In 2009, 49 cases of stillbirth from ELHT were reported to CMACE, which showed ELHT to be an outlier for adjusted stillbirth rates.
At a multidisciplinary meeting, it was felt that other factors may be involved. not collected by CMACE. These included ethnicity, consanguinity, social issues etc. Therefore a detailed review of these cases was carried out using casenotes and electronic maternity database. Data was collected by 2 consultant obstetricians and the Risk Management midwife. The cause of death has been coded in the review using the ReCoDe system which has been shown to reduce the number of stillbirths classified as unexplained.
Several factors were identified in the review, the most interesting being the high level of consanguinity (29%) in the ELHT cohort. There was also a high incidence of smokers. Decreased fetal movements were highlighted in almost half the cases of stillbirth.
There were some discrepancies between the CMACE and the ReCoDe system in classifying the cause of stillbirth particularly in relation to antepartum haemorrhage.
Uptake of post-mortem was poor and very dependant on the practitioner counselling them and we have identified some training issues.
This demonstrated to us the importance of analysing our own stillbirth data and we are currently analysing our data for 2010 and 2011.
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