Interventions to improve rates of post-mortem examination after stillbirth.
OBJECTIVE
Despite recognition of the value of post-mortem examination following stillbirth, worldwide rates have declined since the early 1990s. There is a paucity of published evidence relating to factors that can improve post-mortem uptake. The aim of this study was to assess post-mortem rates following stillbirth and identify trends in the past 18 years that may have affected acceptance of the investigation.


METHODS
Retrospective cohort study.


RESULTS
Sharp declines in post-mortems coincided with publicity surrounding unlawful organ retention. Although nationally post-mortem rates have continued to fall, in our unit there was recovery in post-mortem rates. This increase was associated with implementation of policies to promote the uptake of perinatal post-mortem, including availability of specialist perinatal pathologists, education in the value of post-mortem, and senior staff involvement in counselling regarding the procedure.


CONCLUSIONS
The need to improve uptake of post-mortem examination following stillbirth is internationally recognized. The results of this study suggest that increased local availability of specialist perinatal pathologists, who can support education in the value of post-mortem, along with senior staff obtaining consent, may help achieve this goal.
Stock
Sarah J
SJ
University of Edinburgh, Division of Reproductive and Developmental Sciences, Room S7129, Simpson Centre for Reproductive Health, 51 Little France Crescent, Edinburgh EH16 4SA, United Kingdom. sarah.stock@ed.ac.uk
Goldsmith
Lesley
L
Evans
Margaret J
MJ
Laing
Ian A
IA
D001344:Autopsy / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003376:Counseling; D005260:Female; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D050497:Stillbirth; D006113:United Kingdom / Q000453:epidemiology