Download disposal of non-viable fetuses

DISPOSAL OF NON-VIABLE FETUSES
Purpose:
To provide guidelines for Parental Disposal of non - viable foetus, where the parents indicate this is
their wish.
To ensure that EH Identification Policy guidelines are used when admitting, transferring or
discharging a foetus/embryo from mortuary.
Details:
Guidelines
Staff must remain aware of, and discuss with the parents, any cultural and religious wishes.
A Death Certificate is not required for the non-viable foetus.
Parents have the right to take their non-viable foetus/baby home in an Angel Box (available on 3 East or through Social
Work Department) for burial. Staff must obtain parents written consent through completion of form "Release to Parents of
the Non-Viable Foetus" (MR.200). (Attachment 1).
This is to be documented and filed into patient's history.
All babies/foetus or embryos are to be kept in the Mortuary when not with the parents. Any admission, transfer or discharge
should be recorded in the Angel Book to ensure the exact location of the foetus is known at all times.
The Admission and Discharge Coordinator or Nursing Coordinator is to be notified of all admission, transfers or discharges
from the Mortuary.
Definitions
Non-viable foetus - An Embryo or foetus that does not show signs of life and is less than 20 weeks gestation. If it cannot
be reliably established whether the period of gestation is more or less than 20 weeks, less than 400g in weight is
considered non-viable.
Viable Foetus - A foetus that shows signs of life or is greater than 20 weeks gestation or 400g in weight is considered
viable. Therefore a notification of the birth should be sent to the Registry of Births, Deaths and Marriages and management
of the deceased foetus are to be handled by a Funeral Director.
Angel Book - An 'Admission and Discharge' book found in the mortuary to enable tracking of deceased Non-Viable Fetus.
Equipment Required

Form - "Release To Parents of the Non-Viable Foetus" (MR 200) (Attachment 1)

Angel Box

Maternal Bradmas marked 'Baby of'

Gloves
Protocol/Procedure
Midwife &/or Social Worker to discuss with parents their options/choices regarding disposal, private burial or cremation of
their baby.
Discuss options relating to placenta.
Refer to Social Work Department.
Wrap foetus in nappy and label with dated maternal bradma marked 'baby of''.
Place placenta, if separate, in plastic bag and label with dated bradma.
Place foetus and placenta in gown or pouch and place into Angel Box ensuring maternal bradma is place on the Angel box.
Mortuary Care of Foetus/embryo until discharge
Foetus/embryo is to be kept in the Mortuary when not with the parents.
Any admission or transfer or discharge should be recorded in the Angel Book to ensure the exact location of the feotus is
known at all times.
The Nursing Staff are responsible for completing an identification check on admission, transfer or discharge and recording
the details in the Angel Book located in the mortuary Ante-room.
Nursing staff only are able to admit, transfer or discharge from the mortuary.
If the parents choose to take their baby home:
Complete the 'Release to Parents of the Non-Viable Foetus' form (MR200),' and file in mother's history.
Dress baby in gown or pouch and place into Angel Box and give to parents with instructions on discharge from hospital.
Dispose of placenta depending on pathology testing requirements:
If placenta requires pathology testing, place in plastic bag and label with dated bradma. Send to pathology with request
form.
If placenta for hospital disposal, place in Delivery Suite disposal bin.
Related Policy
AH Disposal of Placenta Policy
AH Viewing of Bodiess by Next of Kin
AH Perinatal Loss Management
AH Disposal of Non-vialbe foetus and Placenta - by Hospital
EH Notification of Births (under development)
EH Death of a Patient - Acute & Aged Care Programs (to be developed)
References/Legislation
Cultural/Religious Practices - When a Baby Dies - Angliss Hospital Death Procedure Manual
Births, Deaths and Marriages Registration Act 1996. Act No. 43/1996
DISPOSAL OF NON-VIABLE FETUS BY HOSPITAL
Purpose:
To provide guidelines for hospital disposal of non-viable foetus in accordance with parents wishes.
To ensure that EH Identification Policy guidelines are adhered to when handling foetus/embryos.
Details:
Guidelines

Staff must remain aware of and discuss the parents' cultural and religious wishes.

A death certificate is not required for a non-viable foetus.

All foetus/embryos are to be kept in the Mortuary when not with the parents until they have made a decision
regarding disposal.

Any admission, transfer or discharge to or from the mortuary should be recorded in the Angel Book to ensure the
exact location of the foetus is known at all times.

If a decision is hospital disposal, staff must obtain parents written consent by completing, "Permission for Hospital
Disposal of the Non-Viable Foetus" Form - (MR201) (Attachment 1).

Parents are to be advised that the decision is final after date indicated on the consent.
(ie 5 days post delivery) as the hospital will have actioned the disposal request.

Parents are able to change their decision (Prior to the date indicated on the "Permission for Hospital
Disposal of the Non-Viable Foetus" Form - (MR201)) and take their non-viable foetus/embryo home in an Angel
Box (available on 3 East or through Social Work Department) for burial. Parents need to sign form, "Release
to Parents of the Non-Viable Foetus" (MR 200).
Definitions
Non-viable foetus - An Embryo or foetus that does not show signs of life and is less than 20
weeks gestation. If it cannot be reliably established whether the period of gestation is more or less than 20 weeks, less than
400g in weight is considered non-viable.
Viable Foetus - A foetus that shows signs of life or is greater than 20 weeks gestation or 400g in weight is considered
viable. Therefore a notification of the birth should be sent to the Registry of Births, Deaths and Marriages and management
of the deceased foetus are to be handled by a Funeral Director.
Angel Book - An 'Admission and Discharge' book found in the mortuary to enable tracking of deceased Non-Viable Fetus.
Equipment Required

Gloves

Nappy

Maternal bradma labels marked 'Baby of'

Pathology request form. Labelled - "Tissue for Disposal"

Signed consent of the "Permission for Hospital Disposal of the Non-Viable Foetus" Form - (MR201)
(Attachment 1) plus photocopy for pathology.
Protocol/Procedure
Social Worker or Midwife to discuss with parents their choices regarding the disposal/burial of their baby (non-viable
foetus).
Refer patient/parents to Social Work Department.
If the parents choose Hospital Disposal:

Ask parents to complete "Permission for Hospital Disposal of the Non-Viable" Form - (MR201) (Attachment 1)

Wrap foetus in nappy and label with dated maternal bradma marked 'Baby of'.

Place placenta, if separate, in plastic bag and label with dated maternal bradma marked 'Baby of'.

Place foetus and placenta in designated carry case. Place dated bradma labels on case. Seal with cable tie.
Send to Pathology:

Any foetus to be discarded should be marked 'For Discard' and be accompanied by a completed request form
signed by the Doctor and the "Permission for Hospital Disposal of the Non-Viable" Form - (MR201) (Attachment 1)

The foetus will be kept in the pathology fridge until the date indicated, usually Day 5 post delivery, then disposed
of.
Related Policy
AH Disposal of Placenta
AH Viewing of Bodies by Next of Kin
AH Perinatal Loss Management
AH Disposal of Non-viable foetus and Placenta - by Parents
EH Notification of Births (to be developed)
EH Death of a Patient -Acute and Aged Care Programs (to be developed)
References/Legislation
Cultural/Religious Practices - When a Baby Dies - Angliss Hospital Death Procedure Manual
Births, Deaths and Marriages Registration Act 1996. Act No. 43/1996