A review of findings from placental histology in cases of stillbirth following the amendment to the Coroner’s Act

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.