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

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

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.

The following codes have been omitted as they are no longer in use: Code 4 (Lack of progress; less than or equal to 3 cm cervical dilatation), Code 5 (Lack of progress in the first stage; 4 cm to less than 10 cm cervical dilatation), Code 6 (Lack of progress in the second stage), Code 7 (Placenta praevia), Code 8 (Placental abruption) and Code 9 (Vasa praevia). For information about their meaning in previous data elements, see superseded versions. For information on how to record these codes in the current value domain, refer to the Guide for use.

National Perinatal Data Development Committee

Up to 2 additional indications can be recorded as contributing to the need for a caesarean section.

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 value domain should only be recorded once.

Code 30 is not to be recorded for additional indications.

National Perinatal Data Development Committee

Supersedes Birth event—additional indication for caesarean section, code N[N] Health, Superseded 03/12/2020

See also Birth event—birth method, code N Health, Standard 03/12/2020

See also Birth event—main indication for caesarean section, code N[N] Health, Superseded 03/12/2020

See also Birth event—main indication for caesarean section, code N[N] Health, Standard 03/12/2020

Perinatal NBEDS 2021–22 Health, Standard 03/12/2020