Still birth classification: Application of relevant condition at death (Recode) classification system in a Tertiary Care Hospital of Peshawar.

Abstract

Objective: To find the different causes of stillbirths at our institution, using the ReCoDe categorization system. Study Design: Prospective Observational study. Setting: Gynae A Unit of Obstetrics and Gynecology Department MTI/Khyber Teaching Hospital, Peshawar. Period: 1^st January 2021 to 31^st December 2023. Methods: Sampling method was consecutive non probability sampling. Patients diagnosed with stillbirth who were admitted to the hospital made up the study population. The patient's highrisk characteristics for pregnancy and delivery as well as the reason for the stillbirth were evaluated. Results: During the study period, 210 stillbirth cases in total met the inclusion criteria. There were 32416 live births in all during this time, or six stillbirths for every 1000 live births. The majority of women (80%) with in utero fetal demise fell within the age range of 20 to 35 years old, according to the age distribution of these cases. Thirteen percent of instances involved mothers above the age of twenty, and sixteen percent were older mothers. There were over 45.4% unbooked cases compared to 54.5% booked hospital cases. Fetal causes accounted for 34.6% of intrapartum deaths, with IUGR making up the largest group (23.5%). Maternal factors accounted for 30.4% of stillbirths; pre-eclampsia was the most often reported comorbidity. 18.8% of cases fell into the unclassified category when no other cause could be identified. Conclusion: Classification of stillbirths using ReCoDe classification is simple and practical to use, especially in low-resource settings, with the ability to identify underlying cause in the majority of cases.