Chapter XV

Pregnancy, childbirth and the puerperium
(O00-O99)

Complications of labour and delivery
(O60-O75)

O60 Preterm delivery
Onset (spontaneous) of delivery before 37 completed weeks of gestation

O61 Failed induction of labour
O61.0 Failed medical induction of labour
Failed induction (of labour) by:
· oxytocin
· prostaglandins
O61.1 Failed instrumental induction of labour
Failed induction (of labour):
· mechanical
· surgical
O61.8 Other failed induction of labour
O61.9 Failed induction of labour, unspecified

O62 Abnormalities of forces of labour
O62.0 Primary inadequate contractions
Failure of cervical dilatation
Primary hypotonic uterine dysfunction
O62.1 Secondary uterine inertia
Arrested active phase of labour
Secondary hypotonic uterine dysfunction
O62.2 Other uterine inertia
Atony of uterus
Desultory labour
Hypotonic uterine dysfunction NOS
Irregular labour
Poor contractions
Uterine inertia NOS
O62.3 Precipitate labour
O62.4 Hypertonic, incoordinate, and prolonged uterine contractions
Contraction ring dystocia
Dyscoordinate labour
Hour-glass contraction of uterus
Hypertonic uterine dysfunction
Incoordinate uterine action
Tetanic contractions
Uterine dystocia NOS
Excludes: dystocia (fetal)(maternal) NOS ( O66.9 )
O62.8 Other abnormalities of forces of labour
O62.9 Abnormality of forces of labour, unspecified

O63 Long labour
O63.0 Prolonged first stage (of labour)
O63.1 Prolonged second stage (of labour)
O63.2 Delayed delivery of second twin, triplet, etc.
O63.9 Long labour, unspecified
Prolonged labour NOS

O64 Obstructed labour due to malposition and malpresentation of fetus
O64.0 Obstructed labour due to incomplete rotation of fetal head
Deep transverse arrest
Obstructed labour due to persistent (position):
· occipitoiliac
· occipitoposterior
· occipitosacral
· occipitotransverse
O64.1 Obstructed labour due to breech presentation
O64.2 Obstructed labour due to face presentation
Obstructed labour due to chin presentation
O64.3 Obstructed labour due to brow presentation
O64.4 Obstructed labour due to shoulder presentation
Prolapsed arm
Excludes: impacted shoulders ( O66.0 )
shoulder dystocia ( O66.0 )
O64.5 Obstructed labour due to compound presentation
O64.8 Obstructed labour due to other malposition and malpresentation
O64.9 Obstructed labour due to malposition and malpresentation, unspecified

O65 Obstructed labour due to maternal pelvic abnormality
O65.0 Obstructed labour due to deformed pelvis
O65.1 Obstructed labour due to generally contracted pelvis
O65.2 Obstructed labour due to pelvic inlet contraction
O65.3 Obstructed labour due to pelvic outlet and mid-cavity contraction
O65.4 Obstructed labour due to fetopelvic disproportion, unspecified
Excludes: dystocia due to abnormality of fetus ( O66.2-O66.3 )
O65.5 Obstructed labour due to abnormality of maternal pelvic organs
Obstructed labour due to conditions listed in O34.-
O65.8 Obstructed labour due to other maternal pelvic abnormalities
O65.9 Obstructed labour due to maternal pelvic abnormality, unspecified

O66 Other obstructed labour
O66.0 Obstructed labour due to shoulder dystocia
Impacted shoulders
O66.1 Obstructed labour due to locked twins
O66.2 Obstructed labour due to unusually large fetus
O66.3 Obstructed labour due to other abnormalities of fetus
Dystocia due to:
· conjoined twins
· fetal:
  · ascites
  · hydrops
  · meningomyelocele
  · sacral teratoma
  · tumour
· hydrocephalic fetus
O66.4 Failed trial of labour, unspecified
Failed trial of labour with subsequent delivery by caesarean section
O66.5 Failed application of vacuum extractor and forceps, unspecified
Failed application of ventouse or forceps, with subsequent delivery by forceps or caesarean section respectively
O66.8 Other specified obstructed labour
O66.9 Obstructed labour, unspecified
Dystocia:
· NOS
· fetal NOS
· maternal NOS

