Perinatal Mortality/Morbidity Rounds

Perinatal Mortality/Morbidity Rounds are scheduled every 12-15 months in each regional facility in Nova Scotia. The intent of these sessions is to discuss the clinical issues that the local care givers have found most troubling in the previous year and to review the assignment of causes of death in the Nova Scotia Atlee Perinatal Database. These sessions may be eligible for Dalhousie University’s Department of CME credits. Often information from the Nova Scotia Atlee Perinatal Database is used to help the local care providers identify clinical issues that would be of general interest for the CME portion of the meeting. The process for mortality/morbidity reviews is outlined below:

  • A convenient data and time for the review is determined by the Chair of the regional hospital Maternal and Child (Perinatal and Pediatric) Committee and an RCP representative. Prior to the visit, RCP provides the Committee and the Health Records Department with a perinatal mortality list from the Nova Scotia Atlee Perinatal Database (NSAPD), including stillbirths and any neonatal or maternal deaths. The list includes the events that occurred in the most recent 12-month-period for which there are data in the Nova Scotia Atlee Perinatal Database.
  • When advisable, the mortality list will be expanded to include cases where there was significant morbidity. These cases usually involve transfer to the IWK Grace Health Centre. The intent is to focus the discussion on cases where the Maternal and Child Committee would find input most beneficial.
  • Members of the Maternal and Child Committee review the causes of death assigned by the physicians at the regional hospital. If there were particular cases where assigning a cause of death was problematic, those should be indicated and the issues identified prior to the RCP visit. Recent cases that may not have been added to the NSAPD by the time of the review can be added to the list by the Maternal and Child Committee. Any additional cases should be communicated to the Health Records Department as well as to the RCP. The RCP team will review the charts of any women or infants transferred to the IWK Health Centre prior to attending the review.
  • An RCP team travels to the regional centre to review the health records that will be discussed during the review session. Members of the RCP team review the records of all patients who died if time permits but concentrate on the cases that are flagged by the Maternal and Child Committee for discussion.
  • Cases are generally presented by a local care provider who has been involved with the family. During the review, members of the RCP team add their thoughts to the Maternal and Child Committee's deliberations. The presentations do not have to be formal but should provide the information necessary to focus the discussion. For record keeping purposes, these reviews are considered a meeting of the regional hospital Maternal and Child Committee. The RCP team members function as ad hoc members of the Committee as described in the Evidence Act.
  • Whenever possible an education session is incorporated into the meeting. The topic(s) discussed reflect the clinical issues identified in the case(s) presented. Presenters or discussion leaders may be local clinicians or RCP team members.