Diagnosis of congenital abnormalities with post-mortem ultrasound in perinatal death

Diagn Interv Imaging. 2018 Mar;99(3):143-149. doi: 10.1016/j.diii.2017.11.005. Epub 2017 Dec 8.

Abstract

Purpose: To determine the sensitivity and specificity of post-mortem ultrasound in the diagnosis of major congenital abnormalities of fetuses using conventional autopsy as the standard of reference.

Material and methods: All fetuses coming from terminations of pregnancy or intrauterine fetal deaths in a single institution were included. A total of 75 fetuses were included during the study period. The results of post-mortem ultrasound examinations were compared to those of conventional autopsy that served as standard of reference.

Results: Gestational age of the fetuses ranged from 15 to 38 weeks gestation. A complete post-mortem ultrasound assessment was possible in all fetuses. Regarding detection of brain abnormalities, post-mortem ultrasound had a sensitivity of 81.5% or 4/5 (95% CI: 63.3-91.8%), and a specificity of 97.9% (95% CI: 89.1-99.6%). Specificities for the diagnosis of thoracic, cardiac, urinary tract, spinal and bone abnormalities were 100%.

Conclusion: Post-mortem ultrasound shows high sensitivity and specificity for the diagnosis of congenital structural abnormalities as compared to conventional autopsy, with the exception of congenital cardiac diseases.

Keywords: Autopsy; Fetal ultrasound; Intrauterine fetal death; Post-mortem imaging; Termination of pregnancy.

Publication types

  • Comparative Study

MeSH terms

  • Abortion, Induced
  • Autopsy
  • Congenital Abnormalities / diagnostic imaging*
  • Congenital Abnormalities / pathology*
  • Female
  • Fetal Death*
  • Gestational Age
  • Humans
  • Pregnancy
  • Prospective Studies
  • Sensitivity and Specificity
  • Ultrasonography