Diagnosing and supporting a stillbirth — communication and management station

Communication and management station: tests the candidate on confirming the diagnosis, breaking the news, conducting the investigation and birth-planning discussion, and supporting the bereaved family. Includes assessor key, marking domains, and fail criteria.

Prompt

A 33-year-old G2P1 at 37 weeks attends the day assessment unit reporting absent fetal movements since the previous evening. Real-time ultrasound by the candidate confirms absent fetal cardiac activity. The woman is weeping; her partner has just arrived and does not yet know. The consultant is in theatre and 20 minutes away.

Station brief

Format. Communication and management station, approximately 12 minutes. You are the obstetric registrar in the day assessment unit with a bereavement midwife. The consultant is in theatre and 20 minutes away, but is contactable. The assessor will play the mother; a second examiner will play the partner arriving partway through. ^[1]

Candidate instruction. Confirm the diagnosis, break the news to the mother and then to her arriving partner, take a focused history for cause, discuss the investigation and birth plan at a pace the family can absorb, and verbalise the bereavement pathway and the consultant handover. ^[1]^[3]

References6Show

[1]Burden C, Merriel A, Bakhbakhi D, Heazell A, Siassakos D; Royal College of Obstetricians and Gynaecologists (RCOG) Care of late intrauterine fetal death and stillbirth: Green-top Guideline No. 55 BJOG, 2025.PMID 39467688
[2]Shami M, Larki M, Makvandi S, Azari M Inducing labor after fetal demise: a systematic review and meta-analysis of the efficacy and safety of mifepristone and misoprostol combination versus misoprostol alone BMC Pregnancy Childbirth, 2025.PMID 40221656
[3]Heazell AEP, Siassakos D, Blencowe H, Burden C, Bhutta ZA, Cacciatore J, et al. Stillbirths: economic and psychosocial consequences Lancet, 2016.PMID 26794073
[4]Ellis A, Chebsey C, Storey C, Bradley S, Jackson S, Flenady V, et al. Systematic review to understand and improve care after stillbirth: a review of parents' and healthcare professionals' experiences BMC Pregnancy Childbirth, 2016.PMID 26810220
[5]Patel K, Pirie D, Heazell AEP, Morgan B, Woolner A Subsequent pregnancy outcomes after second trimester miscarriage or termination for medical/fetal reason: A systematic review and meta-analysis of observational studies Acta Obstet Gynecol Scand, 2024.PMID 38037500
[7]Australian Commission on Safety and Quality in Health Care Stillbirth Clinical Care Standard ACSQHC Clinical Care Standard, 2022.Source

Diagnosing and supporting a stillbirth — communication and management station

Station brief

References6Show

[1]Burden C, Merriel A, Bakhbakhi D, Heazell A, Siassakos D; Royal College of Obstetricians and Gynaecologists (RCOG) Care of late intrauterine fetal death and stillbirth: Green-top Guideline No. 55 BJOG, 2025.PMID 39467688
[2]Shami M, Larki M, Makvandi S, Azari M Inducing labor after fetal demise: a systematic review and meta-analysis of the efficacy and safety of mifepristone and misoprostol combination versus misoprostol alone BMC Pregnancy Childbirth, 2025.PMID 40221656
[3]Heazell AEP, Siassakos D, Blencowe H, Burden C, Bhutta ZA, Cacciatore J, et al. Stillbirths: economic and psychosocial consequences Lancet, 2016.PMID 26794073
[4]Ellis A, Chebsey C, Storey C, Bradley S, Jackson S, Flenady V, et al. Systematic review to understand and improve care after stillbirth: a review of parents' and healthcare professionals' experiences BMC Pregnancy Childbirth, 2016.PMID 26810220
[5]Patel K, Pirie D, Heazell AEP, Morgan B, Woolner A Subsequent pregnancy outcomes after second trimester miscarriage or termination for medical/fetal reason: A systematic review and meta-analysis of observational studies Acta Obstet Gynecol Scand, 2024.PMID 38037500
[7]Australian Commission on Safety and Quality in Health Care Stillbirth Clinical Care Standard ACSQHC Clinical Care Standard, 2022.Source