ABSTRACT
AIM: To assess uptake of perinatal postmortems (PM) among mothers experiencing perinatal deaths. Subjective assessment of factors influencing uptake was studied. Analysis of perinatal PM outcomes and its impact on cause analyses of intrauterine fetal demise was made. METHOD: 2-year prospective audit on all mothers who had experienced stillbirths at a tertiary centre. Couples returning for their postnatal consultation following their stillbirths were offered a subjective questionnaire on issues pertaining to the request of PM and their decisions on the requests. Outcome of their PMs was collated. RESULT: 71 of 87 (81.6%) women with stillbirths in the 2008-2009 (24 months) period were offered PM examination of their babies. The preliminary uptake of perinatal PM was 24 (33.8%) at counseling and but only 12 (16.9%) finally had PMs performed. Perinatal PMs clinched a diagnosis in 5 of 12 cases (42%). Discrepancies existed between external examination by on-site obstetric doctors and subsequent examination by a perinatal pathologist. CONCLUSION: Perinatal PM is a valuable tool in the assessment of intrauterine fetal demise. Increasing the perinatal PM uptake may improve care of women with stillbirths. Factors affecting parental decisions are discussed.
Subject(s)
Fetal Death/pathology , Stillbirth , Asian People , Female , Fetal Death/etiology , Humans , Pregnancy , Prospective StudiesABSTRACT
The anticoagulation of choice for mechanical heart valves is the oral anticoagulant warfarin. Warfarin is associated with increased risk of miscarriage, intrauterine fetal deaths and warfarin embryopathy. This longitudical cross-over study of 5 women observed all 5 having livebirths of healthy infants after heparin-managed pregnancies. Their earlier 8 pregnancies had all resulted in perinatal losses or miscarriages when on regimes based on warfarin.
ABSTRACT
Aim: We audited indications and outcomes of antiphospholipid syndrome (APS) screening in the pregnant population at our centre. Method: Prospective and observational. All APS test results returned were audited for validity of indication and subsequent outcome. Result: 24 of a total of 146 (16%) of requests for the antiphospholipid antibodies and lupus anticoagulant were not indicated. Two positive results returned for a total of 116 “indicated” requests (1.7%). Conclusion: There needs to be increased awareness among obstetricians on the indications for screening for antiphospholipid syndrome (APS). The prevalence of antiphospholipid syndrome with obstetric manefestations in the study population is lower than rates published in the literature.
ABSTRACT
Aim: To assess uptake of perinatal postmortems (PM) among mothers experiencing perinatal deaths. Subjective assessment of factors influencing uptake was studied. Analysis of perinatal PM outcomes and its impact on cause analyses of intrauterine fetal demise was made. Method: 2-year prospective audit on all mothers who had experienced stillbirths at a tertiary centre. Couples returning for their postnatal consultation following their stillbirths were offered a subjective questionnaire on issues pertaining to the request of PM and their decisions on the requests. Outcome of their PMs was collated. Result: 71 of 87 (81.6%) women with stillbirths in the 2008-2009 (24 months) period were offered PM examination of their babies. The preliminary uptake of perinatal PM was 24 (33.8%) at counseling and but only 12 (16.9%) finally had PMs performed. Perinatal PMs clinched a diagnosis in 5 of 12 cases (42%). Discrepancies existed between external examination by on-site obstetric doctors and subsequent examination by a perinatal pathologist. Conclusion: Perinatal PM is a valuable tool in the assessment of intrauterine fetal demise. Increasing the perinatal PM uptake may improve care of women with stillbirths. Factors affecting parental decisions are discussed.
