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A Guide to Obstetrical Coding Production of This Document Is Made Possible by Financial Contributions from Health Canada and Provincial and Territorial Governments ICD-10-CA | CCI A Guide to Obstetrical Coding Production of this document is made possible by financial contributions from Health Canada and provincial and territorial governments. The views expressed herein do not necessarily represent the views of Health Canada or any provincial or territorial government. Unless otherwise indicated, this product uses data provided by Canada’s provinces and territories. All rights reserved. The contents of this publication may be reproduced unaltered, in whole or in part and by any means, solely for non-commercial purposes, provided that the Canadian Institute for Health Information is properly and fully acknowledged as the copyright owner. Any reproduction or use of this publication or its contents for any commercial purpose requires the prior written authorization of the Canadian Institute for Health Information. Reproduction or use that suggests endorsement by, or affiliation with, the Canadian Institute for Health Information is prohibited. For permission or information, please contact CIHI: Canadian Institute for Health Information 495 Richmond Road, Suite 600 Ottawa, Ontario K2A 4H6 Phone: 613-241-7860 Fax: 613-241-8120 www.cihi.ca [email protected] © 2018 Canadian Institute for Health Information Cette publication est aussi disponible en français sous le titre Guide de codification des données en obstétrique. Table of contents About CIHI ................................................................................................................................. 6 Chapter 1: Introduction ............................................................................................................... 6 Guide overview ........................................................................................................................7 Chapter 2: False and preterm labor ............................................................................................ 9 Chapter overview .....................................................................................................................9 2.1 Stages of labor .............................................................................................................9 2.2 False labor ................................................................................................................. 11 2.3 Preterm labor .............................................................................................................. 12 2.4 Threatened preterm labor ........................................................................................... 13 2.5 Management of preterm labor .................................................................................... 14 2.6 Exercises ....................................................................................................................15 2.7 Chapter summary ....................................................................................................... 16 2.8 Case study ................................................................................................................. 17 Chapter 3: Premature rupture of membranes ............................................................................18 Chapter overview ................................................................................................................... 18 3.1 The clinical picture of premature rupture of membranes ............................................. 18 3.2 Management of premature rupture of membranes ...................................................... 21 3.3 Classifying premature rupture of membranes ............................................................. 22 3.4 Classifying oligohydramnios and chorioamnionitis without PROM .............................. 24 3.5 Classifying delayed delivery after spontaneous or unspecified rupture of membrane with PROM ........................................................................................... 25 3.6 Exercises ....................................................................................................................26 3.7 Chapter summary ....................................................................................................... 27 3.8 Case study ................................................................................................................. 28 Chapter 4: Cervical ripening, induction and augmentation of labor ............................................29 Chapter overview ...................................................................................................................29 4.1 Cervical ripening ......................................................................................................... 29 4.2 Methods of cervical ripening ....................................................................................... 31 4.3 Induction of labor ........................................................................................................ 31 4.4 Methods of inducing labor........................................................................................... 33 4.5 Augmentation of labor ................................................................................................ 34 4.6 Failed induction of labor ............................................................................................. 35 A Guide to Obstetrical Coding 4.7 Exercises .................................................................................................................... 36 4.8 Chapter summary ....................................................................................................... 37 4.9 Case study ................................................................................................................. 37 Chapter 5: Dystocia and failure to progress ..............................................................................40 Chapter overview ................................................................................................................... 40 5.1 Fetopelvic relationships .............................................................................................. 40 5.2 Mechanisms of normal labor ....................................................................................... 45 5.3 Dystocia, failure to progress and obstructed labor ...................................................... 48 5.4 Problems with the passenger — Malposition and malpresentation, incomplete rotation of the fetal head ............................................................................................. 50 5.5 Problems with the passage — Cephalopelvic disproportion (CPD) ............................. 54 5.6 Other obstructed labor (O66) ...................................................................................... 55 5.7 Problems with the forces — Uterine inertia and maternal fatigue ................................ 56 5.8 Exercises ....................................................................................................................58 5.9 Chapter summary ....................................................................................................... 58 5.10 Case studies............................................................................................................... 59 Chapter 6: Operative vaginal delivery .......................................................................................62 Chapter overview ................................................................................................................... 62 6.1 Definitions related to operative vaginal delivery .......................................................... 62 6.2 Indications for operative vaginal delivery .................................................................... 65 6.3 Forceps delivery ......................................................................................................... 66 6.4 Vacuum delivery ......................................................................................................... 69 6.5 Failed forceps and vacuum ......................................................................................... 71 6.6 Application of forceps or vacuum through Cesarean section incision .......................... 73 6.7 Exercises ....................................................................................................................74 6.8 Chapter summary ....................................................................................................... 75 6.9 Case studies............................................................................................................... 76 Chapter 7: Breech presentation and extraction .........................................................................79 Chapter overview ...................................................................................................................79 7.1 Breech presentation ................................................................................................... 79 7.2 Breech delivery ........................................................................................................... 81 7.3 Internal podalic version and breech extraction in transverse lie .................................. 85 7.4 Exercises .................................................................................................................... 86 7.5 Chapter summary ......................................................................................................
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