RECOMMENDATION REFERRENCES TYPE OF DELIVERY

National Obstetrics Registry 4 Table 1.1 Distribution of delivery by SDP 2011 and 2012 SDP 2011 2012 n n HTF, Perlis 4,119 3.01 3,954 3.19 HSB, Kedah 10,502 7.67 10,419 8.40 HPP 3,383 2.47 3,046 2.45 HRPB, Perak 6,320 4.62 4,603 3.71 HTAR, Selangor 12,477 9.12 12,212 9.84 HKL 11,868 8.67 11,995 9.67 HTJ Negeri Sembilan 4,886 3.57 6,273 5.05 Hospital Melaka 10,939 7.99 10,877 8.76 HSA, Johor 12,641 9.24 12,466 10.05 HTAA, Pahang 9,431 6.89 8,823 7.11 HSNZ, Terengganu 12,181 8.90 12,945 10.43 HRPZ 11, Kelantan 13,220 9.66 11,096 8.94 HU Sarawak 9,941 7.26 1,522 1.23 HL, Sabah 14,955 10.93 13,865 11.17 Total 136,863 100 124,096 100 Table 1.2 Distribution of Total delivery by Types 2011 and 2012 Delivery Types 2011 2012 n n Vaginal SVD 96,312 70.37 86,080 69.37 Breech 535 0.39 448 0.36 NA 24 0.02 16 0.01 Total 96,871 70.78 86,837 69.98 Instrumental Vacuum 4,387 3.21 4,183 3.37 Forceps 568 0.42 437 0.35 Total 4,947 3.61 4,616 3.72 CS LSCS 31,817 23.25 30,929 24.92 Classical 133 0.10 139 0.11 Hysterotomy 18 0.01 23 0.02 Hysterectomy 53 0.04 51 0.04 Others 10 0.01 10 0.01 Total 32,037 23.41 31,124 25.08 NA 3,007 2.20 1,519 1.22 Total 136,862 100.00 124,096 100.00 3 tio n a l O b st e tri cs R e g ist ry 5 Table 1.3 Distribution of delivery by age 2011 and 2012 Delivery Type 2011 Age 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Vaginal 107 5,381 19,618 33,546 23071 11269 3043 222 14 1 0.11 5.55 20.25 34.63 23.82 11.63 3.14 0.23 0.01 0.00 Instrumental 4 301 1,179 2,062 909 360 100 6 2 0.08 6.08 23.83 41.68 18.37 7.28 2.02 0.12 0.04 0.00 Caesarean 12 867 4,704 10,399 8597 5008 1519 128 7 0.04 2.71 14.68 32.46 26.83 15.63 4.74 0.40 0.02 0.00 NA 4 182 547 956 728 415 103 6 3 0.13 6.05 18.19 31.79 24.21 13.80 3.43 0.20 0.10 0.00 2012 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 Vaginal 104 4,621 17,069 30,701 20876 9963 2668 200 17 0.12 5.32 19.66 35.35 24.04 11.47 3.07 0.23 0.02 0.00 Instrumental 5 278 1,060 1,866 952 332 88 7 1 0.11 6.02 22.96 40.42 20.62 7.19 1.91 0.15 0.02 0.00 Caesarean 17 764 4,103 10,332 8637 4913 1448 101 8 2 0.05 2.45 13.18 33.20 27.75 15.79 4.65 0.32 0.03 0.01 NA 73 281 522 365 196 58 6 0.00 4.81 18.50 34.36 24.03 12.90 3.82 0.39 0.00 0.00 4 N a tio n a l O b st e tri cs R e g ist ry 6 Table 1.4 Distribution of delivery type by SDP 2011 SDP 2011 Vaginal Instrumental Caesarean NA Total SVD Breech NA Vacuum Forceps n n n n n n n n HTF, Perlis 2,999 72.72 18 0.44 0 0.00 119 2.89 4 0.10 952 23.08 32 0.78 4,124 3.01 HSB, Kedah 7,036 66.97 58 0.55 2 0.02 562 5.35 9 0.09 2610 24.84 229 2.18 10,506 7.68 HPP 1,688 49.84 9 0.27 0 