When is a post-mortem skeletal survey of the fetus indicated, and when not?

Objective: Radiography after fetal or perinatal death has become a routine part of post-mortem diagnostics. However, only a selected subset of these babygrams or fetal post-mortem skeletal surveys (FPSSs) provides useful information. We investigated the indication for a FPSS. Methods: Inclusion cons...

Full description

Saved in:
Bibliographic Details
Published in:The journal of maternal-fetal & neonatal medicine 2016-03, Vol.29 (6), p.991-997
Main Authors: Kamphuis-van Ulzen, Karin, Koopmanschap, Desirée H.J.L.M, Marcelis, Carlo L.M., van Vugt, John M. G., Klein, Willemijn M.
Format: Article
Language:English
Subjects:
Autopsy - statistics & numerical data
Babygram
Female
fetal
Fetus - diagnostic imaging
Humans
Infant, Newborn
Male
neonatal
Radiography
Retrospective Studies
Skeleton - diagnostic imaging
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective: Radiography after fetal or perinatal death has become a routine part of post-mortem diagnostics. However, only a selected subset of these babygrams or fetal post-mortem skeletal surveys (FPSSs) provides useful information. We investigated the indication for a FPSS. Methods: Inclusion consisted of the routinely made FPSS (2002-2012) in our university hospital in cases of fetal or perinatal death up to 7 days after birth. We categorized the diagnostic value of the FPSS as no, minor, major or pathognomonic. Regression analysis was used to determine the selection criteria for a useful FPSS. Results: Three hundred and thirty-seven FPSS were included. Three hundred and five (91%) FPSS showed no or minor skeletal malformations. Fourteen (4.2%) FPSS had major skeletal malformations. In 18 (5.3%) cases the diagnosis was based on the pathognomonic skeletal malformations on the FPSS. Two cases were false positive after major birth trauma. The presence of multiple skeletal malformations on prenatal ultrasound or at post-mortem external inspection was highly indicative of a diagnostic FPSS (p < 0.001). Conclusion: The majority of the babygrams/FPSS has no contribution to the diagnostic process. Multiple skeletal malformations on prenatal ultrasound or post-mortem external inspection are indicative for a diagnostic FPSS, and this should be the main selection criterion.
ISSN:1476-7058
1476-4954
DOI:10.3109/14767058.2015.1029913