A Study to Classify the Causes of Stillbirth by Relevant Condition at Death (ReCoDe) in a Tertiary Care Hospital

Kaur, Sukhvinder; Mondal, Md. Aftabuddin; Pati, Anuradha De; Akhtar, Selim; Pati, Shyamapada; Shankar, Nidhi

doi:10.14260/jemds/2020/751

Cited by 2 publications

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“…Notably, there was a slight male preponderance, reflective of the prevailing sex ratio at birth in the state of Maharashtra, India. Similar findings were observed in a study conducted by Kaur et al 7 We report that the most common cause of stillbirth in our study was maternal causes accounting for 43.6% of all stillbirths followed by placental causes and amniotic fluid causes (17%) representative of the socioeconomic and cultural background. The major reason for stillbirth was due to pregnancy-induced hypertension like the study by Kashif et al which reported 33.3% as compared to our study which reported 40.4% of stillbirths.…”

Section: Discussionsupporting

confidence: 92%

Analysis of Stillbirth as per Recode Classification System

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Shah,

Kansaria

2023

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim: To understand and classify the causes of stillbirth as per recode classification system and delineate the demographic details of patients prone to stillbirth. Materials and methods: A prospective, observational study conducted in a tertiary care center with a study population of 250 assessed for causes of stillbirth and maternal and fetal high-risk factors. Patients diagnosed with stillbirth clinically or via ultrasonography after 28 weeks of gestation were included after taking appropriate consent. Results: In maternal demography Majority of the stillbirths occurred in the age group of 26-35 years with the gestational age between 28 and 32 weeks of gestation. Multigravidas were more prone to stillbirth. About 74.8% were delivered via the vaginal route of which 1.2% was instrumental and the remaining underwent C-sections. A predilection of 1.6% more was seen towards the male gender. 40.8% were macerated stillbirths and thus majority was seen to occur in the antepartum period. Application of the Relevant Condition at Death (ReCoDe) Classification system showed maximum stillbirths occurring due to maternal causes commonest of which was a hypertensive spectrum of disorders amounting to 40.4% followed by anemia (21.6%). Amniotic fluid risk factors were next where the commonest cause of oligohydramnios (19.6%) was followed by meconium-stained liquor. In fetal risk factors, the most common cause seen was congenital lethal anomalies amounting to 14% followed by fetal growth restriction which was merely 10%. Placental causes of stillbirth showed preponderance in cases of abruption placenta. In corroboration to other studies, only 12.4% were left unexplained. Conclusion:As seen, ReCoDe classification system allowed us to classify 87.6% of the cases, thus leaving only 12.4% of stillbirths unexplained. The most common cause of stillbirth in our study was a hypertensive spectrum of disorders in pregnancy followed by various other maternal disorders in pregnancy such as anemia, jaundice, heart disease, etc. It was followed by amniotic fluid causes which was followed by fetal causes and then placental causes. Clinical significance: Relevant Condition at Death classification system becomes an effective classification system that can be applied in developing countries to help in the reduction as well as prevention of stillbirth.

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Section: Discussionsupporting

confidence: 92%