O67 Labour and delivery complicated by intrapartum haemorrhage, not elsewhere classified
Excludes: antepartum haemorrhage NEC ( O46.- )
placenta praevia ( O44.- )
postpartum haemorrhage ( O72.- )
premature separation of placenta [abruptio placentae] ( O45.- )
O67.0 Intrapartum haemorrhage with coagulation defect
Intrapartum haemorrhage (excessive) associated with:
· afibrinogenaemia
· disseminated intravascular coagulation
· hyperfibrinolysis
· hypofibrinogenaemia
O67.8 Other intrapartum haemorrhage
Excessive intrapartum haemorrhage
O67.9 Intrapartum haemorrhage, unspecified

O68 Labour and delivery complicated by fetal stress [distress]
Includes: fetal distress in labour or delivery due to drug administration
O68.0 Labour and delivery complicated by fetal heart rate anomaly
Fetal:
· bradycardia
· heart rate irregularity
· tachycardia
Excludes: with meconium in amniotic fluid ( O68.2 )
O68.1 Labour and delivery complicated by meconium in amniotic fluid
Excludes: with fetal heart rate anomaly ( O68.2 )
O68.2 Labour and delivery complicated by fetal heart rate anomaly with meconium in amniotic fluid
O68.3 Labour and delivery complicated by biochemical evidence of fetal stress
Abnormal fetal:
· acidaemia
· acid-base balance
O68.8 Labour and delivery complicated by other evidence of fetal stress
Evidence of fetal distress:
· electrocardiographic
· ultrasonic
O68.9 Labour and delivery complicated by fetal stress, unspecified

O69 Labour and delivery complicated by umbilical cord complications
O69.0 Labour and delivery complicated by prolapse of cord
O69.1 Labour and delivery complicated by cord around neck, with compression
O69.2 Labour and delivery complicated by other cord entanglement
Entanglement of cords of twins in monoamniotic sac
Knot in cord
O69.3 Labour and delivery complicated by short cord
O69.4 Labour and delivery complicated by vasa praevia
Haemorrhage from vasa praevia
O69.5 Labour and delivery complicated by vascular lesion of cord
Cord:
· bruising
· haematoma
Thrombosis of umbilical vessels
O69.8 Labour and delivery complicated by other cord complications
O69.9 Labour and delivery complicated by cord complication, unspecified

O70 Perineal laceration during delivery
Includes: episiotomy extended by laceration
Excludes: obstetric high vaginal laceration alone ( O71.4 )
O70.0 First degree perineal laceration during delivery
Perineal laceration, rupture or tear (involving):
· fourchette
· labia
· skin
· slight
· vagina
· vulva
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during delivery
O70.1 Second degree perineal laceration during delivery
Perineal laceration, rupture or tear as in O70.0, also involving:
· pelvic floor
· perineal muscles
· vaginal muscles
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during delivery
Excludes: that involving anal sphincter ( O70.2 )
O70.2 Third degree perineal laceration during delivery
Perineal laceration, rupture or tear as in O70.1, also involving:
· anal sphincter
· rectovaginal septum
· sphincter NOS
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during delivery
Excludes: that involving anal or rectal mucosa ( O70.3 )
O70.3 Fourth degree perineal laceration during delivery
Perineal laceration, rupture or tear as in O70.2, also involving:
· anal mucosa
· rectal mucosa
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during delivery
O70.9 Perineal laceration during delivery, unspecified

