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.

Study design: 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.

Conclusion: 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.