EXPLORING CAUSES OF STILLBIRTHS THROUGH RECODE CLASSIFICATION: A 4 YEAR EXPERIENCE IN TERTIARY CARE HOSPITAL

Abstract

Objective: To study the causes of stillbirths through ReCoDe classification over 4 years in tertiary care hospital. Methodology: This descriptive study, with non-probability consecutive sampling was carried out from January 2016 till December 2019 in Department of Obstetrics & Gynecology, Lady Reading Hospital (Medical Teaching Hospital), Peshawar-Pakistan. After taking the ethical approval, relevant parameters at death were recorded against the headings of ReCoDe classification (along with the sub classifications) as a. Fetus b. Umbilical cord c. Placenta d. Amniotic fluid e. Uterus f. Mother g. Intrapartum h. Trauma i. Unclassified. Data was analyzed on the SPSS v.23.0 Results: The stillbirth rate recorded over 4 studied years was 7.8%, 6.4%, 5.9%and 4.7% in 2016, 2017, 2018 and 2019 respectively. It was observed that the most common relevant conditions at birth of stillborn babies were associated with fetal, maternal and placental causes. Fetal causes were, however, mainly contributed by congenital abnormalities (65.63%, 79%, 58.11% and 74% respectively). Among the placental causes, placental abruption remained the main killer (54%, 72%, 78% and 76%). Among the maternal causes, diabetes and hypertension contributed the most. Of other notable causes, ruptured uterus was found to be an important entity taking its toll each year (6%, 4%, 6% and 5.3% respectively). Conclusion: The study concluded that overall placental causes were more pre-dominant cause for still births followed by fetal causes. Placental abruption, and congenital anomaly were the most common sub-causes among their categories of placental and fetal causes respectively.