Fetal Autopsy: Improving Clinicians’ Knowledge to Increase Parents’ Acceptance. A Prospective Questionnaire-Based Study

Abstract

Background: Knowing the cause of stillbirth is of paramount importance for bereaved parents and fetal autopsy is one of the key investigations aimed at providing explanation about the fetal death. However, parents often manifest concerns in autopsy acceptance. Barriers against fetal autopsy can be related to caregivers’ disinformation and misconceptions. Our aim was to investigate the knowledge about fetal autopsy in a third level Italian University care Center. Methods: We investigated the knowledge of caregivers (n = 60) about fetal autopsy collecting data from an on-line anonymous questionnaire. We investigated about dismemberment, disfigurement and whether the parents can see their baby after the autopsy. Results: We obtained 34/60 (56.7%) answers, highlighting the discomfort of health care providers about addressing this issue. Only half of the responders knows that the baby will not be dismembered during the autopsy and only one third of caregivers knows that the baby will not be disfigured after the autopsy and parents can see their baby after the post-mortem investigation if they wish. More than 30% of health care providers reported that they did not know technical details about the autopsy procedures, and they did not know answers to some common questions about autopsy such as whether the fetus would be disfigured or dismembers and whether the remains could be viewed following completion of the autopsy. Conclusions: To overcome some barriers about fetal autopsy, it is of paramount importance that both caregivers and parents are aware that the baby will not be dismembered, and the face, hands, feet, and limbs of the baby are untouched during the full autopsy investigation. Deleting caregivers’ misconceptions is a crucial point for improving parents’ autopsy acceptance.

Keywords

• autopsy
• post-mortem examination
• stillbirth