Application of WHO ICD-PM Classification for Perinatal Death (PND) in a Tertiary Care Hospital

Abstract

Objective: To apply the WHO ICD-PM classification for systematically identifying and categorizing the causes of perinatal deaths, improving reporting, understanding risk factors, and reducing mortality.

Methodology: This retrospective cross-sectional study was conducted in Gynae Unit 1 of Dr. Ruth K. M. Pfau Civil Hospital Karachi from January 2019 to December 2020. All perinatal deaths occurring during this period were classified according to the WHO ICD-PM classification. Data were analyzed using SPSS version 24, and the chi-square test was applied to determine statistical significance, with a p-value <0.05 considered significant.

Results A total of 8,309 women delivered during the study period, with 639 perinatal deaths, of which 82.8% were stillbirths and 110 were neonatal deaths. The most common causes of antepartum deaths were antepartum hypoxia and disorders of fetal growth, primarily associated with maternal conditions (M4). Intrapartum deaths were caused by intrapartum events (I3) in 73.87% of cases, mainly due to complications of labor and delivery (M3). Neonatal deaths were mainly related to intrapartum events (I3) or low birth weight (N9) and were primarily associated with maternal complications of pregnancy (M2). In 13.6% of antepartum deaths, no maternal cause could be assigned, compared to 1.87% in intrapartum deaths and 1.8% in neonatal deaths.

Conclusion: The ICD-PM is a globally applicable perinatal death classification system that can be utilized to develop evidence-based national strategies for reducing perinatal mortality.