Value sets – OAS Obstetric surgery reason

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Obstetric surgery reason

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Concept IDDescription
704175009Acute chorioamnionitis
1091821000000108Acute fetal compromise
416413003Advanced maternal age gravida
34842007Antepartum haemorrhage
90532005Central laceration during delivery
11612004Chorioamnionitis
237274002Concealed placental abruption
445548006Dead foetus in utero
275429002Delayed delivery of second twin
249196008Distress from pain in labour
200164009Exhaustion during labour
38451000119105Failed attempted vaginal birth after previous caesarean section
17594002Fetal bradycardia affecting management of mother
14022007Fetal death, affecting management of mother
1208945009Fetal disorder due to placental abruption
12867002Fetal distress affecting management of mother
816967008Fetal distress due to augmentation of labour with oxytocin
267256003Fetal distress-affecting care
22033007Fetal growth restriction
4006006Fetal tachycardia affecting management of mother
57759005First degree perineal laceration
70591005Foetal disorder
288274003Foetal distress – in labour
288273009Foetal distress – prelabour
90562004Foetal distress, in liveborn infant
7996008Foetal intrauterine distress first noted during labour AND/OR delivery in liveborn infant
74796005Foetal intrauterine distress noted before labour in liveborn infant
399031001Fourth degree perineal laceration
16950007Fourth degree perineal laceration involving anal mucosa
34262005Fourth degree perineal laceration involving rectal mucosa
199935005Fourth degree perineal tear during delivery with postnatal problem
237021000Hydrostatic replacement of inverted uterus
237333004Hymen tear
724490006Intrapartum haemorrhage co-occurrent and due to obstructed labour with uterine rupture
249221003Labial tear
1345227001Laceration of clitoris
1345228006Laceration of clitoris during vaginal delivery of fetus
283970001Laceration of female perineum
206267000Liveborn with labour abnormal heart beat
206266009Liveborn with labour foetal distress
206268005Liveborn with labour hypoxia
206269002Liveborn with labour meconium in liquor
206262006Liveborn with prelabour abnormal heart beat
206260003Liveborn with prelabour foetal distress
206263001Liveborn with prelabour hypoxia
206264007Liveborn with prelabour meconium in liquor
237022007Manual replacement of inverted uterus
9838004Manual replacement of obstetrical inverted uterus
408855004Maternal choice
87383005Maternal distress
10808861000119105Maternal distress during childbirth
704144000Maternal history of diabetes mellitus
16356006Multiple pregnancy
130955003Nonreassuring fetal status
398019008Perineal laceration during delivery
237296008Placenta accreta spectrum
36813001Placenta praevia
415105001Placental abruption
47821001Postpartum haemorrhage
724496000Postpartum haemorrhage co-occurrent and due to uterine rupture following obstructed labour
1148794004Postpartum haemorrhage with retained placenta
398254007Pre-eclampsia
198912003Premature separation of placenta with coagulation defect
270500004Prolapsed cord
19644003Repair of inverted uterus
22213003Repair of inverted uterus by vaginal approach
109894007Retained placenta
699949009Retained placenta due to morbidly adherent placenta
111453004Retained placenta, without haemorrhage
109895008Retained placental fragment
371374003Retained products of conception
1148941002Retention of part of placenta and uterine membrane without haemorrhage
1148942009Retention of part of placenta without haemorrhage
1148943004Retention of placenta and uterine membrane
237273008Revealed placental abruption
34430009Rupture of uterus
6234006Second degree perineal laceration
1125006Sepsis during labour
309738002Fetal macrosomia suspected
10217006Third degree perineal laceration
29171003Trapped placenta
36497006Traumatic extension of episiotomy
65147003Twin pregnancy
449807005Type 3a third degree laceration of perineum
449808000Type 3b third degree laceration of perineum
449809008Type 3c third degree laceration of perineum
237332009Vulval tear

CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”