Perinatal and infant postmortem examination

Difficult to ask for but potentially valuable

The relatively large concentration of deaths in the perinatal period and infancy and the need to provide explanations for parents might suggest that clinicians frequently turn to pathologists for information from postmortem examinations. Yet Cartlidge and colleagues in this week's BMJ draw attention to the fact that the rate of postmortem examination for perinatal and infant deaths in Wales is only 58% (p 155).1Their results are probably typical of the rest of Britain. For example, the confidential inquiry into stillbirths and deaths in infancy in the North Western region found a similarly low rate of only 53% in 1993 (A J Barson and J A Sands, personal communication).

The value of the perinatal postmortem examination extends beyond its ascertainment of factors that contributed to death. It may provide the basis for informed genetic counselling; it may challenge or verify diagnoses made by new techniques before death; it serves to monitor possible adverse effects of new treatments; it is a basis …