[Histonet] Re: fetal demise under 20 wks

[Charles.Embrey]

The state of Illinois actually has a law concerning this situation.  Any
miscarriage less than 20 weeks requires a state form be given to the
mother asking if she would like the remains handled as a surgical
specimen and thus disposed of as a surgical specimen or handled as a
fetal death requiring funeral home burial or cremation at the parent's
expense.  This law rose from a situation in which a nurse miscarried and
told hospital staff she wanted her baby released to the funeral home
after pathology examination.  The next week when the funeral home
inquired of picking up the baby it couldn't be found and was discovered
to have been discarded as hospital waste.  There was a lawsuit and
legislative involvement that led to this law.  If the mother signs
requesting the funeral home I can only touch the baby with a full
autopsy authorization permit.
Chuck

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Robert
Richmond
Sent: Monday, January 05, 2009 12:41 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] Re: fetal demise under 20 wks

Jessica Vacca in Brandon FL asks: >>Are there any facilities that do
not perform a gross and micro on a fetus less than 20 wks, if mom
wishes to bury it? Do you have a policy that states this and are you
willing to share? Does mom sign a form stating that she does not wish
for pathology to be done?<<

In a situation like this, the placenta needs to be examined both
grossly and microscopically, but the fetus generally does not. Most
pathology labs are not equipped to do an autopsy on a fetus this size,
and most pathologists (definitely including me) are not trained to do
this kind of autopsy. Most of the services I've worked on do not
routinely dissect the fetus.

Certainly, before I'd undertake any such autopsy, I'd want to make
sure that a funeral wasn't planned. Believe or not, open casket
funerals for fetuses are not unusual.

By the way, if you do dispose of a fetus, do so with great care, and
make sure that all identification is removed from it before final
disposal. Anti-abortion crazies have sometimes used this information
to harass the bereaved mother, as if she'd had the pregnancy aborted.
(This isn't an urban legend - I can supply a reference.)

Bob Richmond
Samurai Pathologist
Knoxville TN

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