The Royal College of Midwives
Education
Noted
The Royal College of Midwives agrees with the coroner's recommendations to retain and safely store placentas for babies compromised in labour. They provide information regarding current practice, disposal and reasons to store placenta within the NHS. (AI summary)
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Dear Mr Hinchliffe , Thank you for your letter of 25 April 2016,and | do apologise for the delay in replying; have taken the opportunity to seek the views of the RCM Advisory Forum as are very helpful with strategic issues and of course all practice within the context of contemporary midwifery practice: response is therefore based on this information and my own experience of best practice across the UK For information purposes the forum is comprised of midwives, students and maternity support workers who are clinically working within maternity services across the UK: Given the view ofthe RCM Advisory forum and what believe to be best practice, entirely agree with your recommendations to this particular NHS Trust: would have expected that for any baby compromised in labour or requiring transfer to the Neonatal Unit the advice would be to have the placenta retained and safely stored and therefore available should there be a demise in the baby and a need for a post mortem examination at a future point in time. For further information have included below information regarding current practice, disposal and reasons to store placenta within the NHS as it stands today: MAy 2016 they they My
Current_placental disposal following the majority of_births is a5 follows All placentas are disposed of post- delivery by sealing them in a sharps guard anatomical plastic and transferred into a permanently sealed plastic pot for incineration following examination by the midwife or clinician post birth_ Exceptions to the above:_retaining_the placenta for pathology purposes Stillbirth Late fetal loss Significant fetal compromise in labour Baby with a low Apgar score Baby transferred to Neonatal Unit Baby who has had extensive resuscitation Baby with abnormalities Prematurity Some maternity units_keep and examine placenta_in_the following cases Intra uterine growth restriction i.e. birthweight below the 3rd centile Placental abruption Rhesus isoimmunisation Morbidly adherent placenta Multiple births Abnormal placental shape vessel cord Prolonged rupture of membranes >36 hours Maternal group B streptococcus eclampsia/maternal hypertension Maternal substance misuse Gestational diabetes Maternal coagulopathy In addition it is worth noting that some women do take care of their own placenta by taking them home from the maternity unit or birth centre_ On a final note one of the biggest challenges within maternity care is safe storage of placenta should we hold large numbers in case of neonatal deterioration, do this information is helpful but please do contact me if you require any further information.
Current_placental disposal following the majority of_births is a5 follows All placentas are disposed of post- delivery by sealing them in a sharps guard anatomical plastic and transferred into a permanently sealed plastic pot for incineration following examination by the midwife or clinician post birth_ Exceptions to the above:_retaining_the placenta for pathology purposes Stillbirth Late fetal loss Significant fetal compromise in labour Baby with a low Apgar score Baby transferred to Neonatal Unit Baby who has had extensive resuscitation Baby with abnormalities Prematurity Some maternity units_keep and examine placenta_in_the following cases Intra uterine growth restriction i.e. birthweight below the 3rd centile Placental abruption Rhesus isoimmunisation Morbidly adherent placenta Multiple births Abnormal placental shape vessel cord Prolonged rupture of membranes >36 hours Maternal group B streptococcus eclampsia/maternal hypertension Maternal substance misuse Gestational diabetes Maternal coagulopathy In addition it is worth noting that some women do take care of their own placenta by taking them home from the maternity unit or birth centre_ On a final note one of the biggest challenges within maternity care is safe storage of placenta should we hold large numbers in case of neonatal deterioration, do this information is helpful but please do contact me if you require any further information.