0.00 53 1.56 15 0.44 1464 43.22 158 4.66 3,387 2.47 HRPB, Perak 3,239 51.23 7 0.11 0 0.00 23 0.36 8 0.13 2909 46.01 137 2.17 6,323 4.62 HTAR, Selangor 8,554 68.60 76 0.61 1 0.01 599 4.80 255 2.04 2895 23.22 90 0.72 12,470 9.11 HKL 8,107 68.28 64 0.54 2 0.02 195 1.64 17 0.14 3397 28.61 91 0.77 11,873 8.68 HTJ, Negeri Sembilan 3,472 71.50 10 0.21 7 0.14 148 3.05 13 0.27 1029 21.19 177 3.64 4,856 3.55 Hospital Melaka 7,922 72.38 27 0.25 1 0.01 396 3.62 61 0.56 2441 22.30 97 0.89 10,945 8.00 HSA, Johor 7,869 62.22 75 0.59 4 0.03 942 7.45 89 0.70 3344 26.44 324 2.56 12,647 9.24 HTAA, Pahang 6,652 70.50 18 0.19 3 0.03 396 4.20 15 0.16 2275 24.11 76 0.81 9,435 6.89 HSNZ, Terengganu 9,551 78.37 55 0.45 2 0.02 86 0.71 26 0.21 2305 18.91 162 1.33 12,187 8.90 HRPZ II, Kelantan 10,677 80.81 53 0.40 1 0.01 54 0.41 14 0.11 2295 17.37 118 0.89 13,212 9.65 HU Sarawak 6,186 62.19 42 0.42 0 0.00 383 3.85 38 0.38 2346 23.59 952 9.57 9,947 7.27 HL, Sabah 12,360 82.66 23 0.15 1 0.01 431 2.88 4 0.03 1769 11.83 364 2.43 14,952 10.92 Total 53,295 59.17 266 0.30 11 0.01 2,292 2.54 186 0.21 32031 35.56 1,996 2.22 90,077 65.81 5 tio n a l O b st e tri cs R e g ist ry 7 Table 1.5 Distribution of delivery type by SDP 2012 SDP 2012 Vaginal Instrumental Caesarean NA Total SVD Breech NA Vacuum Forceps n n n n n n n n HTF, Perlis 7,903 63.37 71 0.57 1 0.01 871 6.98 82 0.66 3385 27.14 158 1.27 12,471 9.11 HSB, Kedah 6,652 63.80 50 0.48 3 0.03 721 6.92 22 0.21 2816 27.01 162 1.55 10,426 7.62 HPP 7,980 71.90 34 0.31 0.00 99 0.89 8 0.07 2144 19.32 834 7.51 11,099 8.11 HRPB, Perak 7,831 71.99 26 0.24 3 0.03 354 3.25 17 0.16 2615 24.04 32 0.29 10,878 7.95 HTAR, Selangor 4,425 70.63 16 0.26 1 0.02 213 3.40 17 0.27 1588 25.35 5 0.08 6,265 4.58 HKL 6,381 72.34 18 0.20 0.00 355 4.02 29 0.33 2030 23.01 8 0.09 8,821 6.45 HTJ, Negeri Sembilan 1,662 36.08 2 0.04 0.00 12 0.26 2 0.04 2872 62.35 56 1.22 4,606 3.37 Hospital Melaka 2,877 72.71 23 0.58 2 0.05 107 2.70 11 0.28 935 23.63 2 0.05 3,957 2.89 HSA, Johor 1,544 50.67 8 0.26 0.00 53 1.74 14 0.46 1350 44.31 78 2.56 3,047 2.23 HTAA, Pahang 11,356 83.64 9 0.07 1 0.01 277 2.04 5 0.04 1928 14.20 1 0.01 13,577 9.92 HSNZ, Terengganu 1,110 72.83 8 0.52 1 0.07 44 2.89 3 0.20 340 22.31 18 1.18 1,524 1.11 HRPZ II, Kelantan 8,056 65.98 73 0.60 1 0.01 589 4.82 184 1.51 3144 25.75 163 1.33 12,210 8.92 HU Sarawak 10,588 81.76 77 0.59 3 0.02 170 1.31 28 0.22 2084 16.09 0.00 12,950 9.46 HL, Sabah 7,715 64.27 33 0.27 0.00 318 2.65 15 0.12 3921 32.66 2 0.02 12,004 8.77 Total 86,080 69.51 448 0.36 16 0.01 4,183 3.38 437 0.35 31152 25.16 1,519 1.23 123,835 90.48 6 N a tio n a l O b st e tri cs R e g ist ry 8 