Obstetrics in Upstate New York

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Obstetrics inUpstate New York

• Chris Glantz, MD, MPH

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The Finger Lakes Region

• Nine Counties
• Monroe 58
• Others 1 to 7
• 14 OB Hospitals
• SMH, HH, RGH 60
• AO 9, Park Ridge 8
• Others
• 15,000 Del/Yr

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Regional Deliveries
2002 USA 4 million NYS 251,000
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Age, Medicaid, and Care1999-2003
Upstate Regions Medicare rising
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Age Changes Over Time(Upstate)
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Antenatal Testing
Upstate Trend Triple Screening Declining
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Genetic Amniocentesis
USA 2002 2
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Labor Induction
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Augmentation of Labor
Including induction, total oxytocin use exceeds
40
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Labor Epidural
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Operative Vaginal Delivery
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Cesarean Delivery
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Primaries and Repeats
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National Comparisons
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Low Risk Cesarean
Low percent is better
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Low Risk VBAC
High percent is better
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Preterm Delivery and Low Birth Weight, 1999-2003
USA 2002 PTD 12.1 LBW 7.8
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Perineal Trauma
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Upstate NY Outcomes1999-2003

• Maternal Transports 0.8
• Neonatal Transports 1.4
• Low 5-minute Apgar 0.6
• RPCs 1.3
• Congenital Anomaly 0.8
• RPCs 1.5
• Patient Satisfaction
• Upstate Office 96 Hospital 97
• Finger Lakes Office 96 Hospital 96
• RPCs Office 95 Hospital 96

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NICU Admissions
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Breast Feeding Intent
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Healthy People 2010 and the Finger Lakes Region
2003
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Five Year Upstate Trends

• Declining
• Teen, Triple Screening, Genetic Amniocentesis
• Operative Delivery (), VBAC, Episiotomy
• Increasing
• Medicaid, Age 35, Labor Induction
• Epidural, Cesarean (Primary Repeat)
• Breast feeding, Satisfaction (Office Hospital)

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Finger Lakes Compared With Other Regions 2003

• Lower
• Early Care, Medicaid, Smoking,
• Low Risk Cesarean, External Monitoring
• Higher
• Age 35, HIV Pretest, Genetic Amniocentesis
• Labor Induction, Epidural, Internal Monitoring
• Operative Delivery, VBAC, Delivery Lacerations
• Maternal Transports, NICU Care
• Breast feeding, Satisfaction (Office Hospital)

Underline Lowest or Highest
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Portrait of Obstetrics in the Finger Lakes Region
and Upstate New York