Caesar audit

01/10/15- 07/10/15

statistic
Mode of delivery

HSAH

SVD

131(62%)

LSCS

EM:65(30%) +
EL:14(7%)= 79(37%)

VENTOUSE

FORCEP

ABD

1(0.5%)

TOTAL

211

FROM BALING
TOTAL DELIVERY AT BALING HOSP: 8
REFERRAL FROM HOSP BALING: 12
SVD
:8
LSCS- EM : 8
EL : VENTOUSE: FORCEP : -

TOTAL: 16

KULIM
: 4 (3 SVD, 1 EM LSCS)
SIK
: 4 ( 2 SVD, 2 EM LSCS)
YAN
: 3( 3 SVD)
PENANG
: 10( 4 SVD, 5+1 LSCS)
PERAK
: 8(4 SVD, 3+1 LSCS)
PERLIS
: 2 ( 1 ABD, 1 EL LSCS)
SELANGOR : 5( 1 SVD, 4 EM LSCS)
JOHOR
: 4( 3 SVD, 1 EM LSCS)
SARAWAK
: 2 (1SVD + 1 EM LSCS)
KELANTAN
:1 EM LSCS
MELAKA
: 1 SVD
N. SEMBILAN : 1 SVD
TOTAL: 45

Indication
FETAL DISTRESS

Total
40

POOR PROGRESS

FAILED IOL

MACROSOMIC BABY

1(WT 3.68)

BREECH IN LABOUR

4(30W, 37WX2,
39W)

UNSTABLE LIE

SCAR DEHISENCE

2 PREV SCAR

2( 37W, 38W)

CPD

BLEEDING PP

SEVERE PE

TOTAL

65

Indications

Total

Breech

2 previous scar

refused VBAC

Twin pregnancy

Placenta praevia

h/o myomectomy

IVF pregnancy

Total

14

Poor apgar score: 5

-SVD +ABD
: 2+1
- Edward Syndrome
-Potter Syndrome
- svd in OT : for fetal distress, at 35w(3/9)
-LSCS
: 2
- fetal distress secondary to abruptio placenta(5/9)
- fetal distress, a/s : 3/9- admitted for post ppv

NICU admission
-

premature
:2
Tro MAS
:1
Post PPV
:1
GBS positive +poor apgar: 1

Total:

Melur admission
Presumed sepsis
Mother active IVDU

: 15
: 1

IDM
RHESUS negative
Total:

: 11
: 3
30

MACROSOMIC BABY
LSCS: <3.5 : 0
3.5- 4.0 : 6
- Svd : 2 (wt :3.8,4.06)

 IOL
: 20 cases
Failed IOL : 39 (15%)

PPH
3 CASES: - 2 EM LSCS

- 1 SVD

Madam F/ 26/ g1p0 at 37w4d

Admitted for reduce fm on 3/10/15 at 6.10 pm
Ctg : reactive , scan : normal
Plan for iol cm
Having pv bleeding in ward at 2220,+ contraction pain
v/e : os 3cm , arm liquor mixed with blood 500 cc
Ctg : fetal tachycardia 170-190 bpm
Plan : for em lscs for fetal distress and suspected abruptio placenta
Patient sent to ot at 2300
Lscs started at 2312- intra op :convalae uterus ,retroplacenta clot
500cc
Total blood loss:900+500=1400cc
Iv duratocin given x1
Post op hb : 8.3

 Baby a/s 5/9, wt 3.02

Admitted for TTN
On admission bay active , pink, mildy
tachypnic
Baby on cpap for 8 hrs
Developed jaundice 39 hrs of life- on
single photo for 2 days
Discharge well day 6 of life

Mdm S /30/ g1p0 at 39+2

Gdm on diet control
Late onset pih on t. nifedipine 10 mg tds
B. asthma not on rx
Prostin x3 for
Em lscs for poor progress
Intra op : EBL 1000cc
Post op Hb : 10.4
BABY A/S 9, WT 2.7

Mdm SS/G3P2 AT 39 W
Admitted on established labour- os 4cm
Delivered on 6/10/15
Complicated with extended vaginal wall tear
Repair in ot
Intra op:
Multiple vaginal wall tears
Vaginal wall fragile with multiple raw area
Vascular vaginal wall
No cervical tear
Uterus well contracted
Ebl : 2.5L
Tranfused 1 pint wb + 1 cycle DIVC regime intra op
Hb : 7.3
Total tranfusion : 2 pint wb+ 2 pint pc + 1 cycle divc
Hb : 9.9

to be continue

Thank you

THANK YOU