5 Maternal Health Outcomes
5.1 Gestational diabetes by year, Nova Scotia, 2011-2020
ᵃ Among women without pre-existing diabetes.
Note: Diabetes mellitus first detected in pregnancy as recorded in the medical record. Please note that the criteria for the diagnosis of gestational diabetes (GDM) were revised by Diabetes Canada (formerly the Canadian Diabetes Association) in 2013. Therefore, the rates of GDM were expected to increase as the new criteria are adopted across Nova Scotia, starting approximately in late 2014.
In April 2020, during the global COVID-19 Global Pandemic, the Society of Obstetricians and Gynecologists of Canada (SOGC) and Diabetes Canada suggested an interim approach for GDM screening, involving serum A1c and fasting glucose. Nova Scotia implemented this strategy to comply with public health social distancing guidelines. It's important to note that this approach primarily aimed to identify the highest-risk pregnant individuals, potentially missing many GDM cases. Consequently, this impacted the reported GDM rates in the NSAPD database during that period.
5.2 Gestational hypertension by year, Nova Scotia, 2011-2020
ᵃ Among women without pre-existing hypertension.
Note: Gestational hypertension is hypertension that is first detected after the 20ᵗʰ week of gestation. Gestational hypertension with significant proteinuria includes those cases denoted as such; severe pre-eclampsia; HELLP syndrome (Hemolysis, Elevated Liver Enzymes, Low Platelets); and eclampsia.
5.3 Pre-eclampsia by year, Nova Scotia, 2011-2020
Note: Pre-eclampsia includes women coded as having gestational hypertension with significant proteinuria, moderate or severe pre-eclampsia, HELLP syndrome (Hemolysis, Elevated Liver Enzymes, Low Platelets), eclampsia, or pre-existing hypertension with superimposed proteinuria.
5.4 Placenta previa by year, Nova Scotia, 2011-2020
Note: Placenta previa is diagnosed when the placenta entirely or partially covers the opening of the uterus (cervix). The diagnosis is not made on ultrasound alone and must be confirmed clinically.
5.5 Placental abruption by year, Nova Scotia, 2011-2020
Note: Placental abruption is defined as bleeding from the placental site due to the partial or complete separation of the placenta. The diagnosis is not made on ultrasound alone and must be confirmed clinically.
5.6 Perineal laceration deliveries by parity and year, Nova Scotia, 2011-2020
ᵃ With known partner status.
Note: Maternal perineal laceration, rupture or tear during delivery involving the pelvic floor, perineal muscles, or vaginal muscles (2ⁿᵈ degree), anal sphincter (3ʳᵈ degree), or rectal mucosa (4ᵗʰ degree).
5.7 Postpartum hemorrhage by year, Nova Scotia, 2011-2020
Note: Postpartum hemorrhage is diagnosed if, after the delivery of the fetus, excessive maternal bleeding occurs from the genital tract with an estimated blood loss of greater than 500ml for vaginal deliveries or 1000ml for Caesarean section deliveries.