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09 August 2020

Response to the draft National Stillbirth Action and Implementation Plan

RANZCR provided written feedback to the Australian Department of Health to recommend that our expert clinical radiologists be directly involved in the ongoing development of the Government’s National Stillbirth Action and Implementation Plan. Four recommendations were made;

  1. Medical imaging has a central role in contemporary stillbirth prevention by:
    a. identifying women at higher risk of stillbirth early in pregnancy thus triggering therapeutic strategies, such as aspirin, and more intensive monitoring of this subgroup to reduce rates of stillbirth
    b. allowing non - invasive investigation of structural and genetic problems leading to stillbirth in the demised infant, both as an alternative and an adjunct to autopsy
  1. Imaging and in particular magnetic resonance imaging (MRI) can provide valuable, non-invasive diagnostic information to parents and inform stillbirth research especially in situations where autopsy is refused by parents; in Australia this continues to be over half of cases of perinatal death.
  1. Imaging has the potential to lift unacceptably low autopsy rates that are a consequence of parental refusal and which may be contributed to by a shortage of pathologists with the required expertise in perinatal autopsy
  1. Radiologists are ideally placed to collaborate with their local colleagues in pathology, genetics, obstetrics and paediatrics to investigate stillbirth and to improve our understanding of its causes in an effort to develop mitigating strategies. This information can also be greatly valued by families who are not only grief – stricken but lack an understanding of why this happened to them, contributing to a lack of healing of their grief. Plans for future pregnancies and the family’s mental health can be adversely impacted by this lack of information and understanding, particularly with regard to possible recurrence of a genetically – determined problem.

RANZCR Response - National Stillbirth Action and Implementation Plan