Still Birth classification

ravimohanv

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A pppt on still birth classification

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Still birth classification :

Still birth classification Dr.V.Ravimohan,SpR(obs&gynae) www.mrcogexam.net

Definition :

Definition Still birth- An in utero death delivering after the 24th week of pregnancy Late fetal loss- An in utero death delivering between 20+0 and 23+6 weeks of gestation

types :

types Wigglesworth classification Aberdeen ReCoDe Fetal neonatal classification

ReCoDe :

ReCoDe Relevant Condition at Death Advantage-this system reduces the proportion of stillbirths currently categorised as unexplained.

ReCoDe :

ReCoDe

Group A-Fetus :

Group A-Fetus

Group B-UMBILICAL CORD :

Group B-UMBILICAL CORD

Group C-PLACENTA :

Group C-PLACENTA

Group D-amniotic fluid :

Group D-amniotic fluid

Group E-Uterus :

Group E-Uterus

Group F-mother :

Group F-mother

Group G-Intrapartum :

Group G-Intrapartum

Group H-trauma :

Group H-trauma

Group I-unclassified :

Group I-unclassified

Wigglesworth Classification :

Wigglesworth Classification Pathophysiological approach

EXTENDED WIGGLESWORTH CLASSIFICATION :

EXTENDED WIGGLESWORTH CLASSIFICATION Category 1 Congenital defect/malformation (lethal or severe): Only lethal or potentially lethal congenital malformation should be included here. Serious biochemical abnormalities such as Tay Sach’s disease any known single gene defects known to have a high risk of death should be included. Category 2 Unexplained antepartum fetal death: Most late fetal losses should be coded here. Where a live-born baby dies due to problems during the antepartum period, code this as ‘other specific causes’ (category6).

EXTENDED WIGGLESWORTH CLASSIFICATION :

EXTENDED WIGGLESWORTH CLASSIFICATION Category 3 Death from intrapartum ‘asphyxia’, ‘anoxia’ or ‘trauma’: This category covers any baby who would have survived but for some catastrophe occurring during labour. These babies will tend to be normally formed, stillborn or with poor Apgar scores, possible meconium aspiration or evidence of acidosis. Very premature infants (those less than 24 weeks gestation) may be asphyxiated at birth, but should not be entered in this category as a rule.

EXTENDED WIGGLESWORTH CLASSIFICATION :

EXTENDED WIGGLESWORTH CLASSIFICATION Category 4 Immaturity: This applies to live births only, who subsequently die from structural pulmonary immaturity, surfactant deficiency, intra ventricular haemorrhage, or their late consequences - including chronic lung damage.

EXTENDED WIGGLESWORTH CLASSIFICATION :

EXTENDED WIGGLESWORTH CLASSIFICATION Category 5 Infection: This applies where there is clear microbiological evidence of infection that could have caused death e.g. maternal infection with Group B streptococci, rubella, parvovirus syphilis etc or in the case of a baby dying with overwhelming sepsis.

EXTENDED WIGGLESWORTH CLASSIFICATION :

EXTENDED WIGGLESWORTH CLASSIFICATION Category 6 Other specific causes: Use this if there is a specific recognisable fetal, neonatal or paediatric condition not covered under the earliercategories. Examples include: (1) fetal conditions; twin-to-twin transfusion and hydrops fetalis; (2) neonatal conditions; pulmonary haemorrhage, pulmonaryhypoplasia due to prolonged loss of liquor (primary hypoplasia being classed as a malformation), persistent transitional circulation (in theabsence of infection, aspiration or surfactant deficiency), blood lossunassociated with trauma (e.g. vasa praevia); (3) paediatric conditions; malignancy acute abdominalcatastrophe (such as volvulus without antecedent congenitalmalrotation).

EXTENDED WIGGLESWORTH CLASSIFICATION :

EXTENDED WIGGLESWORTH CLASSIFICATION Category 7 Accident or non-intrapartum trauma: Confirmed non-accidental injury should be coded here. If only suspected, code as a sudden infant death cause unknown (category 8) Category 8 Sudden infant death, cause unknown: This will include all infants in whom the cause is unknown or unsuspected at the time of death. Modification due to postmortem information should be notified later.

EXTENDED WIGGLESWORTH CLASSIFICATION :

EXTENDED WIGGLESWORTH CLASSIFICATION Category 9 Unclassifiable: To be used as a last resort. Details must be given if this option is ticked.

Nordic-Baltic classification :

Nordic-Baltic classification 5 variables 1-lethal malformation 2-time to death in relation to delivery (before, during,after) 3-Birth weight growth retardation (below -2s.d) 4-gestational age 5-Apgar score (below or equal to / above 7 after 5 min)