When should a neonatal death be referred to the coroner? Initiation of a guideline to aid decision making

Despite improved survival, particularly for extremely preterm infants, sadly some neonates die. When this happens, it may be appropriate to refer the death to the coroner, however, there is huge variation in practice between settings regarding the coroner referral process. After a particular case concerning several hospitals, we reviewed available evidence and produced a guideline to aid this process, involving both neonatologists and our coroner’s office, and including parental concerns. This has enabled a systematic, transparent approach that is equal for all infants.

Narendra Aladangady
FRCPCH, PhD
Consultant Neonatologist and Honorary Clinical Professor in Child Health, Neonatal Unit, Homerton University Hospital NHS Foundation Trust, London, and Queen Mary University of London
n.aladangady@nhs.net

Philippa Chisholm
FRCPCH
Consultant Neonatologist, Neonatal Unit, Homerton University Hospital NHS Foundation Trust, London

Full text available by subscription ...

The full text of this article is available to subscribers in text, and in Tablet/iPad format and as a PDF file.

Please subscribe and log in to see the full article.

Keywords

aplasia cutis congenita; skin disorder; congenital; placental infarct; fetus papyraceus

Key points

Extensive ACC lesions on the trunk and limbs are rare.
ACC can be associated with placental infarcts or the in utero death of a twin fetus, as in the case presented here.
Obstetric history should review maternal medications/infections during pregnancy, determine an initial multiple pregnancy with death of a co-twin and investigate any placental anomalies.
Despite their large size, truncal and limb ACC lesions usually resolve within the first few months of life.

Also published in Infant:

VOLUME 15/ISSUE 3, MAY 2019

Cleft palate and oral synechiae in a newborn infant

Cleft lip or palate associated with fibrous bands, also known as oral synechiae, is rare. This report describes a newborn infant with four fibrous bands in the oral cavity, a left-sided cleft lip and a cleft of the hard and soft palate. The fibrous bands made feeding difficult and raised concerns about the baby’s airway as they prevented normal positioning of the tongue.