Observed cases  divided by expected cases times Canadian average

Logistic regression for risk-adjustment. 

Cases within the denominator with at least one obstetric trauma :

1. Third-degree perineal laceration during delivery, delivered, with or without mention of antepartum condition (ICD-10-CA: O70.201)
2. Fourth-degree perineal laceration during delivery, delivered, with or without mention of antepartum condition (ICD-10-CA: O70.301)
3. Obstetric laceration of cervix, delivered, with or without mention of antepartum condition (ICD-10-CA: O71.301)
4. Obstetric high vaginal laceration alone, delivered, with or without mention of antepartum condition (ICD-10-CA: O71.401)
5. Other obstetric injury to pelvic organs, delivered, with or without mention of antepartum condition (ICD-10-CA: O71.501)
6. Other rupture of uterus during labour, delivered, with or without mention of antepartum condition (ICD-10-CA: O71.181)
7. Obstetric damage to pelvic joints and ligaments, delivered, with or without mention of antepartum condition (ICD-10-CA: O71.601)
8. Surgical repair, postpartum, of obstetric laceration:

• Of corpus uteri (CCI code: 5.PC.80.JH)
• Of current obstetric laceration of cervix occurring at vaginal delivery (CCI code: 5.PC.80.JJ)
• Of current obstetric laceration of bladder and urethra (CCI code: 5.PC.80.JR)
• Of current obstetric laceration of rectum and sphincter ani (CCI code: 5.PC.80.JQ)
• Of current obstetric high vaginal laceration (CCI code: 5.PC.80.JU)
• Of current obstetric laceration of broad ligament(s) of uterus (CCI code: 5.PC.80.JL)

Vaginal delivery discharges with instrument-assisted delivery:  

Inclusions:

1. Admission to an acute care institution (Facility Type Code = 1)
2. Delivery code (ICD-10-CA: O10–O16, O21–O26, O28–O37, O40–O46, O48, O60–O75, O85–O92, O95 or O98–O99 with a sixth digit of 1 or 2 OR Z37 coded in any position)
3. Instrument-assisted vaginal delivery (CCI code: 5.MD.53^^, 5.MD.54^^, 5.MD.55^^, 5.MD.56.NN, 5.MD.56.PC, 5.MD.56.NR, 5.MD.56.PF, 5.MD.56.NW or 5.MD.56.PJ)

Exclusions:

1. Newborn, stillbirth or cadaveric donor records (Admission Category = N, R or S)
2. Records with invalid discharge date
3. Records with invalid age
4. Records with unknown or invalid (>45 completed weeks) gestational age
5. Caesarean sections (CCI code: 5.MD.60.^^)
6. Delivery in which an abortive procedure was recorded (code may be recorded in any position; procedures not coded as "abandoned after onset" [Intervention Status Attribute = A]):

CCI: 5.CA.20.^^, 5.CA.24.^^, 5.CA.88.^^, 5.CA.89.^^, or 5.CA.93.^^

OR

ICD-10-CA: O04

Age; Malposition/malpresentation of the fetus; Gestational age at delivery ≥41 weeks; Diabetes (pre-existing/gestational); Fetal heart rate anomaly/asphyxia during labour and delivery; Shoulder dystocia; Prolonged second-stage labour; Large fetus