Highland Acute Hospital NHS Trust
Raigmore Hospital, Old Perth Road, Highland, IV2 3UJ
www.show.scot.nhs.uk/haht/

2 July 2003

Dear Ms Shaw

Thank you for your letter concerning Caesarian hysterectomy. I will do my best to address the questions you pose regarding our maternity activity in this hospital.

1 Number of Births In 1990 we had 2317 births. this figure rose to a peak of just over 2500 in 1992 but subsequently has fallen year on year to a figure of 1770 2002.

2 Number of Home Births In the past 20 years the number has varied between 20 and 30 per annum, but statistical accuracy of these fugures cannot be guaranteed as not all the home births in the Highland region (almost the size of Belgium) are registered via this department.

3 Number of Caesarean Sections In 1990 we had 331 caesarian sections (14.29%). this figure has gradually risen year on year reflecting nation trends, and in 2002 we had 424 Caesarean secions representing 24.7% of the total births.

4 Number of Hysterectomies This data is not normally recorded in our maternity annual statistics as the number are very small varying between 0 and approximately three per annum. The vast majority of these cases are post Caesarian section, and almost invariably are as a result of uncontrollable maternal haemorrhage. The majority are total hysterectomies but in recent years an increasing number have been sub total.

5 Maternal Deaths In a relatively small unit such as this our maternal deah rate is small and varies between zero and one per annum, on average about one every three years. I regret I do not have the cause of every single maternal death.

6 Number of Baby Deaths Our perinatal mortality rate which includes stillbirths and babies who die within the first six days is normally expressed as a figure per 1000 total births. in 1990 our perinatal loss was 6.47 and this figure has remained fairly static over the past 10 years. The 2002 figure was 6.4 per 1000.

I am sorry that I have not answered all of your questions in as specific manner as you might have wished. While we have no objection to releasing data which is already in the public domain, there are some concerns about the release of details for example of maternal deaths, which could although anonymised, in an area such as this where the numbers are exceedlingly small, be eventually identifiable. I hope you will understand my unwillingness to provide this information. Please let me know if I can be of further assistance. I should add that we would be very happy to pass on your details to anyone in future who has the misfortune to require emergency hysterectmy associated with childbirth. It would be helpful to know if you are acting as a representative of a self help group, or if you are simply an individual who would be willing to share her own experience with others.

With kind regards

Yours sincerley

(signed)

D A RUSSELL LEES
Consultant Obstetrician & Gynaecologist
& Head of Service