Decoding stillbirths using the Relevant Condition at Death classification: Study from the developing worldgerm
Journal Title: Journal of the Turkish-German Gynecological Association - Year 2019, Vol 20, Issue 2
Abstract
Objective: To determine the stillbirth rate in 2017 at Christian Medical College, a tertiary care perinatal center in South India, and to identify causes for the various stillbirths that occurred using the Relevant Condition at Death (ReCoDe) classification. Material and Methods: Medical records of the women with stillbirths between January 1st, to December 31st, 2017, were retrieved and analyzed using the SPSS software (IBM, version 23). The study was approved by the institutional review board (minute no: 11273, retro dated: 28/3/2018). Results: Of the total 14696 deliveries between January 1st, 2017, to December 31st, 2017, there were 247 stillbirths, a rate of 16.8 per 1000 births. Maternal factors: 156 (64.2%) women were booked and the rest were un-booked. Hypertensive disorders of pregnancy were detected in 27.5% (n=67). A greater number of un-booked women had gestational hypertension as compared with booked women (41% vs 24%, p=0.005). Fetal characteristics: still births secondary to lethal congenital anomalies were seen in 18.2% (n=45). Lethal congenital anomalies were diagnosed 10 times more in the booked patients than un-booked ones (24.7% vs 2.3%, p=0.001). Obstetric factors: one or two previous miscarriages were seen in 29.5% cases. Seventeen women (6.9%) had a prior stillbirth. ReCoDe Classification: we were able to successfully classify 84.2% of the stillbirths, leaving 15.78% unclassified. Fetal growth restriction secondary to uteroplacental insufficiency was found in 25.9% cases. Of the placental causes, abruption accounted for 10.9% of cases. Medical co-morbidities were seen in 46.5% pregnancies. Conclusion: The ReCoDe method of classifying stillbirths is useful in the developing world. It helped to elucidate the cause for stillbirths in 84.2% of cases. The majority of cases in our set were due to fetal growth restriction, hypertensive disorders of pregnancy, and uteroplacental insufficiency. Stillbirths can be prevented by a comprehensive ntenatal care system, early recognition, and close monitoring of high-risk pregnancies.
Authors and Affiliations
Neeraj Kulkarni, Deepti Pinto Rosario, Liji Sarah David, Reeta Vijayaselvi, Manisha Madhai Beck,
Keywords
Related Articles
- EP ID EP48638
- DOI 10.4274/jtgga.galenos.2018.2018.0080
- Views 305
- Downloads 0
The immunohistochemical and histologic effects of contrast medium on uterus, fallopian tubes and ovaries, given during hysterosalpingography: rat study
Objective: Previous studies have shown that damage occurs to internal genital tract during hysterosalpingography (HSG). The aim was to show that endometrial and tubal epithelium underwent free radical damage during HSG i...
Ethical and scientific issues of gene-edited twin by clustered regularly interspaced short palindromic repeats Cas9 technology
No summary
Clinicopathologic importance of atypical glandular cells in cervico-vaginal cytology
Objective: To analyze the histopathologic outcomes of patients with atypical glandular cells (AGC) in cervicovaginal cytology examinations. Material and Methods: Patients with AGC in cervicovaginal cytology were include...
Associated factors with neonatal near miss in twin pregnancies in a public referral maternity unit in Brazil
Objective: The aim was to analyze the factors associated with neonatal near miss (NNM) in twin pregnancies in a public referral maternity unit in Brazil. Material and Methods: This retrospective, cross-sectional study i...
Significant improvement of laparoscopic knotting time in medical students through manual training with potential cost savings in laparoscopy - an observational study
Objective: Laparoscopy is a standard procedure in operative gynaecology, but laparoscopic simulator training for novices/junior surgeons is not currently well-established. The aims of this study were to demonstrate that...