European Journal of Cardiovascular Medicine

Background: It is vital to assess, report, record, and document the rate of stillbirths in India for accurate estimation of the concern. Also, for decrease in preventable stillbirths, it is needed to determine its etiology. However, existing literature data is scarce in Indian context. Aim: The present study was aimed to identify the risk factors and causes of stillbirths utilizing the histopathology of placenta in females delivering at Indian healthcare centers and to classify the cause of fetal death using Causes of Death and Associated Conditions (CODAC) simplified classification. Methods: The study assessed the cases of stillbirths at the Institute within the defined study period. In all the cases, clinical data were gathered for mothers and stillbirths were recorded on preformed structured proforma. At birth, heart blood or cord blood along with wedge of placenta were taken and assessed for bacterial culture. Remnant placenta was assessed histopathologically. Reports and data were collected and assessed to determine the cause of death and classified using CODAC simplified classification. Results: The study results showed that the rate of stillbirth in the present study was 26.2 per 1000 total birth. The most common cause of stillbirths in the study subjects was placental factors seen in 51.7% (n=88) mothers followed by maternal factors as recorded in 28.2% (n=48) mothers. Among placental factors, common causes were placental insufficiency, placental abruptions, and placental infarction in 5.9% (n=10), 17.6% (n=30), and 28.2% (n=48) subjects. The most common maternal cause of stillbirths was hypertensive disorders as seen in 22.4% (n=38) subjects.   Conclusion: The present study concludes that classification of stillbirths using CODAC classification depicts vital role of placenta in stillbirths directly as reason for stillbirth or was related indirectly to placental causes as hypertension. Histopathology of placenta identified placenta factors as reason for death in subjects when no other apparent clinical reasons can be assigned and can be classified as unknown when not present.