Investigation into the cause of death?

Sometimes the cause of your baby’s death is immediately clear because, for example, an infection has been detected or because the placenta has detached. Those are things that can be seen on the outside. If the cause is not immediately known, you can have your baby examined further.

There are different ways of research. Each form of research is a different way of looking at things and can therefore also detect other things:

Inspection/appearance examination

The doctor will always examine your baby at the latest. He will see if he can see anything on the outside that could indicate a birth defect. Further research will be discussed as a result.

Placenta Research

In 30-60% of cases, the cause of death is found in the placenta. In many of the cases where the cause of death is unknown, you can still pinpoint a cause upon closer examination of the placenta. For example, in ‘low-risk’ pregnancies, we regularly see that the cause of death can be found in the placenta. That is to say; There are no other factors present in the mother that would have led to a poor outcome of the pregnancy. The placenta is a mirror of pregnancy where we can look at why a baby died. Autopsy is often very intense and does not always yield anything.
Through your gynaecologist or paediatrician, you can always request a second opinion from the specialist in this field, perinatal pathologist Dr L.E. van der Meeren, Erasmus MC/LUMC department of pathology: l.vandermeeren@erasmusmc.nl

“Search in the placenta”

Babygram

These are X-rays of your baby’s entire body. Two photos will be taken of the entire body, one of the front and one of the side. This may show skeletal abnormalities. This examination is only requested if the gynaecologist sees an indication for this

MRI scan

An MRI scan allows us to view and examine the inside of your child’s body. With this technique, abnormalities in the central nervous system, muscles and internal organs can be clearly visualized. No medical intervention is required for the MRI examination, so no damage is visible to the child after the examination. This examination is only requested if the gynaecologist sees an indication for this.

Biopt

If additional genetic testing is required, a piece of tissue can be removed, for example from the thigh. The chromosomes from this tissue can then be examined and it can be determined whether there is an abnormality in the DNA.
This chromosome test can also be done after an amniocentesis, chorionic villus sampling or with tissue from the umbilical cord

Autopsy or autopsy

This means that the pathologist will open up your baby and look at all the organs and take pieces of tissue from them for further examination later. During the autopsy, your baby’s skull can also be made up to view the brain. Your baby’s brain won’t go back and will be left behind for examination in its entirety. If you choose autopsy, you do not automatically choose autopsy of the brain. You must give separate permission for this.

The doctors always have parental consent
necessary before an autopsy can be performed. For the purpose of examining the
brain and removing tissue from the head is separate consent
necessary. Things they can detect in the brain include bleeding and
oxygen deficiency.

If you choose an autopsy, your baby will be transferred to the morgue. Often this is in the hospital where your baby died, but sometimes your baby is transferred to another hospital. The examination will take a few hours, after which your baby will be returned to you. The doctors will explain to you that your baby’s chest and possibly skull will be opened and that the wounds will be neatly taped and bandaged. However, it always remains tangible, even when there is clothing over it, so don’t be alarmed by this.

Because tissue has to be cultured for some time, it often takes a few weeks before the results are in. The doctors will tell you the results in an interview at the hospital. This is often an emotional and charged conversation. Then prepare yourself as well as possible by writing down all your questions. No question is crazy.

The doctor will give you a detailed explanation of the test results. Keep in mind that in some cases nothing will be found and the cause of death will always remain uncertain. In all likelihood, you will also receive the autopsy report. This is a very medical and often difficult to understand document, which mainly contains technical terms.