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PPO.37 Snapshot of Post-Mortem Examinations following Stillbirths at a University Hospital
  1. GC Holding,
  2. D Kenyon-Blair,
  3. L Spooner,
  4. S Collinge,
  5. S Mukherjee,
  6. P Satodia
  1. University Hospital, Coventry and Warwickshire, Coventry, UK

Abstract

Introduction Stillbirth incidence is 1 in 200 births. 2.6 million 3rd trimester stillbirths occur worldwide every year. Parents should be offered full post-mortem (PM) examination to elicit the cause of the stillbirth. PM provides more information than other less invasive investigations which could be crucial to future pregnancy management.1

Aim To evaluate the role of post-mortem examination in identifying the causes of stillbirth in our teaching hospital.

Methods Stillbirth data was collected from bereavement midwifery records and maternity unit birth statistics. Clinical notes were reviewed retrospectively to identify results of PMs and other relevant investigations.

Results 84 cases of stillbirth were identified between February 2011 and September 2013 including 15 at term (> = 37 weeks). The stillbirth rate was 5.36 per 1000 births (national average of 5.2 per 1000 in 2011).2

38 PMs were performed including 3 limited examinations giving consent rate of 45%. We reviewed 35 of the 84 cases using the ReCoDe classification.3 Fetal growth restriction was the main cause of death. Of 35 cases reviewed 11 had PM. PM provided a cause in 72% cases where cause was not identified clinically. 8 cases (23%) had no relevant condition identified (3 following PM). No fetus underwent non-invasive PM using MR imaging.

Conclusion In our series the PM examination provided additional useful information in determining the cause of stillbirths. There is need to improve post-mortem consent rate by improving and standardising consent training.

Minimally invasive post-mortem using MR imaging may be a useful alternative in the future.

References

  1. RCOG Green-top Guideline No. 55 (October 2010) Late Intra-uterine Fetal Death and Stillbirth

  2. Office for National Statistics (2013) Births in England and Wales, 2012. Gardosi J, et al. Classification of stillbirth by relevant condition at death (ReCoDe): population based cohort study. BMJ 2005;331:1113

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