Chapter XV

Pregnancy, childbirth and the puerperium
(O00-O99)

Maternal care related to the fetus and amniotic cavity and possible delivery problems
(O30-O48)

O30 Multiple gestation
Excludes: complications specific to multiple gestation ( O31.- )
O30.0 Twin pregnancy
O30.1 Triplet pregnancy
O30.2 Quadruplet pregnancy
O30.8 Other multiple gestation
O30.9 Multiple gestation, unspecified
Multiple pregnancy NOS

O31 Complications specific to multiple gestation
Excludes: conjoined twins causing disproportion ( O33.7 )
delayed delivery of second twin, triplet, etc. ( O63.2 )
malpresentation of one fetus or more ( O32.5 )
with obstructed labour ( O64-O66 )
O31.0 Papyraceous fetus
Fetus compressus
O31.1 Continuing pregnancy after abortion of one fetus or more
O31.2 Continuing pregnancy after intrauterine death of one fetus or more
O31.8 Other complications specific to multiple gestation

O32 Maternal care for known or suspected malpresentation of fetus
Includes: the listed conditions as a reason for observation, hospitalization or other obstetric care of the mother, or for caesarean section before onset of labour
Excludes: the listed conditions with obstructed labour ( O64.- )
O32.0 Maternal care for unstable lie
O32.1 Maternal care for breech presentation
O32.2 Maternal care for transverse and oblique lie
Presentation:
· oblique
· transverse
O32.3 Maternal care for face, brow and chin presentation
O32.4 Maternal care for high head at term
Failure of head to enter pelvic brim
O32.5 Maternal care for multiple gestation with malpresentation of one fetus or more
O32.6 Maternal care for compound presentation
O32.8 Maternal care for other malpresentation of fetus
O32.9 Maternal care for malpresentation of fetus, unspecified

O33 Maternal care for known or suspected disproportion
Includes: the listed conditions as a reason for observation, hospitalization or other obstetric care of the mother, or for caesarean section before onset of labour
Excludes: the listed conditions with obstructed labour ( O65-O66 )
O33.0 Maternal care for disproportion due to deformity of maternal pelvic bones
Pelvic deformity causing disproportion NOS
O33.1 Maternal care for disproportion due to generally contracted pelvis
Contracted pelvis NOS causing disproportion
O33.2 Maternal care for disproportion due to inlet contraction of pelvis
Inlet contraction (pelvis) causing disproportion
O33.3 Maternal care for disproportion due to outlet contraction of pelvis
Mid-cavity contraction (pelvis)
Outlet contraction (pelvis)
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causing disproportion
O33.4 Maternal care for disproportion of mixed maternal and fetal origin
O33.5 Maternal care for disproportion due to unusually large fetus
Disproportion of fetal origin with normally formed fetus
Fetal disproportion NOS
O33.6 Maternal care for disproportion due to hydrocephalic fetus
O33.7 Maternal care for disproportion due to other fetal deformities
Conjoined twins
Fetal:
· ascites
· hydrops
· meningomyelocele
· sacral teratoma
· tumour
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causing disproportion
O33.8 Maternal care for disproportion of other origin
O33.9 Maternal care for disproportion, unspecified
Cephalopelvic disproportion NOS
Fetopelvic disproportion NOS

O34 Maternal care for known or suspected abnormality of pelvic organs
Includes: the listed conditions as a reason for observation, hospitalization or other obstetric care of the mother, or for caesarean section before onset of labour
Excludes: the listed conditions with obstructed labour ( O65.5 )
O34.0 Maternal care for congenital malformation of uterus
Maternal care for:
· double uterus
· uterus bicornis
O34.1 Maternal care for tumour of corpus uteri
Maternal care for:
· polyp of corpus uteri
· uterine fibroid
Excludes: maternal care for tumour of cervix ( O34.4 )
O34.2 Maternal care due to uterine scar from previous surgery
Maternal care for scar from previous caesarean section
Excludes: vaginal delivery following previous caesarean section NOS ( O75.7 )
O34.3 Maternal care for cervical incompetence
Maternal care for:
· cerclage
· Shirodkar suture
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with or without mention of cervical incompetence
O34.4 Maternal care for other abnormalities of cervix
Maternal care for:
· polyp of cervix
· previous surgery to cervix
· stricture or stenosis of cervix
· tumour of cervix
O34.5 Maternal care for other abnormalities of gravid uterus
Maternal care for:
· incarceration
· prolapse
· retroversion
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of gravid uterus
O34.6 Maternal care for abnormality of vagina
Maternal care for:
· previous surgery to vagina
· septate vagina
· stenosis of vagina (acquired)(congenital)
· stricture of vagina
· tumour of vagina
Excludes: maternal care for vaginal varices in pregnancy ( O22.1 )
O34.7 Maternal care for abnormality of vulva and perineum
Maternal care for:
· fibrosis of perineum
· previous surgery to perineum or vulva
· rigid perineum
· tumour of vulva
Excludes: maternal care for perineal and vulval varices in pregnancy ( O22.1 )
O34.8 Maternal care for other abnormalities of pelvic organs
Maternal care for:
· cystocele
· pelvic floor repair (previous)
· pendulous abdomen
· rectocele
· rigid pelvic floor
O34.9 Maternal care for abnormality of pelvic organ, unspecified

