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

Objective: To apply the WHO ICD-PM classification for systematically identifying and categorizing perinatal death causes, improving reporting, understanding risk factors, to reduce mortality. Methodology: This was a retrospective cross-sectional study conducted in Gynae unit 1 of Dr. Ruth KM PFAU Civil Hospital Karachi from Jan 2019 to Dec 2020. All PND occurring during this period were classified according to WHO ICD–PM classification. Data was analyzed by SPSS–24. Chi square test applied to detect significance based on P–value <0.05. Results: Total 8309 women delivered with 639 PND during the study period of which 82.8% were stillbirth and 110 were neonatal deaths. Most common cause of antepartum deaths were antepartum hypoxia and disorder of fetal growth) which were mainly associated with M4 maternal condition. Intrapartum deaths were caused by intrapartum events in 73.87% cases, mainly due to complications of labour and delivery (M3). Neonatal deaths were mainly related to intapartum events (M3) or low birth weight (N9) and mainly associated with maternal complication of pregnancy (M2). In 13.6% of antepartum deaths no maternal cause could be assigned, as compared to 1.87% in intrapartum deaths and 1.8% in neonatal groups. Conclusion: The ICD–PM observed to be a applicable PND classification system which can be utilized to plan appropriate evidence-based national strategy to reduce perinatal deaths.