Are national recommendations regarding examination and disposal of products of miscarriage being followed? A need for revised guidelines?

Cameron, M; Penney, Gillian

doi:10.1093/humrep/deh617

Cited by 6 publications

(4 citation statements)

References 6 publications

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“…The most common reasons given for not sending routine histology were that respondents were unsure of the benefits of histology and the associated costs. A Scottish study showed similar findings with only 71% of records from 15 hospitals ordering histopathology for POC at miscarriage . Several reasons were given for this low compliance rate, including limited evidence for guidelines, guidelines being viewed as advisory, costs and practical difficulties …”

Section: Discussionmentioning

confidence: 85%

Is tissue an issue? Current practice and opinion in Western Australia for routine histopathology on products of conception

Yap

Watts

Faithfull

et al. 2014

Aust N Z J Obstet Gynaecol

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An anonymous questionnaire-based survey was used to determine current practices and opinions of senior health professionals working in Western Australian (WA) hospitals performing gynaecological procedures, regarding the routine use of histopathology for products of conception (POC) obtained either from the surgical management of miscarriage or termination of pregnancy. Sixty-one senior health professionals completed the survey. Tissue histopathology on POC was routinely requested for miscarriage and termination of pregnancy (TOP) by 87 and 59% of respondents, respectively. Respondents listed the main reasons for requesting routine histopathology as avoidance of misdiagnosis, medico-legal and quality assurance. There were inconsistent practices among WA health professionals regarding sending POC for histopathology; 63% of gynaecology head of departments recommend the introduction of state or national guidelines for the use of histopathology in the surgical management of miscarriages or terminations of pregnancy.

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Section: Discussionmentioning

confidence: 85%

Is tissue an issue? Current practice and opinion in Western Australia for routine histopathology on products of conception

Yap

Watts

Faithfull

et al. 2014

Aust N Z J Obstet Gynaecol

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“…All directives merely constitute guides, and different institutions or organisations in the healthcare sector each still draft their own guidelines, resulting in inconsistencies between different guidelines and implementation more generally. [28] Furthermore, since guidelines serve as guides only, their authority and weight beyond the clinical setting are limited and they therefore cannot be imposed on those institutions or medical personnel functioning under other legal instruments such as burial and cremation laws. When burial or cremation laws are not aligned with the various health sectors' guidelines, the intention to dispose of fetal remains sensitively may therefore be frustrated.…”

Section: Alternative Positions On the Management Of Fetal Remains Emamentioning

confidence: 99%

Managing the remains of fetuses and abandoned infants: A call to urgently review South African law and medicolegal practice

2016

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“…Each hospital trust should have a clear system and protocol for the sensitive disposal of fetal remains 3 . A Scottish study 47 to determine the extent to which health professionals have adopted these recommendations found that only 71% of records contained evidence of histological examination of tissue. Around 50% of women reported involvement with decisions about tissue disposal, although documentation was found in only 29% of records.…”

Section: Disposal Of Products Of Conceptionmentioning

confidence: 99%

Modern management of miscarriage

Sagili

Divers

2007

The Obstetric & Gynaecologis

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Key content • Miscarriage has traditionally been treated by surgical evacuation, on the assumption that any retained tissue increases the risk of infection and haemorrhage. • Over the last decade, effective non‐surgical alternatives have been advocated to minimise unnecessary surgical intervention while maintaining low rates of morbidity and mortality. • Improved access to early pregnancy assessment units and greater awareness among women has led to increasing demand for more conservative management of miscarriage. Learning objectives • To learn about the use of appropriate miscarriage terminology. • To learn about the advantages and disadvantages of expectant, medical and surgical management. • To understand that women's choice is paramount in planning treatment. Ethical issues • Guidance on the sensitive disposal of fetal remains is essential. Please cite this article as: Sagili H, Divers M. Modern management of miscarriage. The Obstetrician & Gynaecologist 2007;9:102–108.

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Are national recommendations regarding examination and disposal of products of miscarriage being followed? A need for revised guidelines?

Abstract: National guidance on these issues was found to be contentious and implementation was variable. Wide consultation with stakeholders is needed prior to the publication of revised guidance.

Cited by 6 publications

References 6 publications

Is tissue an issue? Current practice and opinion in Western Australia for routine histopathology on products of conception

Is tissue an issue? Current practice and opinion in Western Australia for routine histopathology on products of conception

Managing the remains of fetuses and abandoned infants: A call to urgently review South African law and medicolegal practice

Modern management of miscarriage

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