Falling rates of perinatal postmortem examination: Are we to blame?

ArticleinArchives of Disease in Childhood - Fetal and Neonatal Edition 91(6):F465 · December 2006with14 Reads
DOI: 10.1136/adc.2005.091314 · Source: PubMed
    • "Autopsy remains the gold standard for investigating a perinatal death, and offering and consenting for autopsy of a neonate remains a challenging area in the field of neonatology. Over the years there has been a decline in the number of autopsies in neonatology owing to various factors, such as lack of offering autopsy to parents by neonatologists (60 %), lack of availability of perinatal pathologist (35 %) and a perception that autopsies seldom provide useful new information (37 %) [18]. McHaffie et al have reported that the biggest reason for parental refusal of autopsy is the perception of their baby being mutilated and a feeling that there were no unanswered questions [19] . "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Research on perinatal bereavement services is limited. The aim of the study was to compare the uptake of bereavement support services between two tertiary neonatal units (NNU), and to investigate influencing factors. Method: The medical and bereavement records of all neonatal deaths were studied from January 2006 to December 2011. Data collected included parent and baby characteristics, mode of death, consent for autopsy and bereavement follow-up. The categorical data were compared by chi-square or Fisher's exact test and continuous data by Wilcoxon signed-rank test; a multivariable regression analysis was performed using STATA 12.0. Results: The neonatal deaths of 297 babies (182 in NNU1 and 115 in NNU2) with full datasets were analysed. Baby characteristics were similar between units except for lower median gestational age in NNU1 (p = 0.03). Significantly more NNU1 parents were non-Caucasian (p < 0.01), from lower socio-economic status (p = 0.01) and had previous stillbirth/miscarriage (p = 0.03). More babies had care withdrawn in NNU2 (p < 0.01). A significantly higher proportion of parents from NNU1 (61 %) attended bereavement follow-up compared to NNU2 (34 %; p < 0.01). On multivariable analysis, significantly more parents who were married or co-habiting (p = 0.02) and consented for an autopsy (p = 0.01) attended bereavement services. Conclusion: Uptake of bereavement services varied between the two NNUs, which could be due to differences in the ethnic and socio-economic mix of the population. Significantly more parents who were married or co-habiting, or consented for autopsy, attended bereavement follow up services.
    Full-text · Article · Jun 2016
    • "What is critical is that Māori be offered options that include less invasive procedures. Elsewhere, cultural and religious objections, and the exposure of unethical practices, has negatively impacted on post-mortem rates (Rose et al. 2006; SieswerdaHoogendoorn & van van Rijn 2010; Stock et al. 2010). For some pathologists a less invasive client-focused process could work towards more positive engagements between the general public and coroners (Stawicki et al. 2008). "
    [Show abstract] [Hide abstract] ABSTRACT: In Aotearoa New Zealand a post-mortem examination, also known as an autopsy, is the main tool for identifying cause of death. For Indigenous Māori New Zealanders, however, post-mortems remain a foreign and desecrating act. This paper examines how prevailing post-mortem practices affect Māori and discusses possible alternatives. It argues that, even with amendments to the Coroners Act, the coronial office continues to hold an unassailable position of power and there remains tension between the practice of post-mortem procedures and Māori tikanga. Further research is needed to investigate the social and cultural impacts of post-mortems on Māori and into new technologies and procedures that could be more acceptable to Māori.
    Full-text · Article · Nov 2014
    • "n›n daha yüksek oldu¤u bildirilmifltir. [9] Ayr›ca doktorlarda da otopsi izni istemede çekinceler mevcuttur. Bunun 3 ana sebebi vard›r: Perinatal patolo¤un olmamas›, ebeveynleri daha fazla üzmek istememe ve yeni bir onay formu imzalatma gere¤i olmas›. Di¤er bir neden ise sonucun klinik kararlar› sorgulama ihtiyac› do¤urabilecek kayg›s› tafl›makt›r. [11] Dini inançlar da otopsi izni vermede önem arz etmektedir . Türkiye'de yaflayan insanlar›n %88.7'si kendini Müslüman olarak tan›mlamaktad›r. ‹slamiyet'te, iste¤e ba¤l› otopsiye izin yoktur çünkü bedenin bozuldu¤u , çirkinleflti¤i kabul edilmektedir. Ayr›ca ölünün günbat›m›ndan önce gömülmesi önerildi¤inden otopsinin bunu geciktirebilece¤"
    Article · Aug 2013
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