Assessment of changes in the cause of Perinatal deaths during 20 years in Wakayama prefecture using International classification of Disease for Perinatal mortality（ICD-PM）

Abstract

 Objective and methods: For improvement of perinatal prognosis, we reviewed perinatal medical survey conducted for 20 years and examined using ICD-PM.

 Results: Perinatal mortality decreased from 4.44 to 2.33, especially in the proportion of early neonatal deaths. In the ICD-PM classification, A3: antepartum hypoxia, I3: acute intrapartum event, N1: congenital malformations, and M1: complications of placenta/ cord that was the most frequent cause in each group. The mortality rate of fetal hypoxia with maternal complications of placenta/cord did not improve, and the perinatal mortality rate with maternal gestational hypertension, pre-eclampsia deteriorated.

 Conclusions: Fetal management with complications of placenta/ cord, management of maternal medical conditions, and detailed research on the perinatal death cases were considered to be challenges.