Table 1.6 Deliveries in relation to risk level at booking 2011 and 2012 Risk Level at Booking 2011 Vaginal Instrumental Caesarean NA Total SVD Breech NA Vacuum Forceps n n n n n n n n Red 1,672 1.75 13 2.99 0.00 108 2.47 19 3.36 1143 37.60 85 2.89 3,040 2.25 Yellow 8,561 8.93 41 9.43 1 4.35 407 9.32 57 10.09 4971 34.74 270 9.17 14,308 10.57 Green 49,863 52.04 226 51.95 15 65.22 2,349 53.80 318 56.28 17219 24.11 1,431 48.61 71,421 52.75 White II 4,151 4.33 21 4.83 1 4.35 106 2.43 13 2.30 579 11.62 113 3.84 4,984 3.68 White I 12,318 12.86 47 10.80 2 8.70 730 16.72 98 17.35 3193 19.02 400 13.59 16,788 12.40 No Code 4,736 4.94 41 9.43 1 4.35 215 4.92 27 4.78 1158 18.08 227 7.71 6,405 4.73 NA 14,514 15.15 46 10.57 3 13.04 451 10.33 33 5.84 2974 16.13 418 14.20 18,439 13.62 2012 Red 1,694 1.98 15 4.20 0.00 104 2.50 15 3.46 1198 39.07 40 2.66 3,066 2.51 Yellow 11,246 13.14 37 10.36 0 0.00 614 14.76 76 17.55 6283 33.89 284 18.92 18,540 15.15 Green 49,637 58.01 201 56.30 9 56.25 2,355 56.61 232 53.58 17198 24.40 846 56.36 70,478 57.59 White II 5,851 6.84 13 3.64 0.00 174 4.18 11 2.54 948 13.44 55 3.66 7,052 5.76 White I 10,642 12.44 33 9.24 1 6.25 655 15.75 69 15.94 2721 19.03 175 11.66 14,296 11.68 No code 2,943 3.44 35 9.80 1 6.25 130 3.13 18 4.16 1037 24.50 68 4.53 4,232 3.46 NA 3,547 4.15 23 6.44 5 31.25 128 3.08 12 2.77 968 20.53 33 2.20 4,716 3.85 7 tio n a l O b st e tri cs R e g ist ry Table 1.7 Delivery by ethnicity 2011 Ethnicity 2011 Vaginal Instrumental Caesarean NA Total SVD Breech NA Vacuum Forceps n n n n n n n n Malay 65,850 71.07 310 0.33 19 0.02 2,776 3.00 363 0.39 21605 23.32 1,738 1.88 92,661 68.44 Chinese 5,398 64.02 21 0.25 0 0.00 383 4.54 60 0.71 2308 27.37 262 3.11 8,432 6.23 Indian 3,745 58.59 26 0.41 0 0.00 255 3.99 51 0.80 2214 34.64 101 1.58 6,392 4.72 KadazanDusun 3,222 80.51 8 0.20 0 0.00 125 3.12 1 0.02 553 13.82 93 2.32 4,002 2.96 Murut 256 74.42 0.00 0 0.00 7 2.03 0.00 71 20.64 10 2.91 344 0.25 Bajau 2,636 83.66 5 0.16 0 0.00 98 3.11 2 0.06 344 10.92 66 2.09 3,151 2.33 Melanau 90 73.17 0.00 0 0.00 1 0.81 0.00 18 14.63 14 11.38 123 0.09 Iban 1,410 65.52 9 0.42 0 0.00 79 3.67 8 0.37 472 21.93 174 8.09 2,152 1.59 Bidayuh 977 62.11 8 0.51 0 0.00 54 3.43 7 0.45 404 25.68 123 7.82 1,573 1.16 OA Peninsular Malaysia 581 63.85 1 0.11 0 0.00 34 3.74 3 0.33 278 30.55 13 1.43 910 0.67 Other indigenous group in Sabah Sarawak 2,197 81.52 0.00 1 0.04 78 2.89 5 0.19 359 13.32 55 2.04 2,695 1.99 Foreigners 8,217 72.51 33 0.29 3 0.03 426 3.76 57 0.50 2352 20.76 244 2.15 11,332 8.37 Others 916 75.77 10 0.83 0 0.00 38 3.14 6 0.50 204 16.87 35 2.89 1,209 0.89 unknown 320 78.05 4 0.98 0 0.00 