0.00-6.87)
(61.68100.00)
(78.20100.00)
12
13
-1
-1
21
19
20
18
21
20
20
22
0.60%
0.68%
0.36%
0.00%
1.39%
1.78%
82.58%
82.41%
4.1
Jan-Jun
16.2 Abbreviations
ACHS
ACMM
AMOSS
NBHS
NCSP
NDC
NICU
NIPD
NT
NVB
OASIS
OGTT
PCC
PCEA
PDC
PDPH
PIMS
PM
PMB
PMMRC
| 165
16.3 References
Auckland District Health Board 2012. National Womens Annual Clinical Report 2011.
Bell R, Bailey K, Cresswell T, Hawthorne G, Critchley J, Lewis-Barned N, Northern Diabetic Pregnancy Survey
Steering Group. 2008. Trends in prevalence and outcomes of pregnancy in women with pre-existing type I and
type II diabetes. BJOG: An International Journal of Obstetrics and Gynaecology. March 2008. 115, 4. 445-452.
Bulletin of the World Health Organisation. January 2010. Vol. 88 (1), ISSN 0042-9686.
Dodd JM, Crowther CA, Haslam RR, Robinson JS, Twins Timing of Birth Trial Group. 2012. Elective birth at 37
weeks of gestation versus standard care for women with an uncomplicated twin pregnancy at term: the Twins
Timing of Birth Randomised Trial. BJOG: An International Journal of Obstetrics and Gynaecology. July 2012.
119, 8. 964-974.
Esakof TF, Cheng YW, Caughey AB. 2005. Screening for gestational diabetes: different cut-offs for different
ethnicities? American Journal of Obstetrics and Gynecology. 193 (3 Pt 2):1040-1044.
Gunton JE, McElduff A, Sulway M, Shiel J, Kelso I, Boyce S, Fulcher G, Robinson B, Clifton-Bligh P, Wilmhurst E.
2000. Outcome of pregnancies complicated by pre-gestational diabetes mellitus. Australian and New Zealand
Journal of Obstetrics and Gynaecology. 200; 40: 1:38-43.
Jensen DM, Damm P, Moelsted-Pederson L, Ovesen P, Westergaard JG, Moeller M, Beck-Nielsen H. 2004.
Outcomes in Type 1 diabetic pregnancies. Diabetes Care, December 2004. 27: 2819-2823.
Lewis G. (ed) 2007. The Confidential Enquiry into Maternal and Child Health (CEMACH). Saving Mothers
Lives: reviewing maternal deaths to make motherhood safer 2003-2005. The Seventh Report on Confidential
Enquiries into Maternal Deaths in the United Kingdom. London: CEMACH. (www.cemach.org.uk)
Nahum EG, Huffaker BJ. 1993. Racial differences in oral glucose screening test results: establishing race-specific
criteria for abnormality in pregnancy. American Journal of Obstetrics and Gynecology. April 1993. 81 (4):517522.
New Zealand Health Information Service, 2007. Report on Maternity: Maternal and Newborn Information 2004.
Wellington: NZ Ministry of Health.
New Zealand Ministry of Health, 2010. Hospital-based Maternity Events 2006. Wellington: NZ Ministry of Health.
New Zealand Ministry of Health. 2012. New Zealand Maternity Clinical Indicators 2009: Revised June 2012.
Wellington: NZ Ministry of Health
New Zealand Ministry of Health. 2012. Report on Maternity, 2010. Wellington: NZ Ministry of Health.
PMMRC. 2012. Sixth Annual Report of the Perinatal and Maternal Mortality Review Committee: Reporting
mortality 2010. (www.hqsc.govt.nz)
Sacks DA, Abu-Fadil S, Greenspoon JS, Fotheringham N. 1989. How reliable is the fifty-gram, one-hour glucose
screening test? American Journal of Obstetrics and Gynecology. 161 (3):642-5.
Statistics New Zealand. 2013. Births and Deaths: Year ended December 2012. (www.stats.govt.nz)
The Australian Council on Healthcare Standards. 2012. Clinical Indicator Users Manual 2012. (www.achs.org.au)
166 |
CI. 1.1
CI. 1.2
CI. 1.3
Desired Rate:
1.1 High
1.2 Low
1.3 Low
1.4 Low
Definitions of Terms: For the purpose of these
indicators:
singleton pregnancy
cephalic presentation
CI. 1.4
singleton pregnancy
cephalic presentation
CI. 2.1
CI. 3.1
Desired Rate:
Not specified
CI. 3.2
CI. 3.3
CI. 3.4
Desired Rate:
3.1 High
3.2 Low
3.3 Low
CI. 3.5
3.4 Low
3.5 Low
3.6 Low
168 |
CI. 3.6
CI. 7.2
| 169
170 |
Desired Rate:
1.1
Low
1.2
Low
Desired Rate:
1.16 Low
Definitions of Terms: For the purpose of indicator
1.16
A surgical site infection (SSI) is defined by the
anatomical location of the infection (superficial, deep
or organ space) however, due to the difficulty of
distinguishing between these categories the indicators
have been separated to measure two categories:
superficial and deep organ or space.
Note:
Note:
CI. 1.16
CI. 1.2
INDICATOR AREA 1:
GYNAECOLOGY
Indicator Topic: Blood transfusion for gynaecology
surgery.
Rationale: This indicator is included as a general
measure of surgical management.
Type of Indicator: These are comparative rate-based
indicators addressing the process and outcome of
patient care.
INDICATOR AREA 2:
GYNAECOLOGY
Indicator Topic: Injury to a major viscus, with repair
during a gynaecological operative procedure, or
subsequently during the same admission.
| 171
3.3 Low
Definitions of Terms: For the purpose of these
indicators
Desired Rate:
Low
Definitions of Terms: For the purpose of this
indicator
Note:
CI. 3.1
CI. 3.2
INDICATOR AREA 3:
GYNAECOLOGY
Indicator Topic: Laparoscopic gynaecological surgery.
Rationale: These indicators have been included as an
index of the utilisation of a laparoscopic approach for
gynaecological surgery.
CI. 3.3
INDICATOR AREA 4:
GYNAECOLOGY
Desired Rate:
5.2 Low
5.1 Low
5.3 Low
CI. 5.2
Note:
INDICATOR AREA 5:
GYNAECOLOGY
Indicator Topic: Urogynaecology.
CI. 5.3
| 173