Maternity Morbidity & Mortality Forum SW Victoria 2010 STATS

1. Maternity Morbidity & Mortality Forum SW Victoria2010 STATS (Your Service Name and Brand here) e.g Timboon District Healthcare Service 15 minutes to present STATS & case presentation 5 minute group comment

2. 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) O09.4 26 – 33 Completed weeks and O09.5 34 – 36 Completed weeks • Early onset of labour (O60 preterm labour and delivery) Total numbers of cases and • Fetal death in utero (O36.4) • Premature rupture of membranes (042) < 37 weeks completed gestation • Premature labour (O47.0). False labour < 37 weeks • 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) • O61.8 Other failed induction of labour

3. 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)

4. 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 =

5. Your Service Normal birth % Forceps % Ventouse % EL LUSCS % EM LUSCS % Vaginal Breech % VBAC % Mode of birth 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)

6. 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 = Maternity STATS

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

8. 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)

9. 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). Neonatal Transfers out

10. 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

11. 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

12. Group Discussion Expert Comments • Analyse the circumstances • Recommendations for future practice • Initiate appropriate action for process improvement