OBSTETRICS AUDIT FORM – HKCOG 2004 NAME : (initials) Date of Delivery : (dd/mm/yy) AGE : Status : * HK Resident / Non-HK Resident ID. No : X(X) (at least 5 digits) Maternal Death : * No / Yes ANTENATAL COMPLICATIONS INFORMATION ABOUT LABOUR Cardiac Disease * 1. No Onset of Labour * Spontaneous / Induced / No Labour 2. Rheumatic heart disease Duration of Labour hours 3. Congenital heart disease Indication for Induction (at most 3) 4. MVP * 1. No / irrelevant 5. Arrhythmia 2. DM / GDM / IGT 6. Others 3. Maternal disease Diabetes * 1. No 4. Bad obstetrical history 2. Pre-existing DM 5. Prolonged pregnancy / Post- date (= 41 weeks) 3. Gestational DM 6. Hypertension 4. Impaired glucose tolerance (IGT) 7. PROM ± intraut. Infection Anaemia * No / Yes 8. APH Renal Disease * 9. Multiple pregnancy Liver Disease * No / Yes 10. Suspected IUGR / IUGR Respiratory Disease * 11. IUD 12. Fetal anomaly GI / Biliary Disease * No / Yes 13. Suboptimal CTG / fetal distress Epilepsy * 14. Others Psychiatric Disease * No / Yes Syntocinon Augmentation * No / Yes Immunological Disease * No / Yes Epidural Anaesthesia * Thyroid Disease * Surgical Disease * No / Yes Episiotomy * No / Yes OBSTETRIC HISTORY & COMPLICATIONS POSTNATAL COMPLICATIONS Parity * 0 / 1 / 2 / 3 / 4 / 5 / 5+ Postpartum Haemorrhage (at most 3) * 1. No Multiple Pregnancy * Singleton/Twins/Triplets/Higher 2. Uterine atony Previous Uterine Scar * No / Yes 3. Retained ...