Value of CODAC classification in identifying causes of stillbirths

Abstract

Purpose

Stillbirth is a public health problem and one of the main obstetrical complications of pregnancy that practitioners can ever witness. A careful etiological investigation and a search for risk factors is necessary. The main objective of our study was to identify the causes of stillbirths using the CODAC classification system.

Methods

It was a monocentric retrospective descriptive study conducted over 5 years in our gynecology department. We collected 114 cases.

Results

The overall frequency was 8.26 ‰. The average age of women was 32.19 years. Women came from an urban environment in 48.2% and had a low level of education in 54.4% of cases. Our patients were moderately obese (48%). A history of stillbirth was found in 33 cases (28.9%), and the average term of pregnancy was 32 weeks’ gestation. Pregnancy was poorly monitored in 2/3 of the population studied. The most frequent reason for consultation was a decrease/absence of fetal movement perception (30%). Labor was induced in 53.5% of deliveries. Delivery was by vaginal route in 58% of cases and the male sex was predominant (61%). For funicular anomalies, a placental abruption was found in 21.1% of cases, and a cord loop in 11.4%. For the etiological investigation via the CODAC classification, maternal pathologies were the most frequent with 28.07% of cases dominated by hypertension. Placental pathologies (placental abruption) and cord abnormalities (cord loop) represented, respectively, 22 and 21.05%. An unexplained cause was found in 20.17%.

Conclusions

For the etiological investigation, we relied on the CODAC classification to minimize unexplained causes. This etiological investigation is essential not only to provide answers for the bereaved couple but also to prevent the recurrence of such incidents in subsequent pregnancies.