Parental care pathway after late fetal loss and stillbirth: an audit of cases in sunderland royal hospital over a 2-year period
Background Recently the RCOG published Green-Top Guideline ‘Late Intrauterine Fetal Death & Stillbirth’.1 The North East has the highest adjusted mortality for stillbirth,2 therefore an audit of the parental care pathway following stillbirth was appropriate.
Objectives To establish whether all aspects of a DGH care pathway following stillbirth are being followed and to detect areas for improvement.
Method A retrospective audit of stillbirths at SRH from May 2008–June 2010. Data was collected against a proforma of 19 standards expected to be met in 100% of cases, regarding actions, advice and documentary evidence. Sample size=45.
Results The following standards were met in >90% of cases.
▶ Cytogenetic investigation other than Post Mortem (PM).
▶ ‘Chaplaincy visit’.
▶ Parental medical photography.
▶ Support group information for example, SANDS.
▶ Fetal lock of hair, hand/foot prints.
Only 55% were counselled about cytogenetic investigations by a consultant (or supervised SpR). In 91%, it was not documented whether the parental copy of the PM consent form was given. Support group leaflets were given to just 33%. Only 13% of patients were offered lactation suppression. Parental medical photography was unavailable at follow-up in 36%.
Conclusions 5 of the 19 standards are being met in >90% which is encouraging. Ensuring that parents are given their copy of the PM consent form is a key area for improvement, also documentation of the offer of lactation suppression, support group leaflets and ensuring that parental medical photographs are available for the follow-up appointment.