Editorials

Less invasive investigation of perinatal death

BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h3598 (Published 08 July 2015) Cite this as: BMJ 2015;351:h3598
  1. Owen J Arthurs, academic consultant paediatric radiologist1,
  2. Charlotte Bevan, bereaved parent and senior research adviser2,
  3. Neil J Sebire, professor of paediatric pathology1
  1. 1Great Ormond Street Hospital for Children, London WC1N 3JH, UK
  2. 2Stillbirth and neonatal death charity (Sands), London, UK
  1. Correspondence to: OJ Arthurs owen.arthurs{at}gosh.nhs.uk

Emphasis is shifting to a service driven by parental acceptability and involvement

Whether a baby is stillborn (dies before or during labour after 24 weeks of pregnancy) or dies in early life (a neonatal death) bereaved parents may not be best served by current approaches to investigating their baby’s death. The NHS routinely offers standard autopsy, with incisions to the body to examine internal organs. Although this type of perinatal autopsy provides useful additional information in 30-40% of cases, a falling minority of parents agree to it.1 Some do agree, for altruistic as well as personal reasons—they hope that their child’s postmortem examination may contribute to the body of research that will shape future prevention.

Preliminary results from Europe indicate that almost all parents who decline standard autopsy, and are currently not offered an alternative, would agree to a less invasive autopsy.2 3 This comprises postmortem imaging and ancillary tests, with or without tissue biopsy. Less invasive autopsy has considerable implications for future clinical practice, because it could provide additional diagnostic information for more families as well as for public health and for evaluating the quality of obstetric and neonatal care, where data are …

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