* The perinatal necropsy rate in most of the United Kingdom fails to reach the minimum target of 75% * The quality of many perinatal postmortem examinations is considered poor * Present findings show that necropsy discloses the main cause of death in 18% of perinatal and infants deaths and other new information in a further 8% of deaths * Clinically important information is more likely to emanate from a good quality necropsy * Clinicians should take a more positive attitude towards postmortem examinations net increase in the number classified as dying of a congenital anomaly was only 4% as compared with 10% reported by Duley.'6 The classification was most frequently changed in spontaneous abortions and stillbirths, and so for epidemiological surveys it is particularly important to obtain a necropsy in these settings.This study has shown that necropsy is an invaluable investigation which is currently underused. The rate is likely to increase only if clinicians take a more positive attitude and realise how much clinically relevant information can be obtained from a good quality examination.We thank local convenors, district coordinators, and pathologists for help with data collection, and Professor D P Davies for reviewing the manuscript. We are particularly grateful to the survey administrator, Mrs J M Hopkins, for dedication to the project. The all Wales perinatal survey incorporates the confidential enquiry into stillbirths and deaths in infancy and is funded by the Welsh Office.

No abstract

Although it is likely that the most significant contributions to reducing health inequalities will be in improving economic and social conditions and the physical environment, there are interventions which health services, either alone or in collaboration with other agencies, can use to reduce inequalities in health.

No abstract