13 3.17 2 0.49 55 13.41 16 3.90 410 0.30 Total 95,815 70.77 435 0.32 23 0.02 4,367 3.23 565 0.42 31237 23.07 2,944 2.17 135,386 100.00 8 N a tio n a l O b st e tri cs R e g ist ry 10 Table 1.8 Delivery by ethnicity 2012 Ethnicity 2012 Vaginal Instrumental Caesarean NA Total SVD Breech NA Vacuum Forceps n n n n n n n n Malay 59,674 69.88 268 0.31 12 0.01 2,774 3.25 278 0.33 21146 24.76 1,245 1.46 85,397 69.78 Chinese 4,707 63.49 20 0.27 0 0.00 366 4.94 46 0.62 2198 29.65 77 1.04 7,414 6.06 Indian 3,512 57.31 23 0.38 0 0.00 256 4.18 36 0.59 2265 36.96 36 0.59 6,128 5.01 KadazanDusun 2,912 80.73 2 0.06 0 0.00 64 1.77 3 0.08 624 17.30 2 0.06 3,607 2.95 Murut 215 83.33 1 0.39 0 0.00 3 1.16 0.00 39 15.12 0.00 258 0.21 Bajau 2,463 85.40 2 0.07 0 0.00 62 2.15 6 0.21 351 12.17 0.00 2,884 2.36 Melanau 23 60.53 1 2.63 0 0.00 3 7.89 0.00 11 28.95 0.00 38 0.03 Iban 573 75.79 1 0.13 1 0.13 24 3.17 1 0.13 145 19.18 11 1.46 756 0.62 Bidayuh 254 70.56 2 0.56 0 0.00 11 3.06 0.00 92 25.56 1 0.28 360 0.29 OA Peninsular Malaysia 446 59.55 3 0.40 0 0.00 18 2.40 1 0.13 278 37.12 3 0.40 749 0.61 Other indigenous group in Sabah Sarawak 1,911 82.91 1 0.04 0 0.00 46 2.00 2 0.09 342 14.84 3 0.13 2,305 1.88 Foreigners 7,423 70.51 31 0.29 3 0.03 457 4.34 58 0.55 2443 23.20 113 1.07 10,528 8.60 Others 1,070 73.79 1 0.07 0 0.00 48 3.31 2 0.14 321 22.14 8 0.55 1,450 1.18 Unknown 377 74.51 1 0.20 0 0.00 28 5.53 0.00 98 19.37 2 0.40 506 0.41 Total 85,560 69.91 357 0.29 16 0.01 4,160 3.40 433 0.35 30353 24.80 1,501 1.23 122,380 100.00 9 tio n a l O b st e tri cs R e g ist ry Table 1.9 Delivery by Parity 2011 and 2012 Parity 2011 Vaginal Instrumental Caesarean NA SVD Breech NA Vacuum Forceps n n n n n n n 1 29,941 64.30 157 0.34 7 0.02 2,818 6.05 406 0.87 12197 26.19 1,038 2.23 2 - 5 60,230 73.33 332 0.40 17 0.02 1,477 1.80 158 0.19 18144 22.09 1,781 2.17 ≥ 6 5,971 75.16 46 0.58 0 0.00 86 1.08 3 0.04 1663 20.93 175 2.20 NA 170 78.34 0.00 0 0.00 6 2.76 1 0.46 27 12.44 13 5.99 Total 96,312 70.37 535 0.39 24 0.02 4,387 3.21 568 0.42 32031 23.40 3,007 2.20 2012 n n n n n n n 1 27,133 63.07 139 0.32 6 0.01 2,773 6.45 331 0.77 11998 27.89 638 1.48 2 - 5 53,938 72.77 288 0.39 10 0.01 1,348 1.82 98 0.13 17638 23.79 805 1.09 ≥ 6 4,938 74.72 21 0.32 0 0.00 61 0.92 8 0.12 1506 22.79 75 1.13 NA 71 85.54 0.00 0 0.00 1 1.20 0.00 10 12.05 1 1.20 Total 86,080 69.51 448 0.36 16 0.01 4,183 3.38 437 0.35 31152 25.16 1,519 1.23 10 N a tio n a l O b st e tri cs R e g ist ry 12 Table 1.10 Deliveries in relation to Medical problems 2011 Medical Problems Vaginal Instrumental Caesarean NA Total SVD Breech NA Vacuum Forceps n n n n n n n n Diabetes 6,861

