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A regional audit of perinatal and infant autopsies in Northern Ireland
Author(s) -
Thornton C. M.,
O'Hara M. D.
Publication year - 1998
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1998.tb09344.x
Subject(s) - audit , geography , northern ireland , medicine , socioeconomics , history , business , ethnology , sociology , accounting
Objective To investigate the rate and quality of perinatal/infant autopsies and their contribution to the final diagnosis. Methods The anonymised reports of autopsies performed on 174 of the 367 cases reported to the Northern Ireland Regional Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) coordinator in 1993 were reviewed. They were scored using a modification of the CESDI Pathology Audit Form 93 and, based on the score obtained, ascrined to one of three groups: good, adequate or inadequate. Based on the information obtained, they were also assessed as providing diagnostic, confirmatory, additional or no diagnostic data. The pre‐autopsy clinical extended Wigglesworth classification was compared with that based on autopsy findings. Results The autopsy rate was 47.4% and included 18 late fetal losses, 70 stillbirths, 57 neonatal deaths and 29 post neonatal deaths. The Regional Paediatric Pathology Centre performed 34.5% of the autopsies. Of the total number of autopsies, 46.6% failed to reach an adequate standard. Only 4.9% of the inadequate autopsies were performed in the Regional Centre. The Wigglesworth classification was altered in 20.7% of cases following autopsy. The autopsy findings of 49 cases were diagnostic, 75 confirmatory, 23 yielded additional information and 27 were useful in only a negative sense. Conclusion The autopsy rate for this region is well below the recommended level of 75%. With the exception of the Regional Centre, the quality of the perinatallinfant autopsy did not reach the standard suggested in the CESDI Pathology Audit form 93. Despite this the autopsy yielded valuable diagnostic, confirmatory or additional findings in 84.5% and resulted in alteration to the pre‐autopsy Wigglesworth classification in 20.7%.