Post-Mortem Imaging to Investigate the Causes of Stillbirth in Australia: Views of Parents, Midwives and Obstetricians.

IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Siobhan A Loughnan, Aleena M Wojcieszek, Laura Singline, Alison Griffin, Frances M Boyle, David Ellwood, Vicki Flenady, Stacy Goergen
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Abstract

Introduction: There is increasing interest regarding the role and value of post-mortem imaging in identifying the causes of stillbirth. We sought to understand the experiences of parents and the perceptions and practices of midwives and obstetricians regarding post-mortem imaging (computed tomography [CT], magnetic resonance imaging [MRI], ultrasound and X-rays of the baby), in the investigation of stillbirths, and how its use and perceived value compares to that of other stillbirth investigations.

Methods: Cross-sectional, web-based surveys of parents who experienced stillbirth in Australia from 2018 to 2022 and midwives and obstetricians involved in the care of parents who experienced stillbirth in the same 5 years. Data were analysed descriptively.

Results: Data from 68 parents and 94 midwives and obstetricians were included. According to parents, post-mortem imaging (CT, MRI, ultrasound and X-ray) were the least discussed (1%-16%) and performed (0%-13%) stillbirth investigations. Twenty-eight percent of midwives and obstetricians had recommended the option of post-mortem imaging to parents, while 45% felt that doing so was beyond their scope of practice. Relative to autopsy, midwives and obstetricians were often unsure of the value of MRI across a range of clinical scenarios, and CT, MRI, ultrasound and X-ray were the investigations least often discussed (17%-47%) with parents.

Conclusions: Post-mortem imaging is currently underutilised in the investigation of stillbirths. Education and training are needed to enhance maternity care professionals' awareness of the role and value of imaging for identifying the causes of stillbirths, and how best to discuss these investigations with families.

死后成像调查死产的原因在澳大利亚:家长,助产士和产科医生的观点。
导论:人们对尸检成像在确定死产原因中的作用和价值越来越感兴趣。我们试图了解死产调查中父母的经验以及助产士和产科医生对死后成像(计算机断层扫描[CT]、磁共振成像[MRI]、婴儿超声和x射线)的看法和做法,以及与其他死产调查相比,其使用和感知价值如何。方法:对2018年至2022年在澳大利亚经历死产的父母以及参与护理同样5年经历死产父母的助产士和产科医生进行横断面、基于网络的调查。对数据进行描述性分析。结果:纳入了68名家长和94名助产士和产科医生的数据。根据父母的说法,死后成像(CT、MRI、超声和x线)是讨论最少的(1%-16%),进行死产调查的(0%-13%)。28%的助产士和产科医生向父母推荐了死后成像的选择,而45%的人认为这样做超出了他们的实践范围。相对于尸检,助产士和产科医生通常不确定MRI在一系列临床情况下的价值,CT、MRI、超声和x射线是与父母讨论最少的检查(17%-47%)。结论:尸检成像目前在死产调查中应用不足。需要进行教育和培训,以提高产科护理专业人员对成像在确定死产原因方面的作用和价值的认识,以及如何最好地与家庭讨论这些调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.30
自引率
6.20%
发文量
133
审稿时长
6-12 weeks
期刊介绍: Journal of Medical Imaging and Radiation Oncology (formerly Australasian Radiology) is the official journal of The Royal Australian and New Zealand College of Radiologists, publishing articles of scientific excellence in radiology and radiation oncology. Manuscripts are judged on the basis of their contribution of original data and ideas or interpretation. All articles are peer reviewed.
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