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Parental care pathway after late fetal loss and stillbirth: an audit of cases in sunderland royal hospital over a 2-year period
  1. L E Waller1,2,
  2. H M Cameron2
  1. 1Newcastle University, Newcastle-upon-Tyne, UK
  2. 2Sunderland Royal Hospital, Sunderland, UK

Abstract

Background Recently the RCOG published Green-Top Guideline ‘Late Intrauterine Fetal Death & Stillbirth’.1 The North East has the highest adjusted mortality for stillbirth,2 therefore an audit of the parental care pathway following stillbirth was appropriate.

Objectives To establish whether all aspects of a DGH care pathway following stillbirth are being followed and to detect areas for improvement.

Method A retrospective audit of stillbirths at SRH from May 2008–June 2010. Data was collected against a proforma of 19 standards expected to be met in 100% of cases, regarding actions, advice and documentary evidence. Sample size=45.

Results The following standards were met in >90% of cases.

Offering:

  • Cytogenetic investigation other than Post Mortem (PM).

  • ‘Chaplaincy visit’.

  • Parental medical photography.

  • Support group information for example, SANDS.

  • Fetal lock of hair, hand/foot prints.

Only 55% were counselled about cytogenetic investigations by a consultant (or supervised SpR). In 91%, it was not documented whether the parental copy of the PM consent form was given. Support group leaflets were given to just 33%. Only 13% of patients were offered lactation suppression. Parental medical photography was unavailable at follow-up in 36%.

Conclusions 5 of the 19 standards are being met in >90% which is encouraging. Ensuring that parents are given their copy of the PM consent form is a key area for improvement, also documentation of the offer of lactation suppression, support group leaflets and ensuring that parental medical photographs are available for the follow-up appointment.

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