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Table 2 Costs of comprehensive stillbirth care‡ (UK Sterling, price year 2010)

From: A structured review and exploration of the healthcare costs associated with stillbirth and a subsequent pregnancy in England and Wales

Resource type

Cost

Reference

Core investigations and counselling

Bereavement counselling*

£521

[16, 22]

Autopsy/post-mortem

£650

University of Manchester Hospital Laboratory

Placental pathology

£54

University of Manchester Hospital Laboratory

Kleihauer test

£17

University of Manchester Hospital Laboratory

Total core investigations

£1,242

 

Other investigations (depending on clinical scenarios)

Cytogenetics

£246

University of Manchester Hospital Laboratory

Thrombophilia screen

£132

University of Manchester Hospital Laboratory

- Prothrombin gene variant, Factor V Leiden mutation, Antithrombin III, Protein C, Protein S, Lupus anticoagulant, anticardiolipin antibodies.

Pre-eclampsia

£20

University of Manchester Hospital Laboratory

- Urea and electrolytes, liver function tests, serum urate.

HbA1c

£6

University of Manchester Hospital Laboratory

Haematology

£24

University of Manchester Hospital Laboratory

- Full blood count, DIC screen

Immunology

£9

University of Manchester Hospital Laboratory

Biochemistry

£28

University of Manchester Hospital Laboratory

- Bile acids, thyroid function tests, C-reactive protein.

Microbiology

£55

University of Manchester Hospital Laboratory

- Blood cultures, mid-stream urine, vaginal swabs, cervical swabs.

Serology

£42

University of Manchester Hospital Laboratory

- Parvovirus B19, rubella (if nonimmune at booking), CMV, herpes simplex and Toxoplasma gondii

Total cost for all tests

£1,804

 
  1. *Initial session with midwife plus 8 sessions with a specialist bereavement counsellor.
  2. ‡ The resource use for comprehensive stillbirth care were obtained from RCOG guidelines on late intrauterine fetal death and stillbirth [10]. The guidelines recommend that all women should be offered full post-mortem examination which would include an autopsy, x-rays and pathological examination of the cord and placenta. In addition they suggest a list of diagnostic tests, these include the core tests recommended for all women, such as the Kleihauer test. Other investigations are recommended based on the clinical scenario such as maternal haematology and biochemistry tests used to investigate pre-eclampsia and multi-organ failure.