The National Maternity Hospital, Holles Street, Dublin, Ireland.
Ir J Med Sci. 2021 Nov;190(4):1435-1437. doi: 10.1007/s11845-020-02446-6. Epub 2021 Jan 6.
An amendment to the 1962 Coroner's Act in the Republic of Ireland mandated that all stillbirths and neonatal deaths were to be reported to the local coroner's office. In response to this, the bereavement team and department of anatomic pathology modified the pathway for placental examination following stillbirth and reporting deaths to the coroner. This paper is a review of the effect of this practice.
This study is a review of all cases of stillbirths for 9 months following the amendment of the Coroner's Act. A descriptive, exploratory design was used involving a retrospective chart review.
Twenty-nine cases of stillbirth occurred during the study period. In cases where a placental examination was performed (n = 22), a cause of death was identified in the placenta or cord for seventeen (68%) of these cases. Seven cases had a consented autopsy with six cases confirming the initial diagnosis made at the time of gross placental examination. In one case, the cause of the stillbirth remained unexplained following placental examination and a full autopsy. No new information was gained from the autopsy in these seven cases. A further two cases had an autopsy directed by the coroner; the cause of death in these cases will be decided by the coroner.
The introduction of the pathway has improved the care provided to bereaved parents by providing parents with timely information about the potential cause of stillbirth and thereby reduces the need for an autopsy examination.
爱尔兰共和国对 1962 年《验尸官法》的修正案规定，所有死产和新生儿死亡都必须报告给当地验尸官办公室。作为对此的回应，悲痛团队和解剖病理学部门修改了死产后胎盘检查以及向验尸官报告死亡的途径。本文回顾了这种做法的效果。
本研究回顾了《验尸官法》修正案通过后 9 个月内所有死产病例。采用描述性、探索性设计，涉及回顾性图表审查。
在研究期间，有 29 例死产。在进行胎盘检查的病例中（n=22），17 例（68%）的胎盘或脐带中确定了死因。7 例进行了同意尸检，其中 6 例证实了大体胎盘检查时的初步诊断。在一例中，胎盘检查和全面尸检后，死产的原因仍未得到解释。在这 7 例中，尸检没有获得新的信息。另有两例由验尸官指导进行尸检；这些病例的死因将由验尸官决定。
该途径的引入通过及时向父母提供潜在死产原因的信息，改善了对悲痛父母的护理，从而减少了尸检检查的需要。
