Perinatal postmortem: factors influencing uptake and subsequent outcomes in an Asian population

To assess uptake of perinatal postmortems (PM) among mothers experiencing perinatal deaths. Subjective assessment of factors influencing uptake was studied. Analysis of perinatal PM outcomes and its impact on cause analyses of intrauterine fetal demise was made.

2-year prospective audit on all mothers who had experienced stillbirths at a tertiary centre. Couples returning for their postnatal consultation following their stillbirths were offered a subjective questionnaire on issues pertaining to the request of PM and their decisions on the requests. Outcome of their PMs was collated.

71 of 87 (81.6%) women with stillbirths in the 2008-2009 (24 months) period were offered PM examination of their babies. The preliminary uptake of perinatal PM was 24 (33.8%) at counseling and but only 12 (16.9%) finally had PMs performed. Perinatal PMs clinched a diagnosis in 5 of 12 cases (42%). Discrepancies existed between external examination by on-site obstetric doctors and subsequent examination by a perinatal pathologist.

Perinatal PM is a valuable tool in the assessment of intrauterine fetal demise. Increasing the perinatal PM uptake may improve care of women with stillbirths. Factors affecting parental decisions are discussed.