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143 Standalone Chapters NMH Annual Rep t | 2020 Outpatient Clinics The Anaesthetic High Risk Clinic was held three to four times per month and a variety of patients were reviewed for obstetric and gynaecology pre- assessment. In 2020 a total of 160 new patients & 25 return patients were reviewed. Some patients are also reviewed at the weekly multidisciplinary high risk meeting. Chronic Pain Medicine Clinic The chronic pain medicine service continued to welcome multidisciplinary referrals from within house, from consultant obstetric, anaesthetic and pain medicine colleagues, physiotherapists, midwives and from primary care physicians in the community. 61 patients attended for first time evaluation and 115 return patients were reviewed. Invasive interventions in the form of local anaesthetic, local anaesthetic and steroid injection and radiofrequency neuromodulation were provided in the operating theatre for 34 patients. Data collated from MN-CMS & theatre database. • Not all patients who had PDPH had recognised dural puncture. • Not all patients with PDPH had epidural blood patch. High Dependency Unit (HDU) There were 140 instances of patients requiring overnight stay in HDU in 2020 (ranging from 9-16 admissions per month). The most common reasons for HDU admission were: • Haemorrhage 60 (43%) • Hypertensive disease of pregnancy 42 (30%) • Sepsis 13 (9%) • Other 24 (17%) Some patients were admitted for more than one of the above reasons. There were 4 patients transferred from HDU to St Vincent's University Hospital for further specialist care and 2 patients transferred into HDU from other hospitals in 2020. Total Delivered Pre-labour C-Section Epidural Rate % Nullip 3201 427 2176 78% (2176/2774) Multip 4062 1086 1462 49% (1462/2976) Total 7263 1513 3638 63% (3638/5750) SVD Instrumental C-Section Nullip 1029 (47%) 684 (31%) 463 (21%) Multip 1223 (84%) 136 (9%) 103 (7%) Accidental dural puncture recorded 12 Epidural blood patch performed 13 % Spinal 1663 74% Spinal/Epidural 73 3% Epidural 466 20% General 77 3% Total 2279 Mode of Delivery after Epidural Analgesia Mode of Anaesthesia for C-Section on MN-CMS Epidural Rate Post Dural Puncture Headaches (PDPH) and Epidural Blood Patch