Falling neonatal autopsy rates

Khong, T. Yee

doi:10.1136/bmj.324.7340.749

Cited by 20 publications

(9 citation statements)

References 9 publications

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“…The decline in autopsy rate and issues surrounding the retention of tissues and organs for diagnostic studies, teaching, and research has been the subject of much debate since the adverse publicity concerning autopsies and organ retention 12 – 15…”

Section: Discussionmentioning

confidence: 99%

Autopsy after termination of pregnancy for fetal anomaly: retrospective cohort study

Boyd

2004

BMJ

132

118

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Objective To study trends in termination of pregnancy for fetal anomaly over 10 years and to assess the contribution of autopsy to the final diagnosis and counselling after termination. Design Retrospective study with cases from a congenital anomaly register and a defined unselected population. Data sources Pregnancies resulting in termination for fetal anomaly identified from the Oxford congenital anomaly register. Details about the prenatal diagnosis and autopsy findings were retrieved from case notes. Results Of the 57 258 deliveries, 309 (0.5%) were terminated because of prenatally diagnosed abnormality. There were 129/29 086 (0.4%) terminations for fetal anomaly carried out in 1991-5 and 180/28 172 (0.6%) in 1996-2000. The percentage of fetuses that underwent autopsy fell from 84% to 67%. Autopsy was performed in 132 cases identified by ultrasound scan, with no evidence for abnormal karyotype. In 95 (72%) the autopsy confirmed the suspected diagnosis and did not add important further information, two cases were not classified, and in 35 (27%) the autopsy added information that led to a refinement of the risk of recurrence (reduced in 17, increased in 18); in 11 of these 18 cases it was increased to a one in four risk. Conclusions Though there has been an increase in the rate of terminations of pregnancy for fetal anomaly, there has been a decline in the autopsy rate. When a prenatal diagnosis was based on the results of a scan only, the addition of information from an autopsy by a specialist paediatric pathologist provided important information that changed the estimated risk of recurrence in 27% of cases and in 8% this was to a higher (one in four) risk.

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Section: Discussionmentioning

confidence: 99%

Autopsy after termination of pregnancy for fetal anomaly: retrospective cohort study

Boyd

2004

BMJ

132

118

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“…Falling consent rates for postmortems, regardless of age of death, have been widely reported in recent years (4–6). In the United Kingdom, rates for perinatal autopsies have decreased since publicized organ retention events of the 1990s at Bristol and Alder Hey hospitals, and similarly in Australia (7), although they had been declining well before this (8).…”

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confidence: 99%

Perinatal Postmortems: What Is Important to Parents and How Do They Decide?

Breeze

Statham

Hackett

et al. 2012

Birth

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“…Sixty percent of these neonates were premature. Median week of gestation was found to be 32 (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). Median overall survival of the neonates were 4 (0-80) days.…”

Section: Resultsmentioning

confidence: 99%

Newborn Autopsies: Experience of Referral Level III Neonatal Intensive Care Unit in Turkey

Aksoy¹

2013

Perinatal J

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Objective: Neonatal autopsies are a guide to explore the causes of the perinatal mortalities which is important marker for evaluation of the health policies. Multidisciplinary approach which includes obstetrician, pediatrician, pathologist and geneticist is required for the neonatal autopsies. In our study, we have examined the significance of neonatal autopsy in neonatal deaths occurred in our clinic within 2 years, and analyzed whether neonatal autopsy has any impact on confirming and/or modifying reason of death. Methods: Thirty-eight neonatal autopsies between January 2009 and December 2010 were evaluated in respect to demographic characteristics, clinical and pathological diagnosis retrospectively. Results: Totally 7055 neonates were hospitalized in our neonatal intensive care unit between January 2009 and December 2010. Among them, 404 of the neonates passed away (5.7%). Only 38 (9.4%) of the neonates' parents gave permission for autopsy. Fifteen of these neonates were female (39%) and 23 of them were male (61%). Sixty percent of these neonates were premature. Prematurity was higher in male neonates (p=0.001). Median week of gestation was 32 (22-41). Median overall survival of the neonates were 4 (0-80) days. When compared according to gender, there was statistically no significant difference between survival periods. Prematurity rate was quite high among male neonates (p=0.001). Eighty-three percent of the clinical diagnoses were correlated with the pathological diagnosis. Sixty percent of the clinical and pathological diagnoses were cardiovascular anomalies, diaphragmatic hernia, perinatal asphyxia and prematurity. Two neonates had pneumonia diagnosis by the autopsy. Only one of these cases had chorioamnionitis in the placenta. Conclusion: Neonatal autopsy rates should be increased to decrease the neonatal mortality rate in our country. Neonatal autopsies should be done with multidisciplinary approach and become prevalent and get more progress in our country.

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Falling neonatal autopsy rates

Cited by 20 publications

References 9 publications

Autopsy after termination of pregnancy for fetal anomaly: retrospective cohort study

Autopsy after termination of pregnancy for fetal anomaly: retrospective cohort study

Perinatal Postmortems: What Is Important to Parents and How Do They Decide?

Newborn Autopsies: Experience of Referral Level III Neonatal Intensive Care Unit in Turkey

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