Application of the international classification of diseases-perinatal mortality (ICD-PM) system to stillbirths: A single center experience in a middle income country

The present study is intended to investigate the causes of stillbirth and its relationship with maternal conditions using the International Classification of Diseases-Perinatal Mortality (ICD-PM) system. All early and late fetal deaths between 2015 and 2020 were analyzed. Time of death, fetal causes, and the maternal conditions involved were identified using the ICD-PM classification system. During the study period, out of 74,102 births a total of 475 stillbirths were recorded (6.4 per 1000 births), of which 83.6% of the cases were antepartum and 11.8% were intrapartum fetal deaths, and the time of death could not be determined in 4.6% of the cases. Fetal developmental disorder was the most common cause of antepartum fetal death (24.2%). Intrapartum deaths were mostly due to extremely low birth weight (44.6%). The most common maternal conditions involved were complications of placenta, cord, and membranes (19.8%). The applicability of the ICD-PM classification system for stillbirths is easy. It was observed that fetal deaths mostly occurred in the antepartum period and the cause of death could not be identified in over half of these antepartum fetal deaths. In over half of the stillbirths, there is at least one maternal condition involved. The most common maternal conditions involved are complications of placenta, cord, and membranes. The most common maternal medical problem is hypertensive diseases of pregnancy.