Name of the Procedure:

Necropsy (autopsy), gross examination only; macerated stillborn

Summary

A necropsy, also known as an autopsy, is a detailed examination of a body after death. This specific procedure focuses on the gross examination of a stillborn baby that has undergone maceration, meaning the tissues have softened due to prolonged exposure to amniotic fluid after death.

Purpose

This procedure aims to understand the cause of stillbirth and the developmental status at the time of death. The goal is to provide insight into any medical conditions that led to the stillbirth, which may help in counseling and managing future pregnancies.

Indications

The procedure is indicated when there is a stillbirth and the body shows signs of maceration. It is especially important for:

• Stillbirths with no clear cause.
• Multiple stillbirths in a family.
• Cases where congenital abnormalities are suspected.

Preparation

As this is a post-mortem procedure, no patient preparation is needed. However, consent from the next of kin is required. Prior to the necropsy, a detailed medical and prenatal history is gathered.

Procedure Description

1. External Examination: The body is first examined externally for any visible anomalies, describing skin changes, and taking measurements (weight, length).
2. Internal Examination: The body cavities are opened to inspect major organs. Organs are assessed for developmental status and any abnormalities.
3. Photography and Documentation: Detailed notes and photographs are taken for medical records.
4. Sample Collection: Tissue samples may be collected for further microscopic or genetic analysis if necessary.

Tools/equipment used include scalpels, forceps, and dissecting scissors. No anesthesia is required as this is a post-mortem examination.

Duration

The procedure typically takes between 1 to 2 hours, depending on the complexity of the findings.

Setting

The procedure is performed in a hospital or a medical examiner's office equipped with a mortuary and autopsy facilities.

Personnel

The procedure is conducted by a pathologist, with the assistance of a pathologist's assistant or mortuary technician.

Risks and Complications

As a post-mortem procedure, it bears no risk to the patient. However, there may be emotional impacts on the family, requiring sensitive communication and support.

Benefits

The primary benefit is the determination of the cause of death, which provides closure for the family and critical information for managing future pregnancies and improving overall maternal and fetal health care.

Recovery

As this is a post-mortem examination, there is no recovery process for the deceased. However, families might be offered genetic counseling or support services if the results indicate a hereditary condition or for emotional support.

Alternatives

The alternative is not to conduct an autopsy, leaving the cause of stillbirth uncertain. Advanced imaging (like MRI) can be used in some cases but may not reveal as much detail as a physical examination.

Patient Experience

As the procedure is performed on a deceased stillborn, there is no patient experience. Families might experience grief, and it is essential they are supported through the process, with care providers available to discuss findings sensitively and compassionately.