Reclassification of unexplained stillbirths using clinical practice guidelines

摘要: Background: Twenty-eight per cent of stillbirths in Australia remain unexplained. A clinical practice guideline (CPG) produced by the Perinatal Society and New Zealand (PSANZ) Mortality Special Interest Group is use to assist clinicians investigation audit perinatal deaths. Aims: To describe a tertiary hospital using PSANZ stillbirth guidelines: (i) distribution classification stillbirths, (ii) compliance with suggested core investigations. Methods: Retrospective cohort all delivered between November 2005 March 2008. Stillbirths were defined as no sign life on delivery at ≥ 20 weeks gestation or 400 g birthweight if unknown. Data collected via Audit Committee (PMAC). Cause death was classified Death Classification. Results: There 86 (rate 7.2 1000 births). The percentage unexplained 34% 13% before after CPG investigations, respectively. Unexplained had highest recommended investigations. initial cause documented certificate changed PMAC 19 cases. investigations most likely prompt change autopsy placental pathology. Conclusions: lower than national average Guidelines. However, overall low, suggesting targeted approach used despite policy that aims be non-selective. Autopsy examination are useful assisting formal death.