The main indication should be the indication that the clinician attending the birth believes to be the primary 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.
For national reporting of the Birth event-main indication for caesarean section (NHDD) data element the following mapping occurs:
An ICD-10-AM code in the range O360-O365 or O367-O369 (Maternal care for other known or suspected fetal problems) is mapped to code 1 Fetal compromise.
ICD-10-AM code O366 (Maternal care for excessive fetal growth) or code O662 (Labour and delivery affected by unusually large fetus) is mapped to code 2 Suspected fetal macrosomia.
An ICD-10-AM code in the range O320-O329 (Maternal care for known or suspected malpresentation of fetus) or O640-O649 (Labour and delivery affected by malposition and malpresentation of fetus) is mapped to code 3 Malpresentation.
ICD-10-AM code O622 (Other uterine inertia) or code O629 (Abnormality of forces of labour, unspecified) together with Cervical dilatation prior to caesarean = code 1 (3cm or less) is mapped to code 10 Lack of progress; less than or equal to 3 cm cervical dilatation.
ICD-10-AM code O622 (Other uterine inertia) or code O629 (Abnormality of forces of labour, unspecified) together with Cervical dilatation prior to caesarean = code 2 (More than 3cm) is mapped to code 11 Lack of progress in the first stage; greater than 3 cm to less than 10 cm cervical dilatation.
ICD-10-AM code O622 (Other uterine inertia) or code O629 (Abnormality of forces of labour, unspecified) together with Labour and delivery complication code = O631 (Prolonged second stage (of labour)) is mapped to code 12 Lack of progress in the second stage.
An ICD-10-AM code in the range O440-O441 (Placenta praevia) is mapped to code 13 Placenta praevia.
An ICD-10-AM code in the range O450-O459 (Premature separation of placenta [abruptio placentae]) is mapped to code 14 Placental abruption.
ICD-10-AM code O694 (Labour and delivery complicated by vasa praevia) is mapped to code 15 Vasa praevia.
An ICD-10-AM code in the range O200-O209 (Haemorrhage in early pregnancy), O460-O469 (Antepartum haemorrhage, not elsewhere classified) or O670-O679 (Labour and delivery complicated by intrapartum haemorrhage, not elsewhere classified) is mapped to code 16 Antepartum/intrapartum haemorrhage.
An ICD-10-AM code in the range O300-O309 (Multiple gestation) is mapped to code 17 Multiple pregnancy.
ICD-10-AM code O665 (Failed application of vacuum extractor and forceps, unspecified) is mapped to code 18 Unsuccessful attempt at assisted delivery.
ICD-10-AM code O690 (Labour and delivery complicated by prolapse of cord) is mapped to code 19 Cord prolapse.
ICD-10-AM code Z352 (Supervision of pregnancy with other poor reproductive or obstetric history) with Caesarean section event (main indication) type of poor reproductive or obstetric history = 3 (Previous adverse fetal/neonatal outcome) is mapped to code 20 Previous adverse perinatal outcome.
ICD-10-AM code O342 (Maternal care due to uterine scar from previous surgery) with Number of previous caesarean sections => 1 is mapped to code 21 Previous caesarean section.
ICD-10-AM code Z352 (Supervision of pregnancy with other poor reproductive or obstetric history) with Caesarean section event (main indication)-type of poor reproductive or obstetric history = 2 (Previous perineal trauma/4th degree tear) is mapped to code 22 Previous severe perineal trauma.
ICD-10-AM code Z352 (Supervision of pregnancy with other poor reproductive or obstetric history) with Caesarean section event (main indication)-type of poor reproductive or obstetric history = 1 (Previous shoulder dystocia) is mapped to code 23 Previous shoulder dystocia.
ICD-10-AM code Z352 (Supervision of pregnancy with other poor reproductive or obstetric history) with Caesarean section event (main indication)-type of poor reproductive or obstetric history = 8 (Other) is mapped to code 29 Other obstetric, medical, surgical, psychological indications.
ICD-10-AM code O82 (Single delivery by caesarean section) is mapped to code 30 Maternal choice in the absence of any obstetric, medical, surgical, psychological indications.
An ICD-10-AM code except those listed in this mapping list, and excluding codes in the range U781-U882 (Supplementary codes for chronic conditions), is mapped to code 29 Other obstetric, medical, surgical, psychological indications. ICD-10-AM codes in the range U781-U882 (Supplementary codes for chronic conditions) are excluded from this data element.