[Proposals for standardization of autopsy reports]

Code of practice for medical autopsies: a minimum standard position paper for pathology departments performing medical (hospital) autopsies in adults

The medical autopsy (also called hospital or clinical autopsy) is a highly specialised medical procedure, which requires professional expertise and suitably equipped facilities. To ensure high standards of performance, the Working Group of Autopsy Pathology of the European Society of Pathology (ESP) suggests a code of practice as a minimum standard for centres performing medical autopsies. The proposed standards exclusively address autopsies in adults, and not forensic autopsies, perinatal/or paediatric examinations. Minimum standards for organisation, standard of premises, and staffing conditions, as well as minimum requirements for level of expertise of the postmortem performing specialists, documentation, and turnaround times of the medical procedure, are presented. Medical autopsies should be performed by specialists in pathology, or by trainees under the supervision of such specialists. To maintain the required level of expertise, autopsies should be performed regularly and in a number that ensures the maintenance of good practice of all participating physicians. A minimum number of autopsies per dedicated pathologist in a centre should be at least 50, or as an average, at least one autopsy per working week. Forensic autopsies, but not paediatric/perinatal autopsies may be included in this number. Turnaround time for final reports should not exceed 3 weeks (14 working days) for autopsies without fixation of brain/spinal cord or other time-consuming additional examinations, and 6 weeks (30 working days) for those with fixation of brain/spinal cord or additional examinations.

[Autopsy of children, neonates, fetuses and embryos: Preparation, technique and report writing]

Information obtained from the autopsies of children, neonates, fetuses and embryos, may not only be useful to explain the loss experienced by the parents but also to estimate the risk of recurrence. The detection of diseases by an autopsy helps to reduce the risk as well as with the planning of the next pregnancy and the optimal care of mother and fetus. Although incidences are continually dropping, according to the World Health Organization (WHO) statistics each year at least 2.6 million children worldwide suffer intrauterine death after the 28th week of pregnancy. Despite a general decrease in the number of autopsies, the parents agreed to a post-mortem examination in 500 out of 512 cases. The post-mortem examination and interpretation of results of children differ from those obtained from adults. As a supplement to previous publications, this article discusses these differences and may provide standardized instructions on performing autopsies and evaluation of autopsy findings.