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Factors influencing the availability of a local hospital guideline on maternal care and fetal post-mortem work-up after antepartum stillbirth -- A national survey
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  • Dana Muin,
  • Sabrina Neururer,
  • Veronika Rotter,
  • Hermann Leitner,
  • Stephanie Leutgeb,
  • Peter HUSSLEIN,
  • Herbert Kiss,
  • Petra Kohlberger
Dana Muin
Medical University of Vienna Department of Obstetrics and Gynaecology
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Sabrina Neururer
Tirol Kliniken GmbH
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Veronika Rotter
Medical University of Vienna Department of Obstetrics and Gynaecology
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Hermann Leitner
Tirol Kliniken GmbH
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Stephanie Leutgeb
Austrian Society of Obstetrics and Gynecology
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Peter HUSSLEIN
Medical University of Vienna Department of Obstetrics and Gynaecology
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Herbert Kiss
Medical University of Vienna Department of Obstetrics and Gynaecology
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Petra Kohlberger
Medical University of Vienna Department of Obstetrics and Gynaecology
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Abstract

Objective: To describe the use of local hospital guidelines on maternal care and fetal post-mortem work-up following intrauterine fetal death (IUFD) in Austria and to evaluate epidemiological factors influencing the availability of such in secondary and tertiary referral hospitals Design: Prospective national survey Setting: 75 secondary and tertiary referral hospitals providing obstetrical care in Austria Population: Obstetrical departments Methods: National survey with a paper-based questionnaire covering nine general questions regarding local hospital facilities and four comprehensive questions regarding medical approach following IUFD Main Outcome measures: Epidemiological data Results: 46 (61.3%) obstetrical departments [37 (80.4%) secondary; 9 (19.6%) tertiary referral hospitals] participated in this survey, of which 17 (37.0%) had local hospital guidelines on care after IUFD, whilst 29 (63.0%) denied. Availability of a local guideline was strongly correlated with the regular practice of post-mortem consultations (p=0.012). 16 (34.8%) hospitals replied to always schedule a follow-up consultation with affected parents, whilst 7 (15.2%) denied. In 8 (17.4%) hospitals post-mortem consultations would only be scheduled, if post-mortem examinations had been conducted. Neither type of institution (p=0.613), on-site pathology department (p=0.177), nor institutional annual live birth (p=0.291) and stillbirth rates (p=0.438) were found to influence the availability of local hospital guidelines. 26 (56.5%) participants considered a national guideline on IUFD necessary. Conclusion: Less than half of the surveyed institutions, regardless of annual live- or stillbirth rate and type of referral centre, have implemented a local guideline at their department. Availability of such may be influenced by regular conduction of post-mortem follow-up consultations.