Abstract

Amalgamation of Group 6– 10 prevents data validation. Groups 8 and 9 are consistently similar sizes universally and are known to have high PPH rates. The rationale behind this amalgamation fails to acknowledge one of the great strengths of the StTGCST as being a core maternity quality metric. We do appreciate that further subdivision or amalgamation of the TGCS may be useful in certain instances, to provide appropriate denominators depending on the event being evaluated. It is important to agree a standard starting point for presentation of perinatal data. If the TGCS is accepted as that starting point, then we must also accept that the only reason not to start with this is the unavailability of the data. Any modifications, in particular amalgamation of groups, should only be undertaken after an initial analysis using the StTGCST. If the modification is due to unavailability of data, then this should be clearly stated in the methodology. We suggest that all papers using the TGCS philosophy should begin by using the StTGCST. Indeed, including the caesarean section rates for each group also adds a lot to the interpretation of data quality, the context of the population and philosophy of practice. Ultimately, this will encourage everyone to ensure that the required data is collected routinely and, most importantly, we can all learn from each other.