Provider attitudes about gaining consent for perinatal autopsy

Khong, T. Y.; Turnbull, Deborah; Staples, Alan

doi:10.1016/s0029-7844(01)01123-1

Cited by 25 publications

(27 citation statements)

References 20 publications

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“…Although most likely to show concern over disfigurement, bereaved parents were singled out as the group especially likely to see benefits of a PM (listed in order of importance as advancement of medical knowledge, knowing the cause of death, and reassurance that all appropriate care was given). As 45% of those who did not permit a PM stated that they had not been approached, the authors argue, in contrast with the study by Khong and colleagues, 38 that reluctance of clinicians to offer PMs is likely to be more important than reluctance of relatives to sanction procedures.…”

Section: Parental Viewscontrasting

confidence: 56%

Perinatal pathology in the context of a clinical trial: a review of the literature

Snowdon

Elbourne²,

Garcia³

2004

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Section: Parental Viewscontrasting

confidence: 56%

Perinatal pathology in the context of a clinical trial: a review of the literature

Snowdon

Elbourne²,

Garcia³

2004

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…Directors of British neonatal units may have reservations about requesting an autopsy in some cases,2 but Australian neonatologists do not seem to share these 3. Nurses' attitudes may differ from doctors' 3. Grief counsellors, nurses, or social workers who may be in contact with parents can unconsciously send messages that discourage parents from consenting to an autopsy.…”

mentioning

confidence: 99%

Falling neonatal autopsy rates

Khong

2002

BMJ

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“…A study found that while perinatal pathologist were the most knowledgeable about the autopsy procedure and its efficacy in determining the cause of death, they were less likely to meet the bereaved parents [126]. One Australian study showed that while midwives and neonatal nurses were reluctant to seek consent, obstetricians and neonatologists viewed nurses and midwives as influential on parent's decisions around autopsy [135]. Studies from USA, UK and Japan reported that nurses and midwives felt ill-equipped to deal with grieving parents and highlighted lack of experience, communication skills, confidence and competence to provide sensitive care [136].…”

Section: Investigation Of Stillbirthmentioning

confidence: 99%

“…Other factors that have been identified which affect clinicians' willingness to approach parents for autopsy consent include: low gestational age at death [135,139], the professional discipline of the clinician and their level of seniority [140], ambivalence about the value of autopsy [141], and lack of technical understanding of autopsy procedures [142]. Parents may regret their decision about autopsy as a result of poor communication or inadequate information [143].…”

Section: Investigation Of Stillbirthmentioning

confidence: 99%

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Preventing stillbirths: Better data to inform interventions in Australia

Ibiebele¹

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BackgroundIn Australia, one in every 139 women reaching 20 weeks gestation will have a stillborn baby. There is significant disparity in stillbirth rates within subgroups of the Australian population. Among Aboriginal and Torres Strait Islander (Indigenous) women, the stillbirth rate is one in every 93 women reaching 20 weeks gestation. Unfortunately, there has been no reduction in the national stillbirth rates over the past two decades and nearly a third are 'unexplained'. The ability to identify women at increased risk of stillbirth is an important and challenging priority. At present in Australia, there is a paucity of high quality data on causes and contributing factors to stillbirth. Furthermore, inconsistent approaches to investigation and classification affect the quality of data on causes of death and hamper the development of effective interventions to prevent stillbirth. AimsThe primary aim of this Thesis is to describe the epidemiology of stillbirth within the Australian context. This aim was addressed by: Examining trends in stillbirth by clinical classification of cause of death, Indigenous status and gestational age, to identify focal areas for preventive efforts  Assessing gestational age specific risk of stillbirth associated with four important contributors (diabetes, hypertension, antepartum haemorrhage and small-forgestational age) to higher stillbirth rates among Indigenous women in order to identify periods of increased risk  Developing and validating a statistical model to predict the risk of antepartum stillbirth at term (≥37 weeks) using maternal and pregnancy factors as a potential decision-making aid for clinicians and women  Assessing consistency in application of the Perinatal Society of Australia and New Zealand Perinatal Death Classification system between hospital committees and an independent expert panel, to identify areas for quality improvement  Determining maternal and pregnancy factors associated with parental consent to autopsy following stillbirth and explore parents' views and experiences of the autopsy consent process to inform clinical practice iii Methods and Results Data for 1995-2011 (n=881,211 singleton births) from the Queensland Perinatal DataCollection was analysed to address the first three aims. Stillbirth trends analysis found consistently higher rates of stillbirth among Indigenous women, however, the gap in stillbirth rates had narrowed. Gestational age specific stillbirth risk analysis found disparity in the magnitude of stillbirth risk for pre-existing diabetes and small-for-gestational age between Indigenous and non-Indigenous women. Despite strong association between maternal clinical factors and antepartum stillbirth risk, the prediction model had a poor ability to predict stillbirth risk at term.Consistency in application of the perinatal death classification system was assessed by calculating agreement. A substantial level of agreement was found between hospital committee and expert panel review of a cohort of 217 stillbirth cases, howeve...

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Provider attitudes about gaining consent for perinatal autopsy

Cited by 25 publications

References 20 publications

Perinatal pathology in the context of a clinical trial: a review of the literature

Perinatal pathology in the context of a clinical trial: a review of the literature

Falling neonatal autopsy rates

Preventing stillbirths: Better data to inform interventions in Australia

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