Maternity Morbidity & Mortality Forum

SW Victoria 2010

STATS

(Your Service Name and Brand here)e.g. Timboon District Healthcare Service

15 minutes to present STATS & case presentation 5 minute group comment

Data source reference (VAED data) Pregnancy childbirth & the puerperium

Information to give HIM at your when requesting / collating your data (Omit this slide when you have completed your presentation) Code for delivery (O80 – 084)Duration of pregnancy – O009 (category O09)O09.4 26 – 33 Completed weeks & O09.5 34 – 36 Completed weeks Early onset of labour (O60 preterm labour and delivery) Fetal death in utero (O36.4) Premature rupture of membranes (042) < 37 weeks completed gestation Premature labour (O47.0). False labour < 37 weeks Complications of labour & delivery (060 – 075) O60.0 Preterm labour without delivery O60.1 Preterm spontaneous labour with delivery Failed Induction of labour (O61) O61.0 Failed medical induction (oxytocin / Prostin) O61.1 Failed instrumental induction of labour (mechanical surgical) Other failed induction of labour

Service Capability

Level of service aligned with Department of Health Capability framework http://docs.health.vic.gov.au/docs/doc/Capability-framework-for-Victorian-maternity-and-newborn-services

Level = (1 – 6) Variance to Capability (no of episodes /

cases) over past 12 months = Reasons (Workforce / equipment)

General Service Stats

Number of women giving birth in State Public Hospitals

Total Number of Births = Primigravida = Multigravida = Preterm birth < 33/40 = Preterm birth < 37 completed weeks = Total Number of babies Born =

Mode of birth

Your Service Normal birth % Forceps % Ventouse % EL LUSCS % EM LUSCS % Vaginal Breech % VBAC %

State STATS Normal Birth % Forceps % Ventouse % EL LUSCS % EM LUSCS %Mat indicator (1b)- rate of C/S in standard Primip Vaginal Breech % VBAC % Mat Indicator 4 – VB after primary C/S)

Maternity STATS

Your Service IOL Primips %Gestation @ induction =

Mode of birth = IOL Multi’s %Gestation @ Induction = PPH = MROP = Stillbirths = Neonatal Deaths =

State STATS

IOL Primips %Mat Indicator (1a) rate of

inductions' in standard Primip

PPH = MROP = Stillbirths = Neonatal deaths =

Analgesia / Anaesthesia Labour & Birth Your Service Nil % Inhalational % Narcotic % Epidural % Spinal % GA % Other %

Regional STATS Nil % Inhalational % Narcotic % Epidural % Spinal % GA % Other %

Maternal transfers out to a service / clinician providing higher level of care (brief reason for transfer)

Number of Antenatal Transfers = fFN deciding factor (TPL) Yes / No

Number of Intrapartum Transfers = Number of Postnatal Transfers = Tertiary level transfer Yes / No Transfers back to referring service < 24hrs (if > 24hrs provide comment)

Neonatal Transfers out

Regional transfer to SWHC =

Transfer to tertiary centre =

(e.g. IUGR/ Prematurity < 37 weeks

Prematurity < 32 weeks) Other

Time of decision to transfer to departure from hospital

State STATS – NETS retrievals 2010

= (Mat Indicator 2 –

Term infants without birth defects who require additional care).

Case presentation guide(omit this slide when you have selected your case)

e.g. IOL CTG reduced variability / reactivity- baseline FHR 100 method of induction Labour History Birth History (type of birth, NVB, Assisted, LUSCS) Apgar Scores Neonatal management (resuscitation) Transfer details Investigations Outcome Discharge Post discharge follow up

Case presentation selected by service Age, Primip / Multi Intended place of birth, actual place of birth - ? Transfer Description of condition / diagnosis Past Obstetric History Past Medical History relevant to clinical situation Tests & Investigations this pregnancy?

Clinical Picture; pregnancy / birth post partum Sequence of events Treatment Outcome Implications for ongoing practice Evidence Base

Group Discussion Expert Comments Analyse the circumstances Recommendations for future practice Initiate appropriate action for process

improvement