2023-08-23 Coding death following legally induced abortion Update 2

[mortality-forum]

2023-08-23 Coding death following legally induced abortion 

 

Hello everybody, I have a question for the following clinical picture: 38-year-old female has a legally induced abortion in June without complications. In August, she had a sudden cardiac arrest. An autopsy is performed, and the result is a pulmonary thromboembolism. What do they code as the underlying cause of death?

 

Best regards,

Liliana Bernardo

Portugal

 

Response from Dr. Torres, Mexico

 

This death should be investigated to determine its relationship or association with the induced abortion. It must be determined if:

- Occurred during the puerperium (42 days post abortion)

- Presented complications during the puerperium such as pelvic thrombophlebitis or in the lower limbs, or some postpartum infectious complication.

- autopsy revealed any pelvic complication.

etc

 

If there is no information or evidence that it occurred in the puerperium, the underlying cause of death is pulmonary thromboembolism.

If it occurred during the puerperium and there is no more information, my opinion is that it is a maternal death and the underlying cause would be O88.2 Obstetric blood-clot embolism​

 

Dr. Luis Manuel Torres Palacios

Centro Colaborador para la Familia de Clasificaciones Internacionales 

de la OMS en México (CEMECE)

 

 

Response from Kathy O’Brien, Canada

 

Hello,

 

Here in Canada, we would be counting the days from the termination of pregnancy (regardless of how the pregnancy was terminated) and the date of death. 

 

If it is 42 days or less, we would code the pulmonary thromboembolism to O88.2, “Obstetric blood-clot embolism”, which would underlying cause of death.

 

If it was 43 days or greater, we would code the pulmonary thromboembolism to O96.0, “Death from direct obstetric cause occurring more than 42 days but less than one year after delivery” (the abortion being the delivery in this case).   O96.0 would be underlying cause of death.  However, in Canada we also have a multiple cause data base, so we would also include the O88.2 for the multiple causes, so the pulmonary thromboembolism information would be captured.

 

Kind Regards,

 

Kathy

Canada