In elective Caesarean section, a 2 u bolus of oxytocin results in less haemodynamic change than 5 u, with less nausea and no difference in the need for additional uterotonics.

Collection of near-miss data has the potential to become a useful tool for the assessment of obstetric care in both in CBH and in other Australian hospitals but is time-consuming and requires continuous surveillance by medical staff if cases are not to be overlooked.

RHD has a major impact on maternal cardiac outcomes. However, with current management practices, maternal and fetal mortality are low, and the incidence of complications is predictable based on known risk factors.

Background: Obesity is prevalent in the Australian antenatal population, but there are scarce data on the prevalence and associated outcomes of body mass index (BMI) ≥50 kg/m 2 . Aims: To examine the prevalence and outcomes for women with BMI ≥50 kg/m 2 delivering in a non-tertiary hospital. Materials and Methods:Retrospective cohort study of women delivering a singleton pregnancy in a non-tertiary Victorian hospital during 2011-2016. Women >180 kg were excluded as their care was managed in a tertiary centre. Maternal and perinatal outcomes were analysed by BMI group. Statistical analysis was performed using χ 2 , Kruskal-Wallis and logistic regression with a significance level of 0.05. Results:Of the 18 518 births between 2011 and 2016, 99.4% had a maternal BMI recorded. The prevalence of BMI ≥50 kg/m 2 was 0.5%. Highest complication rates were observed among women with BMI ≥50 kg/m 2 , including gestational diabetes (29%), hypertensive disorders of pregnancy (20%) and caesarean section (48%). Of infants born to women with BMI ≥50 kg/m 2 , 12% were late-pre-term, 23% required special or intensive care and 20% had birth weight ≥4.0 kg. When compared with obese women with BMI 30-49 kg/m 2 , women with BMI ≥50 kg/m 2 were significantly more likely to develop a hypertensive disorder of pregnancy (preeclampsia adjusted odds ratio (aOR) 3.98 (1.93-8.18), pregnancy-induced hypertension aOR 3.55 (1.79-7.03)) and deliver a late pre-term infant (aOR 2.45 (1.31-4.58)). Conclusions:The prevalence of severe maternal obesity in our non-tertiary setting is higher than previous national estimates. Women with BMI ≥50 kg/m 2 are an important subgroup of the obese obstetric population who experience high rates of complications and interventions. Health services need to respond to evolving needs of the antenatal population to achieve the best outcomes for mothers and babies. K E Y W O R D SBMI, maternal obesity, maternal outcomes, perinatal outcomes, severe obesity SUPPORTING INFORMATIONAdditional supporting information may be found online in the Supporting Information section at the end of the article. Table S1. Listed categories of indications for induction of labour.

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