Related Experiment Video
Updated: Mar 7, 2026
A Protocol for Rapid Post-mortem Cell Culture of Diffuse Intrinsic Pontine Glioma DIPG
Published on: March 7, 2017
Factors affecting uptake of postmortem examination in the prenatal, perinatal and paediatric setting
C Lewis1,2, M Hill1,2, O J Arthurs2,3
1North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Insights
Understanding barriers and motivators is key to increasing postmortem examination rates for children. Addressing concerns like invasiveness and improving communication can enhance parental consent for these vital investigations.
Area of Science:
- Perinatal and paediatric pathology
- Medical ethics
- Parental bereavement support
Background:
- Postmortem examinations are crucial for determining the cause of infant and child deaths.
- Despite their importance, uptake rates for postmortem examinations remain significantly below recommended levels.
Purpose of the Study:
- To systematically review and identify barriers and motivators influencing parental consent for perinatal, prenatal, and paediatric postmortem examinations.
Main Methods:
- A comprehensive literature search was conducted across key databases (e.g., PubMed, CINAHL) and other sources.
- Peer-reviewed qualitative, quantitative, or mixed-methods research on factors affecting postmortem examination uptake was selected.
- Narrative synthesis was employed to compare findings across studies.
Main Results:
- Key barriers include procedure invasiveness, organ retention, protective parenting, communication issues, cultural/religious factors, and professional/organizational challenges.
- Motivators for consent encompass the desire for information, contribution to research, improved coping and well-being, respectful care, minimally invasive options, and supportive policies.
- Best practices for facilitating postmortem examinations were also identified in the literature.
Conclusions:
- Enhanced health professional education and the availability of less invasive postmortem techniques can mitigate parental concerns.
- Improved consent processes and updated codes of practice may positively influence perceptions and uptake of postmortem examinations.
- Ongoing research is essential to evaluate the impact of these changes on examination rates.
Background:
Postmortem examination is the single most useful investigation in providing information to parents about why their baby or child died. Despite this, uptake remains well below the recommended 75%.
Objective:
To address the question 'what are the barriers and motivators to perinatal, prenatal and paediatric PM examination?'
Search Strategy:
Key databases including Pubmed and CINAHL; Cochrane library, websites of relevant patient organisations, hand search of key journals, first and last authors and references.
Selection Criteria:
Peer-reviewed qualitative, quantitative or mixed methods research examining factors affecting uptake or decline of perinatal or paediatric postmortem examination.
Data Collection And Analysis:
Narrative synthesis; findings were compared across studies to examine interrelations.
Main Results:
Seven major themes describing barriers to postmortem uptake were identified: dislike of invasiveness, practicalities of the procedure, organ retention issues, protective parenting, communication and understanding, religion and culture and professional or organisational barriers. Six major themes related to factors which facilitated parental consent were identified: desire for information, contributing to research, coping and well-being, respectful care, minimally invasive options, and policy and practice. There were a number of themes in the literature that reflected best practice.
Conclusion:
Findings highlight the need for better health professional education and the fact some concerns may be mitigated if less invasive methods of postmortem were routinely available. New consent packages and codes of practice may have a positive impact on perception of examination after death. The landscape is changing; further research is necessary to assess the impact on postmortem uptake rates.
Tweetable Abstract:
Systematic review to explore the barriers and motivators to perinatal, prenatal and paediatric postmortem examination.
More Related Videos
08:08Determination of the Transport Rate of Xenobiotics and Nanomaterials Across the Placenta using the ex vivo Human Placental Perfusion Model
Published on: June 18, 2013
12:17The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology In Vivo
Published on: August 2, 2017
Related Concept Videos
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:21Factors Affecting Drug Response: Overview
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:19Factors Affecting Drug Distribution: Miscellaneous Factors
Age plays a significant role due to differences in body composition among different age groups. Infants, for instance, have a higher proportion of total body water and lower albumin levels, a protein that binds drugs in the bloodstream. This unique composition in infants enhances the...
01:15Factors Affecting Drug Distribution: Organ Perfusion Rate
Perfusion rate-limited distribution relies on the...
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution