II.

Classifications of perinatal deaths have been undertaken for surveillance of causes of death, but also for auditing individual deaths to identify suboptimal care at any level, so that preventive strategies may be implemented. This paper describes the history and development of the paired obstetric and neonatal Perinatal Society of Australia and New Zealand (PSANZ) classifications in the context of other classifications. The PSANZ Perinatal Death Classification is based on obstetric antecedent factors that initiated the sequence of events leading to the death, and was developed largely from the Aberdeen and Whitfield classifications. The PSANZ Neonatal Death Classification is based on fetal and neonatal factors associated with the death. The classifications, accessible on the PSANZ website (http://www.psanz.org), have definitions and guidelines for use, a high level of agreement between classifiers, and are now being used in nearly all Australian states and New Zealand.

The aims of this study were to provide a population-based prevalence for congenital talipes equinovarus (CTEV), to conduct an epidemiological investigation into the risk factors for CTEV and describe associated features. The study used a retrospective case-control design of CTEV notified to the South Australian Birth Defects Register between 1986 and 1996 inclusive, linking characteristics of mother and baby from the perinatal data collection. The prevalence of isolated CTEV was 1.1/1000 total births (n = 231). Four factors were significantly associated with an increased risk of CTEV: maternal Aboriginal race (ORadj = 2.0; 95% CI 1.1, 3.6), male gender (ORadj = 2.4; 95% CI 1.8, 3.2), maternal anaemia (ORadj = 1.8; 95% CI 1.0, 2.9) and maternal hyperemesis (ORadj = 3.6; 95% CI 1.3, 9.8). The prevalence of CTEV associated with another birth defect or syndrome (n = 157) was 0.7/1000 total births. CTEV was associated with specific birth defects and also with oligohydramnios when another birth defect was present.

The feasibility of OPathPaed model has been confirmed. It is significant and timely that when this pilot study was completed, a government-led initiative to study the feasibility of newborn screening for IEM in the public health care system on a larger scale was announced in the Hong Kong Special Administrative Region Chief Executive Policy Address of 2015.

2 received platelets, 2 received coagulation factor, and all received fresh-frozen plasma and/or cryoprecipitate. Of the 19 women with AFE who delivered in a hospital, 5 stillbirths and 1 neonatal death were reported. Three perinatal deaths occurred among surviving mothers, and the perinatal mortality rate for mothers who died was 50%. Follow-up data for the 13 survivors indicated that 6 of these patients required hospitalization within 12 months of the AFE episode for a variety of reasons, some of which could have been unrelated to the AFE. Two survivors had subsequent births during the study period. Of note, both women experienced AFE and an associated perinatal death during the second birth.Although 66% of women and infants survived AFE, many had severe morbidity. Based on their data analysis, the investigators were able to identify 2 new risk factors for AFE-induction with vaginal prostaglandin and manual removal of the placenta. Compared to data from the United Kingdom, the incidence rate reported in this Australian study was higher but the maternal and perinatal case fatality rates were similar. In contrast, the incidence rates reported in database studies from the United States and Canada were higher and the maternal mortality rates were lower compared to the Australian data.O ver the last 3 decades, cesarean delivery rates have increased worldwide. A concern exists for uterine rupture in these women during subsequent pregnancies. Previous studies have found that the risk of uterine rupture among women who attempt vaginal birth after cesarean (VBAC) is higher compared to women who do not labor but rather undergo elective repeat cesarean delivery. The risk of rupture has been reported to be highest when labor is induced with prostaglandins. This population-based retrospective cohort study was designed to quantify the risk of uterine rupture during the second singleton birth when the first birth had been by cesarean delivery.The data were obtained from databases from the 4 largest Australian states that include 60% of the annual births in the country. All women having a singleton second pregnancy during 1998 to 2000 were included if the first birth was a live-born singleton infant delivered by cesarean section (CS). Women were placed in the following subgroups: (1) repeat CS without labor (elective cesarean), (2) spontaneous onset of labor with oxytocin augmentation, (3) induction of labor with oxytocin, (4) induction of labor with prostaglandins, (5) induction of labor with both oxytocin and prostaglandins, and (6) induction of labor with neither oxytocin nor prostaglandins. Each subgroup was compared with a reference group that included women with spontaneous onset of labor without oxytocin augmentation. Cases of uterine rupture were identified from the International Classification of Diseases (ICD) codes. The uterine rupture was then confirmed by review of case records.During the study period, data from 29,008 women were found that met the inclusion criteria. The mean age was 31.2 years, and 22% were Z35 ...