ARE PERINATAL AUTOPSY RATES SATISFACTORY

Objective: To determine perinatal autopsy rates and whether any matern al or obstetric factors affect consent for autopsy. Design: Ascertainm ent of perinatal autopsy rates between 1990 and 1993 for three categor ies of perinatal deaths: termination of pregnancy for antenatally diag nosed anomalies; fetal deaths and stillbirths; and neonatal and postne onatal deaths. A case-control study matched deaths for which consent f or autopsy was refused with the next death in the same category for wh ich consent was given.Setting: A tertiary maternity hospital in South Australia. Results: The autopsy rate for pregnancies terminated for fe tal abnormalities was 92.4% (171/185) and for intrauterine death was 8 7.7% (264/301); the rates in these two groups were higher for registra ble births (gestation > 20 weeks) than non-registrable births. The ove rall autopsy rate in liveborn babies was 58.8% (80/136), the neonatal autopsy rate being 59.6% (68/114). No significant differences were fou nd with regard to gestational age at birth, maternal gravidity and par ity, employment, health insurance or marital status, or, among Livebor n babies, postnatal age, between the autopsy and non-autopsy groups. C onclusions: Perinatal autopsy rates are higher than rates in adults bu t are lower in registrable births than the recommended 75%. Consent fo r autopsy is the limiting factor. There is a need for a clearer defini tion of perinatal autopsies, and perinatal autopsy rates, to take into account non-registrable deliveries.