Postmortem examination of human fetuses: comparison of two‐dimensional ultrasound with invasive autopsy

ABSTRACT Objective To assess the diagnostic accuracy of postmortem ultrasound performed by operators blinded to prenatal findings and to invasive autopsy results in fetuses at different gestational ages and to investigate the effect of various parameters on its diagnostic success. Methods We perform...

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Bibliographic Details
Published in:Ultrasound in obstetrics & gynecology 2019-02, Vol.53 (2), p.229-238
Main Authors: Kang, X., Shelmerdine, S. C., Hurtado, I., Bevilacqua, E., Hutchinson, C., Mandalia, U., Segers, V., Cos Sanchez, T., Cannie, M. M., Carlin, A., Sebire, N. J., Arthurs, O. J., Jani, J. C.
Format: Article
Language:English
Subjects:
Abdomen
Abnormalities
Abortion, Spontaneous - etiology
Accuracy
Anomalies
Autopsies
Autopsy
Autopsy - methods
Brain
Diagnostic systems
Female
Fetal Death - etiology
Fetus - diagnostic imaging
Fetuses
Gestation
Gestational Age
Heart
Humans
Maceration
MRI
Organs
postmortem
Pregnancy
Prospective Studies
Regression Analysis
Sensitivity
Sensitivity and Specificity
Single-Blind Method
termination
Thorax
Ultrasonic imaging
Ultrasonography - methods
Ultrasound
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Summary:ABSTRACT Objective To assess the diagnostic accuracy of postmortem ultrasound performed by operators blinded to prenatal findings and to invasive autopsy results in fetuses at different gestational ages and to investigate the effect of various parameters on its diagnostic success. Methods We performed postmortem two‐dimensional ultrasound examination, blinded to clinical details, on 163 fetuses at 13–42 weeks' gestation. Logistic regression analysis was used to investigate the effect of: (i) gestational age at postmortem ultrasound, (ii) presence of maceration and (iii) mode of death, on whether the exam succeeded or failed to reach a diagnosis. In 123 cases in which invasive autopsy was available, the diagnostic accuracy of ultrasound in detecting major organ abnormalities was evaluated, using invasive autopsy as the gold standard. Results For the fetal brain, postmortem ultrasound exam was non‐diagnostic in significantly more fetuses with maceration (39.5%; 17/43) vs those without maceration (20.0%; 24/120) (P = 0.013). For the fetal thorax, the exam was non‐diagnostic in 34.1% (15/44) of fetuses
ISSN:0960-7692
1469-0705
DOI:10.1002/uog.18828