Birth event—main indication for caesarean section, code N[N]

Identifying and definitional attributes

Metadata item type:Data Element
Short name:Main indication for caesarean section
METeOR identifier:695698
Registration status:Health, Standard 12/12/2018
Definition:

The main indication for a caesarean section being performed during a birth event, as represented by a code.

Data Element Concept:Birth event—main indication for caesarean section

Value domain attributes

Representational attributes

Representation class:Code
Data type:Number
Format:N[N]
Maximum character length:2
Permissible values:
ValueMeaning
1Fetal compromise
2Suspected fetal macrosomia
3Malpresentation
10Lack of progress; less than or equal to 3 cm cervical dilatation
11Lack of progress in the first stage; greater than 3 cm to less than 10 cm cervical dilatation
12Lack of progress in the second stage
13Placenta praevia
14Placental abruption
15Vasa praevia
16Antepartum/intrapartum haemorrhage
17Multiple pregnancy
18Unsuccessful attempt at assisted delivery
19Cord prolapse
20Previous adverse perinatal outcome
21Previous caesarean section
22Previous severe perineal trauma
23Previous shoulder dystocia
29Other obstetric, medical, surgical, psychological indications
30Maternal choice in the absence of any obstetric, medical, surgical, psychological indications
Supplementary values:
99Not stated/inadequately described

Collection and usage attributes

Guide for use:

CODE 1   Fetal compromise

Includes suspected or actual fetal compromise and intra uterine growth restriction.

CODE 10   Lack of progress; less than or equal to 3 cm cervical dilatation

Lack of progress includes slow or no progress.

May be appropriate for cases of unsuccessful induction.

CODE 11   Lack of progress in the first stage; greater than 3 cm to less than 10 cm cervical dilatation

Lack of progress includes slow or no progress.

CODE 12   Lack of progress in the second stage

Lack of progress includes slow or no progress.

CODE 13   Placenta praevia

Record placenta praevia as the indication for caesarean section if there is ultrasound or clinical evidence that the edge of the placenta covers the internal cervical os, or encroaches into the lower segment less than 2 cm away from the internal cervical os.

CODE 14   Placental abruption

Record placental abruption as the indication for caesarean section if there is ultrasound or clinical evidence antenatally of abruption of the placenta prior to onset or during labour.

CODE 15   Vasa praevia

Record vasa praevia as the indication for caesarean section if there is ultrasound or visual evidence of exposed fetal blood vessels running across the fetal membrane below or at the level of the fetal presenting part in the lower segment of the uterus. Recorded when the caesarean section is planned or in the case of an emergency caesarean section when the vessels may have ruptured.

CODE 16   Antepartum/intrapartum haemorrhage

Record antepartum/intrapartum haemorrhage as the indication for caesarean section if there has been any antenatal or intrapartum vaginal bleeding that leads to the immediate delivery of the baby by caesarean section. Should only be recorded as a main indication if a more specific cause of the antepartum/intrapartum haemorrhage is not known.

Where there is a vasa praevia and an antepartum/intrapartum haemorrhage, Code 15 is to be recorded as the main indication and Code 16 as an additional indication.

CODE 22   Previous severe perineal trauma

Includes previous 4th degree perineal tears and other perineal damage or injury where a female is symptomatic and the clinician determines the caesarean section is justified.

CODE 29   Other obstetric, medical, surgical, psychological indications

Where a female has a psychopathological indication for caesarean section, e.g. extreme fear of natural childbirth, this code should be recorded. It is not to be recorded for psychosocial indications which should recorded as Code 30.

CODE 30   Maternal choice in the absence of any obstetric, medical, surgical, psychological indications

Includes psychosocial indications.

Not to be recorded in conjunction with additional indications.

Comments:

Codes 4 to 9 have been omitted as these codes are no longer in use. For information about their meaning in previous data elements, see superseded versions.

Source and reference attributes

Submitting organisation:

National Perinatal Data Development Committee

Data element attributes

Collection and usage attributes

Guide for use:

Only one code may be recorded.

Up to 2 additional indications may be recorded using the Birth event—additional indication for caesarean section, code N[N] once main indication is completed.

Jurisdictions that record perinatal data using the ICD-10-AM may have more than one unique ICD-10-AM code that maps to a single permissible value for the Birth event—main indication for caesarean section, code N[N] and Birth event—additional indication for caesarean section, code N[N] data elements. In these cases, the relevant permissible value should only be recorded once.

Collection methods:

The main indication should be the indication that the clinician attending the birth determines to be the main reason for the caesarean section being performed. It should be determined at the time of delivery and not revised later or selected based on information that becomes available after delivery such as results of tests or procedures.

Source and reference attributes

Submitting organisation:

National Perinatal Data Development Committee

Relational attributes

Related metadata references:

See also Birth event—additional indication for caesarean section, code N[N] Health, Standard 12/12/2018

See also Birth event—birth method, code N Health, Standard 12/12/2018

Supersedes Birth event—main indication for caesarean section, code N[N] Health, Superseded 12/12/2018

Implementation in Data Set Specifications:

Perinatal NBEDS 2019–20 Health, Standard 12/12/2018

DSS specific attributes +
Implementation in Indicators:Used as numerator
Australian Atlas of Healthcare Variation 2018: Caesarean section at less than (i) 39 completed weeks, (ii) 37 completed weeks without medical/obstetric indication, 2015 Australian Commission on Safety and Quality in Health Care, Standard 13/12/2018