http://bmj.com/cgi/content/abstract/324/7340/761
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 Collections under
which this article appears: Other
Pathology Medicine
and the law (incl forensic medicine) Neonatal
Neonates
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Malcolm Brodlie
a Royal Hospital for Sick Children, Edinburgh EH9 1LW, b Neonatal Unit, Simpson Memorial Maternity Pavilion, Edinburgh EH3 9YW, c Department of Paediatric Pathology, Royal Hospital for Sick Children, Edinburgh
Correspondence to: Ian Laing Ian.Laing@ed.ac.uk
Objectives: To measure the neonatal autopsy rate at a
tertiary referral centre and identify trends over the past decade. To
identify factors that may influence the likelihood of consent being
given for autopsy. To examine any discordance between diagnoses
before death and at autopsy.
Design: Retrospective review of patients' records.
Setting: Tertiary neonatal referral centre affiliated to
university.
Outcome measures: Sex, gestational age, birth weight, type of
delivery, and length of stay in neonatal unit for baby. Maternal age,
marital status, history of previous pregnancies, and details of who
requested permission for autopsy. Concordance between diagnoses
before death and at autopsy.
Results: An autopsy was performed in 209/314 (67%) cases. New
information was obtained in 50 (26%) autopsies. In six (3%) cases
this information was crucial for future counselling. In 145 (74%)
there was complete concordance between the clinical cause of death
and the findings at autopsy. From 1994 onwards the autopsy rate in
the neonatal unit fell. The only significant factor associated with
consent for autopsy was increased gestational age.
Conclusions: Important extra information can be gained at
neonatal autopsies. This should help parents to make an informed
decision when they are asked to give permission for their baby to
have an autopsy. These findings are of particular relevance in view
of the recent negative publicity surrounding neonatal autopsies and
the general decline in the neonatal autopsy rate over the decade
studied.
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What is already known on this topic Over recent years there has been a large amount of negative publicity surrounding neonatal autopsies in the United Kingdom What this study adds This finding is likely to be of use to bereaved parents who are asked to give permission for autopsy and provides a more positive perspective on the utility of neonatal autopsies |
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