7.12 28

5.23 1

4.17 355

8.09 64 11.27 4193 13.09

234 7.78 11,736 8.57 Pre-existing 504 0.52 5

0.93 0.00

37 0.84 5 0.88 374 1.17 23 0.76 948 0.69 Gestational 6,326 6.57 23 4.30 1 4.17 316 7.20 59 10.39 3795 11.85 196 6.52 10,716 7.83 NA 88,983 92.39 400 92.34 22 91.67 4,013 91.47 501 88.20 27068 84.51 2,720 92.38 124,973 91.31 Hypertension 2,886

3.00 24

4.49 0.00

177 4.03 17 2.99 2603 8.13 116 3.86 5,823 4.25 Pre-existing 520 0.54 5

0.93 0.00

40 0.91 0.00 446 1.39 25 0.83 1,036 0.76 Gestational 2,169

2.25 17

3.18 0.00

119 2.71 16 2.82 1872 5.84 77 2.56 4,270 3.12 Pre-eclampsia 260 0.27 2 0.37 0.00 23 0.52 4 0.70 620 1.94 9 0.30 918 0.67 Eclampsia 7 0.01 0.00 0.00 0.00 0.00 37 0.12 2 0.07 46 0.03 Heart Disease 572

0.59 5

0.93 0.00

62 1.41 6 1.06 267 0.83 14 0.47 926 0.68 NYHA I 354 0.37 4 0.75 0.00 36 0.82 4 0.70 111 0.35 5 0.17 514 0.38 NYHA II 60 0.06 1 0.19 0.00 7 0.16 1 0.18 39 0.12 4 0.13 112 0.08 NYHA III 4 0.00 0.00 0.00 0.00 0.00 13 0.04 1 0.03 18 0.01 NYHA IV 0.00 0.00 0.00 0.00 0.00 1 0.00 0.00 1 0.00 NA 95,397 99.56 430 99.07 23 100.00 4,323 98.95 560 99.12 31073 97.01 2,934 99.67 136,148 99.48 Others 4,782

4.97 27

5.05 0.00

221 5.04 41 7.22 1763 5.50 107 3.56 6,941 5.07 TB 52 0.05 0.00 0.00 2 0.05 1 0.18 20 0.06 22 0.73 97 0.07 Blood Disorder 778 0.81 5 0.93 0.00 32 0.73 4 0.70 249 0.78 13 0.43 1,081 0.79 Thalassemia 332 0.34 1 0.19 0.00 15 0.34 2 0.35 120 0.37 4 0.13 474 0.35 Collagen Disease 3 0.00 0.00 0.00 0.00 0.00 2 0.01 0.00 5 0.00 Asthma 1,615 1.68 7 1.31 0.00 61 1.39 9 1.58 701 2.19 49 1.63 2,442 1.78 Renal Disease 22 0.02 0.00 0.00 2 0.05 0.00 13 0.04 0.00 37 0.03 11 tio n a l O b st e tri cs R e g ist ry 13 Table 1.11 Deliveries in relation to Medical problems 2012 Medical Problems Vaginal Instrumental Caesarean NA Total SVD Breech NA Vacuum Forceps n n n n n n n n Diabetes 6,286