Women and Newborn Health Service
Services A — Z
King Edward Memorial Hospital
Perinatal Pathology Post Mortem Examinations
Is It Compulsory to Have a Hospital Post Mortem Examination?
Post Mortem Examination Options
Post Mortem Examinations
Whenever a baby dies, regardless of the gestation, there are many questions that parents ask such as:
- Was the baby abnormal in any way?
- Are there any findings important for future pregnancies?
- Are any problems likely to recur in future pregnancies?
- Could these events have been prevented?
- Why did the baby die?
Many of these questions can only be addressed by a full examination of the baby and placenta by a Pathologist. Perinatal Pathology offers a state-wide non-coronial (not legally required) perinatal post mortem examination service to all hospitals in Western Australia. There are many options available to parents regarding the extent of a post mortem examination.
Even if specific questions cannot be answered, important information can be gathered for the benefit of parents and care givers. For example, it may be useful to know that there was no evidence of infection or physical abnormalities, even if a precise cause of death cannot be stated.
The more complete the examination, the more information the final report will contain. A full examination enables parents to obtain the most accurate explanation for what has happened to their baby and whether this could affect future pregnancies or other family members.
Is It Compulsory to Have a Post Mortem Examination?
No, it is always the parents’ choice. The Perinatal Pathology Service supports the philosophy that the informed wishes of the parents should determine what happens to their baby after death. A post mortem examination can only be carried out with parental consent.
If a post mortem examination is not offered, parents do have the right to request one.
Post Mortem Examination Options
The choice of a post mortem examination is always up to the parents and there are varying options, regardless of the gestational age of the baby as outlined below:
Full Post Mortem Examination
A full post mortem examination provides the maximum possible
information. It allows the Pathologist to examine all
of the organs of the baby, to give a very detailed report
of any external or internal abnormalities, organ growth,
and structural defects. It is often a great help for
parents to feel that they, through their decision to
permit a full post mortem examination, are in possession
of all the relevant facts that could possibly be known.
The full post mortem includes:
- X-ray/s
- Photographs to create a permanent record
- Full external examination
- Full internal examination (the face, limbs and hands
are never cut)
Each of the individual organs are examined, weighed and small samples from every organ are taken for microscopic examination, which are kept indefinitely to create a permanent record. If necessary, small samples are taken for investigating infectious organisms or chromosomal abnormalities. Whole major organs (eg: heart, brain, liver), are not retained without specific consent from the parents. All remaining tissues are returned to the body at the end of the examination for burial or cremation. - Examination of the placenta, if received.
Limited Post Mortem Examination
Parents have the right to limit an examination to only
certain organs or areas of the body. The focus can be directed
towards a specific problem that has been identified during
pregnancy or after delivery, such as a heart defect or
a specific abnormality of an organ. The examination includes:
- X-ray/s
- Photographs to create a permanent record
- Full external examination
- Internal examination of only the areas selected by the parents in discussion with their Doctor, the Pathologist, and/or the Post Mortem Coordinator
- Examination of the placenta, if received.
Parents choosing a limited post mortem should be aware that abnormalities in one part of the body are often accompanied by important abnormalities elsewhere which may only be seen at a full post mortem examination. The limited post mortem will not provide the same amount of useful information as a full post mortem examination.
External Examination
No internal cuts are made and no internal organs are studied.
The examination includes:
- X-ray/s
- Photographs to create a permanent record
- Full external examination
- Examination of the placenta, if received.
Some useful information can be gained by external observations, measurements and X-rays but no comment can be made on organ development and form.
Step-Wise Examination
Parents may decide to place limits on the examination,
but include permission for the Pathologist to examine other
areas if the initial findings suggest there may be abnormalities
elsewhere. For example, if parents choose a step-wise examination
after a condition mainly affecting the abdomen, the Pathologist
will examine the abdomen, and only examine the chest if
he/she finds clear suggestions that the condition has affected
the chest too.
When are the Results Ready?
The Pathologist writes a detailed report, listing the findings made and results of any special investigations.
The preliminary report should be available within one to two working days. This includes the visual observations made by the Pathologist during the external examination.
The final report should be available within six to eight weeks. This contains the findings of:
- Standard tests carried out as part of the post mortem (eg: x-rays, histology tests)
- Special investigations carried out as a result of any abnormalities or health conditions found.
The Pathologist is available to discuss the report findings with parents and care givers.