O71 Other obstetric trauma
Includes: damage from instruments
O71.0 Rupture of uterus before onset of labour
O71.1 Rupture of uterus during labour
Rupture of uterus not stated as occurring before onset of labour
O71.2 Postpartum inversion of uterus
O71.3 Obstetric laceration of cervix
Annular detachment of cervix
O71.4 Obstetric high vaginal laceration alone
Laceration of vaginal wall without mention of perineal laceration
Excludes: with perineal laceration ( O70.- )
O71.5 Other obstetric injury to pelvic organs
Obstetric injury to:
· bladder
· urethra
O71.6 Obstetric damage to pelvic joints and ligaments
Avulsion of inner symphyseal cartilage
Damage to coccyx
Traumatic separation of symphysis (pubis)
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obstetric
O71.7 Obstetric haematoma of pelvis
Obstetric haematoma of:
· perineum
· vagina
· vulva
O71.8 Other specified obstetric trauma
O71.9 Obstetric trauma, unspecified

O72 Postpartum haemorrhage
Includes: haemorrhage after delivery of fetus or infant
O72.0 Third-stage haemorrhage
Haemorrhage associated with retained, trapped or adherent placenta
Retained placenta NOS
O72.1 Other immediate postpartum haemorrhage
Haemorrhage following delivery of placenta
Postpartum haemorrhage (atonic) NOS
O72.2 Delayed and secondary postpartum haemorrhage
Haemorrhage associated with retained portions of placenta or membranes
Retained products of conception NOS, following delivery
O72.3 Postpartum coagulation defects
Postpartum:
· afibrinogenaemia
· fibrinolysis

O73 Retained placenta and membranes, without haemorrhage
O73.0 Retained placenta without haemorrhage
Placenta accreta without haemorrhage
O73.1 Retained portions of placenta and membranes, without haemorrhage
Retained products of conception following delivery, without haemorrhage

O74 Complications of anaesthesia during labour and delivery
Includes: maternal complications arising from the administration of a general or local anaesthetic, analgesic or other sedation during labour and delivery
O74.0 Aspiration pneumonitis due to anaesthesia during labour and delivery
Inhalation of stomach contents or secretions NOS
Mendelson's syndrome
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due to anaesthesia during labour and delivery
O74.1 Other pulmonary complications of anaesthesia during labour and delivery
Pressure collapse of lung due to anaesthesia during labour and delivery
O74.2 Cardiac complications of anaesthesia during labour and delivery
Cardiac:
· arrest
· failure
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due to anaesthesia during labour and delivery
O74.3 Central nervous system complications of anaesthesia during labour and delivery
Cerebral anoxia due to anaesthesia during labour and delivery
O74.4 Toxic reaction to local anaesthesia during labour and delivery
O74.5 Spinal and epidural anaesthesia-induced headache during labour and delivery
O74.6 Other complications of spinal and epidural anaesthesia during labour and delivery
O74.7 Failed or difficult intubation during labour and delivery
O74.8 Other complications of anaesthesia during labour and delivery
O74.9 Complication of anaesthesia during labour and delivery, unspecified

O75 Other complications of labour and delivery, not elsewhere classified
Excludes: puerperal:
· infection ( O86.- )
· sepsis ( O85 )
O75.0 Maternal distress during labour and delivery
O75.1 Shock during or following labour and delivery
Obstetric shock
O75.2 Pyrexia during labour, not elsewhere classified
O75.3 Other infection during labour
Septicaemia during labour
O75.4 Other complications of obstetric surgery and procedures
Cardiac:
· arrest
· failure
Cerebral anoxia
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following caesarean or other obstetric surgery or procedures, including delivery NOS
Excludes: complications of anaesthesia during labour and delivery ( O74.- )
obstetric (surgical) wound:
· disruption ( O90.0-O90.1 )
· haematoma ( O90.2 )
· infection ( O86.0 )
O75.5 Delayed delivery after artificial rupture of membranes
O75.6 Delayed delivery after spontaneous or unspecified rupture of membranes
Excludes: spontaneous premature rupture of membranes ( O42.- )
O75.7 Vaginal delivery following previous caesarean section
O75.8 Other specified complications of labour and delivery
O75.9 Complication of labour and delivery, unspecified


Processed on 29.10.2004 M.S. Source: World Health Organization © Copyright WHO/DIMDI 1994/2004