Survey of women's reactions to perinatal necropsy

Rahman, Hayati Abdul; Khong, T. Yee

doi:10.1136/bmj.310.6983.870e

Cited by 24 publications

(14 citation statements)

References 5 publications

(5 reference statements)

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“…Questionnaires were designed specifically for this study, addressing issues previously reported as important in postmortem decision‐making (24,32,33) and those which the investigators considered might be important in the light of recent organ retention events and their own clinical experience. Some questionnaire items varied, depending on the nature of the pregnancy loss.…”

Section: Methodsmentioning

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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Section: Methodsmentioning

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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“…Poor communication between medical staff and parents within this very emotional and sensitive period of grief will strengthen the parents' denial. Time, experience and empathy of the physician are indispensable to discussing such complex situations with bereaved parents [6,7]. One of the most common reasons for the lack of consent is that the explanation of the benefits of necropsy was left to an inexperienced junior doctor [8].…”

Section: Introductionmentioning

confidence: 99%

MR Autopsy in Fetuses

Huisman

Wisser²,

Stallmach

et al. 2002

Fetal Diagn Ther

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Objective: The purpose of this study was to determine whether postmortem magnetic resonance imaging (MR autopsy) could serve as an alternative to necropsy of fetuses. The value of MR autopsy in the validation of the obstetric management and in risk counseling concerning future pregnancies is discussed. Methods: 10 consecutive, malformed fetuses were examined by postmortem MRI within 24 h of delivery. Prenatal ultrasound (US) was performed in all fetuses. Complete necropsy served as gold standard. Results: MR autopsy confirmed every US diagnosis responsible for termination. All MRI findings were confirmed by necropsy. In two fetuses, necropsy gave additional information relevant for risk counseling. Histologic examination corrected the diagnosis in one case. Conclusions: MR autopsy provides valuable information previously only available from necropsy. In parents who refuse perinatal necropsy, the information obtained by MR autopsy can be used to validate obstetric management and to evaluate the risk for future pregnancies. Necropsy however remains the gold standard.

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“…In a survey of women who had had a perinatal loss and been offered autopsy, it was apparent many did not have enough understanding about what the postmortem involved to make an informed choice 28 . Counselling parents regarding the role of postmortem takes time and requires skill.…”

Section: Discussionmentioning

confidence: 99%

Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses?

Elder

Zuccollo

Stanley

2005

BJOG

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a Background Case review after fatal perinatal asphyxia may have medicolegal implications. Accurate diagnosis of cause of death is therefore essential. Objective To determine consent rate and utility of autopsy after fatal grade III hypoxic ischaemic encephalopathy (HIE) presumed to be secondary to birth asphyxia. Design A retrospective clinical review from January 1995 to December 2002.Setting Regional tertiary referral neonatal unit, Wellington, New Zealand.Population Inclusion criteria were gestation 37 weeks, resuscitation after delivery and clinical course of grade III HIE. Exclusions were a recognised major lethal malformation. Methods Review of clinical records including the autopsy report.Main outcome measures Consent for autopsy, change in diagnosis after autopsy.Results Twenty-three infants died during the time period with a major diagnosis of grade III HIE. Three did not meet inclusion criteria. Of the remaining 20, 11 were female. Median gestation at birth was 40 weeks (range 38 -42 weeks) and median birth weight was 3568 g (range 2140-4475 g). In 8/17 of the infants for whom length and head measurements were available, the Ponderal Index suggested intrauterine growth retardation. The 16/20 infants had an autopsy. Four of these were Coroner's cases giving an autopsy rate of 80% with a rate by consent of 60%. In 10 (62.5%) infants, significant new information was added to the clinical diagnoses. Conclusions Neonatal HIE is a symptom rather than a final clinical diagnosis. A full autopsy is required to fully explore the reasons for fatal neonatal HIE and may provide information that is important medicolegally.

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Survey of women's reactions to perinatal necropsy

Cited by 24 publications

References 5 publications

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

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

MR Autopsy in Fetuses

Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses?

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