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Differences in Postmortem Investigation following Perinatal Death.

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|June 14, 2021
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Postmortem investigation rates for perinatal deaths remain low. Stillbirths undergo more thorough investigation, including autopsy and genetic testing, compared to early neonatal deaths, highlighting a need for improved protocols.

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Area of Science:

  • Perinatal Medicine
  • Pathology
  • Medical Investigation

Background:

  • Perinatal death, encompassing stillbirths and early neonatal deaths, necessitates thorough investigation to determine causes and improve future outcomes.
  • Current investigation patterns for perinatal deaths vary, with potential disparities between stillbirths and neonatal deaths.

Purpose of the Study:

  • To describe postmortem investigation practices for perinatal deaths.
  • To compare the extent of investigation between stillbirths and early neonatal deaths.

Main Methods:

  • A single-center retrospective review of perinatal deaths between 2011 and 2017.
  • Definition of perinatal death included intrauterine fetal death (≥20 weeks' gestation) and neonatal deaths within the first 7 days of life.
  • Comparison of autopsy, postmortem genetic testing, and maternal testing rates between stillbirths and neonatal deaths.

Main Results:

  • Of 97 perinatal deaths, 54 were stillbirths and 43 were neonatal deaths.
  • Stillbirths were significantly more likely to undergo autopsy (p=0.013) and postmortem genetic testing (p=0.0004) than neonatal deaths.
  • 33% of cases lacked postmortem evaluation beyond placental pathology.

Conclusions:

  • Investigation following perinatal death is more common in stillbirths than in neonatal deaths.
  • Current rates of postmortem investigation for perinatal deaths are low.
  • Improved methods for postmortem investigation are needed, especially for neonatal deaths.