PP.52 National Review of Postmortem Rates in Ireland – Are We to Blame?

Abstract

One in 200 babies in the Republic of Ireland is stillborn. Investigating the cause of stillbirth helps gives the clinician valuable information in relation to managing a subsequent pregnancy. A PM is the most useful and informative investigation that can be performed in the postnatal period.PM uptake rates in Ireland are low, circa 50%. There are few guidelines for staff on how to broach this issue and it is possible that individual clinicians’ attitudes to PM affect the uptake rates.We conducted a questionnaire study examining the attitudes of midwives and obstetricians in Ireland to perinatal PM. This questionnaire has been validated by the ISA, ANZSA and also by UK−Sands.In total 117 questionnaires were completed. Obstetricians made up 44% of respondents - the rest were midwives. 17% of respondents never gave information to parents about PMs. Of those who did, only 37% did so at the time of diagnosis. The majority of respondents (76%) were dissatisfied with the quality of training received in how to counsel for PM. 46% of respondents were satisfied with the quality of information materials available in counselling parents re PM. 83% felt that a clinical guideline would be helpful to assist parents in decision making.To summarise, there is a wide variation among health care staff in the current knowledge and clinical practise relating to stillbirth and consenting for PM. We anticipate that by introducing a standardised guideline and improving staff education that our PM rates will improve dramatically.