A study to evaluate the causes of stillbirths according to the ReCoDe classification

Abstract

Background: Foetal death or stillbirth is a major obstetrical complication and a devastating experience for the pregnant patients and relatives. Worldwide an estimate of at least 3.2 million stillbirths occurs each year. There are intensified demands on medical, political and epidemiological ground for proper determination and classification of causes of perinatal death. The aim of this study was to test a new classification system- Re. Co. De. Classification (Relevant Condition at Death) for stillbirths to improve our understanding of the main causes and conditions associated with foetal deaths.Methods: This study was a hospital based Prospective study conducted in department of obstetrics and Gynaecology, SZH, Bhopal. The study included 463 women who were admitted with Intra Uterine Foetal Demise. All cases were evaluated and after delivery the stillborn baby, the placenta and cord were examined. The causes were classified according to Re. Co. De. System.Results: The analysis of the new classification system Re. Co. De. Allowed attributable causes to about 90.72% of causes of still births explained where 9.28% were unexplained. The commonest cause was found to be class F4-Toxaemia of pregnancy (13.17%) followed by class A7- IUGR (10.58%), class C1-Abruptio placentae (10.36%), class E3-Obstructed labour (9.8%) and class A1- Lethal congenital malformations (8.42%).Conclusions: The Re. Co. De. Classification system gives us a better understanding of antecedents of stillbirths and the clinical practices, which need to be addressed to reduce perinatal mortality and have a better obstetric result in the next pregnancy.

Classification of stillbirth by relative condition at death (Re Co De) at various trimesters of pregnancy: a rural tertiary teaching hospital based study

“…16 The classification systems used in the study was ReCoDe in ordered to cut down the rates of unexplained stillbirths.…”

“…In Parihar et al study, fetal lethal anomaly formed thelargest group (8.14%). 16 Strengths and Limitations: MIMS is a large tertiary care referral centre probably a lone referral centre for all high risk obstetric cases catering to a large rural population. MIMS also has significant number of booked cases that have regular obstetric care.…”

Stillbirths - Determining the associated factors and causes according to relevant condition at death: an experience from Pokhara, Nepal

“…[7] Similarly, cause of stillbirths was identifiable in almost 90% of the cases in studies using ReCoDe classification system. [13,14] Intrauterine growth restriction was the major cause of stillbirths (22%) followed by congenital anomalies (15%) and hypertensive disorders of pregnancy (14%) in our study. Similar observation was made in studies using ReCoDe classification system.…”

“…Congenital anomalies as the cause of stillbirth were found in 15% of our cases. Other studies also reported slightly lower figures [11][12][13][14]16]. Congenital anomalies diagnosed were neural tube defects (anencephaly, hydrocephalus), cardiac anomalies, duodenal atresia, gastrochiasis all of which could have been diagnosed early in gestation.…”

“…[7,14] The fact that other studies [11,12,17] reported IUGR in comparatively fewer stillbirth could be due adoption of different classification in these studies. A hypertensive disorder in pregnancy was the major cause in some of the studies [11][12][13][16][17].…”