Stillbirth and Autopsy
Most of the time, when a pregnancy ends in stillbirth, patients aren't given any reason for the death of the infant. As a mother tries to come to terms with her tragedy, she'll imagine that there may have been some undetected virus that caused the baby's death, or maybe she'll assume there were genetic problems. But if she dares to ask why this happened, in general, she'll be addressing that question to her Higher Power.
However, sometimes the hospital does decide to perform an autopsy on a stillborn infant. This is done when miscarriage or stillbirth is recurrent and doctors want to help figure out what went wrong so they can prevent this from happening again in the future. A woman may be surprised to learn that an autopsy was performed, but in general, learning the results—the cause of death—yields a great deal of comfort and helps the mother move on in her grieving process.
The reason this knowledge so comforts the mourning mother is because at some level, she can't help but wonder if her baby's death was somehow her fault. Knowing the true cause of death relieves the woman's fear that she is culpable for the loss of her child. For this reason, it is unfortunate that autopsies are not performed very often. A mother is left with no real answers and is forced to imagine the worst.
Now, a new study may help to change this state of affairs. University of Utah researchers have found that the cause of a stillbirth can be determined by autopsy eight times out of ten. The very idea that doctors have looked into the cause of death can help a couple to find closure. Furthermore, doctors may glean information in the course of such autopsies that can help them to prevent fetal deaths in future.
Robert Silver, who heads up the labor and delivery department at the University's hospital says, "If you do a thorough evaluation, you're more likely to find a cause."
Silver was one of the investigators for a study about causes of death in stillbirths. The study was done under the auspices of the National Institute of Child Health and Human Development. Silver has written up his preliminary findings in the American Journal of Obstetrics & Gynecology.
The Utah expert hopes the results of his study will persuade physicians across the nation to perform four tests on stillborn infants: autopsy, placental evaluation, karyotyping to check for chromosomal anomalies, and an examination for hemorrhaging. The problem lies in costs. Silver says that hospitals will pay for autopsies, but other tests will run from $1,000-$1,600 and may not be covered by insurance.
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