O35 Maternal care for known or suspected fetal abnormality and damage
Includes: the listed conditions in the fetus as a reason for observation, hospitalization or other obstetric care of the mother, or for termination of pregnancy
Excludes: maternal care for known or suspected disproportion ( O33.- )
O35.0 Maternal care for (suspected) central nervous system malformation in fetus
Maternal care for (suspected) fetal:
· anencephaly
· spina bifida
Excludes: chromosomal abnormality in fetus ( O35.1 )
O35.1 Maternal care for (suspected) chromosomal abnormality in fetus
O35.2 Maternal care for (suspected) hereditary disease in fetus
Excludes: chromosomal abnormality in fetus ( O35.1 )
O35.3 Maternal care for (suspected) damage to fetus from viral disease in mother
Maternal care for (suspected) damage to fetus from maternal:
· cytomegalovirus infection
· rubella
O35.4 Maternal care for (suspected) damage to fetus from alcohol
O35.5 Maternal care for (suspected) damage to fetus by drugs
Maternal care for (suspected) damage to fetus from drug addiction
Excludes: fetal distress in labour and delivery due to drug administration ( O68.- )
O35.6 Maternal care for (suspected) damage to fetus by radiation
O35.7 Maternal care for (suspected) damage to fetus by other medical procedures
Maternal care for (suspected) damage to fetus by:
· amniocentesis
· biopsy procedures
· haematological investigation
· intrauterine contraceptive device
· intrauterine surgery
O35.8 Maternal care for other (suspected) fetal abnormality and damage
Maternal care for (suspected) damage to fetus from maternal:
· listeriosis
· toxoplasmosis
O35.9 Maternal care for (suspected) fetal abnormality and damage, unspecified

O36 Maternal care for other known or suspected fetal problems
Includes: the listed conditions in the fetus as a reason for observation, hospitalization or other obstetric care of the mother, or for termination of pregnancy
Excludes: labour and delivery complicated by fetal stress [distress] ( O68.- )
placental transfusion syndromes ( O43.0 )
O36.0 Maternal care for rhesus isoimmunization
Anti-D [Rh] antibodies
Rh incompatibility (with hydrops fetalis)
O36.1 Maternal care for other isoimmunization
ABO isoimmunization
Isoimmunization NOS (with hydrops fetalis)
O36.2 Maternal care for hydrops fetalis
Hydrops fetalis:
· NOS
· not associated with isoimmunization
O36.3 Maternal care for signs of fetal hypoxia
O36.4 Maternal care for intrauterine death
Excludes: missed abortion ( O02.1 )
O36.5 Maternal care for poor fetal growth
Maternal care for known or suspected:
· light-for-dates
· placental insufficiency
· small-for-dates
O36.6 Maternal care for excessive fetal growth
Maternal care for known or suspected large-for-dates
O36.7 Maternal care for viable fetus in abdominal pregnancy
O36.8 Maternal care for other specified fetal problems
O36.9 Maternal care for fetal problem, unspecified

O40 Polyhydramnios
Hydramnios

O41 Other disorders of amniotic fluid and membranes
Excludes: premature rupture of membranes ( O42.- )
O41.0 Oligohydramnios
Oligohydramnios without mention of rupture of membranes
O41.1 Infection of amniotic sac and membranes
Amnionitis
Chorioamnionitis
Membranitis
Placentitis
O41.8 Other specified disorders of amniotic fluid and membranes
O41.9 Disorder of amniotic fluid and membranes, unspecified

O42 Premature rupture of membranes
O42.0 Premature rupture of membranes, onset of labour within 24 hours
O42.1 Premature rupture of membranes, onset of labour after 24 hours
Excludes: with labour delayed by therapy ( O42.2 )
O42.2 Premature rupture of membranes, labour delayed by therapy
O42.9 Premature rupture of membranes, unspecified

O43 Placental disorders
Excludes: maternal care for poor fetal growth due to placental insufficiency ( O36.5 )
placenta praevia ( O44.- )
premature separation of placenta [abruptio placentae] ( O45.- )
O43.0 Placental transfusion syndromes
Transfusion:
· fetomaternal
· maternofetal
· twin-to-twin
O43.1 Malformation of placenta
Abnormal placenta NOS
Circumvallate placenta
O43.8 Other placental disorders
Placental:
· dysfunction
· infarction
O43.9 Placental disorder, unspecified

O44 Placenta praevia
O44.0 Placenta praevia specified as without haemorrhage
Low implantation of placenta specified as without haemorrhage
O44.1 Placenta praevia with haemorrhage
Low implantation of placenta, NOS or with haemorrhage
Placenta praevia:
· marginal
· partial
· total
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NOS or with haemorrhage
Excludes: labour and delivery complicated by haemorrhage from vasa praevia ( O69.4 )

O45 Premature separation of placenta [abruptio placentae]
O45.0 Premature separation of placenta with coagulation defect
Abruptio placentae with (excessive) haemorrhage associated with:
· afibrinogenaemia
· disseminated intravascular coagulation
· hyperfibrinolysis
· hypofibrinogenaemia
O45.8 Other premature separation of placenta
O45.9 Premature separation of placenta, unspecified
Abruptio placentae NOS

O46 Antepartum haemorrhage, not elsewhere classified
Excludes: haemorrhage in early pregnancy ( O20.- )
intrapartum haemorrhage NEC ( O67.- )
placenta praevia ( O44.- )
premature separation of placenta [abruptio placentae] ( O45.- )
O46.0 Antepartum haemorrhage with coagulation defect
Antepartum haemorrhage (excessive) associated with:
· afibrinogenaemia
· disseminated intravascular coagulation
· hyperfibrinolysis
· hypofibrinogenaemia
O46.8 Other antepartum haemorrhage
O46.9 Antepartum haemorrhage, unspecified

O47 False labour
O47.0 False labour before 37 completed weeks of gestation
O47.1 False labour at or after 37 completed weeks of gestation
O47.9 False labour, unspecified

O48 Prolonged pregnancy
Post-dates
Post-term