Evaluation of 239 cases of perinatal death using a fundamental classification system.
OBJECTIVE
To classify 239 cases of perinatal death in a newly introduced classification system for underlying causes of perinatal death.


METHODS
Prospective, descriptive.


METHODS
Dutch healthcare region Delft-Westland-Oostland (DWO).


METHODS
In 10 years (1983-1992), all cases of perinatal death with a birthweight above 500 g (n=239) were included into the study. We used a classification model based upon the underlying cause of death using simple principles of obstetrical and neonatal pathology. A team consisting of a gynaecologist, neonatologist and pathologist classified all cases of perinatal death into seven groups to determine the "most-probable" cause of death.


RESULTS
Birth trauma was seen in two cases (0.8%). Infections were seen in 16 cases (6.8%). Acute/subacute placental pathology in 77 cases (32.2%) and chronic placental pathology in 50 cases (21%). Bloodtype antagonism was seen in two cases (0.8%). Lethal congenital malformations in 55 cases (23%). Complications of pre-viable delivery in 20 cases (8.4%). Unclassifiable were 17 cases (7%): two cases could not be classified despite thorough investigation (1%) and 15 cases were lost for follow-up (6%).


CONCLUSIONS
Classification of perinatal death causes by using our fundamental classification system gives insight in the possible underlying causes of death. The results of such a classification can be used as guidelines for preventive measures in the future.
de Galan-Roosen
A E M
AE
Department of Obstetrics and Gynaecology, TweeSteden Hospital, Postalcode 90107, 5000 LA Tilburg, The Netherlands. de.galan@12move.nl
Kuijpers
J C
JC
van der Straaten
P J C
PJ
Merkus
J M W M
JM
D001424:Bacterial Infections / Q000401:mortality; D001720:Birth Injuries / Q000401:mortality; D001787:Blood Group Incompatibility / Q000401:mortality; D002423:Cause of Death; D000013:Congenital Abnormalities / Q000401:mortality; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D009426:Netherlands; D007752:Obstetric Labor, Premature / Q000401:mortality; D010920:Placenta / Q000473:pathology; D010922:Placenta Diseases / Q000401:mortality; D011247:Pregnancy; D011446:Prospective Studies; D012042:Registries; D014777:Virus Diseases / Q000401:mortality