The perinatal autopsy

by Claudia Ravaldi

There are important medical reasons to know in order to understand the meaning of the perinatal autopsy, and there are also some relational aspects to know when as operators we propose, carry out and then return the answers after an autopsy examination. Let’s briefly see the things to know.

In the past we have already dealt with this topic on our blog: here you can read the interview with Prof Gaetano Bulfamante, who has generously collaborated with us for many years to promote the right practices in the field of in-depth diagnostics, and here you can read why the autopsy is also important in view of a pregnancy following the loss, by Dr. Valentina Violante Pontello. A further study on what should happen during the first gynecological examination after a stillbirth can be read here , by Dr. Laura Avagliano.

During the last world congress organized by the International Stillbirth Alliance on stillbirth, held in Cork in September 2017, there was much discussion, both in the session for operators and in that for parents, the role of diagnostic investigations and examination of the placenta and cord for diagnosis and research , but also how these examinations, if correctly carried out and correctly re-explained to parents, can be an important factor of resilience and well-being for the bereaved couple and also a means to build the therapeutic alliance between hospital and families.

In many countries around the world, the autopsy is read by the team (one representative for each professional category) to the couple. The couple receives written and graphic explanations, with understandable language, both when there are certain causes, both when there are diagnostic hypotheses on some probable risk factors, and when nothing has been found that could explain the death of the child.

In many countries, all this takes place inside the hospital where the birth took place, with the same team that followed the woman, usually within six to eight weeks after the birth, after two follow-ups: one by telephone, and one at the famous visit. of the 40 days, which in these countries still takes place in the same hospital where the birth took place.

This continuity of care, the clarity in the procedures and diagnostic paths, the possibility of feeling part of a linear and coherent project in which everyone has a defined role and respects times and ways to communicate, is present in all the international guidelines, which put at the center not only the grieving couple and their dead child, but also the operators, who are placed in the best conditions to work, and can feel part of a team that works.

All this to tell you that we still receive emails like this.

“There was no interview even to explain what what the pathologist wrote about our child and the placenta means.”

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