Abstract
The value of autopsies following perinatal death is debated by both pathologists and perinatologists. In order to determine the extent to which autopsies contribute to understanding fetal and neonatal deaths, we prospectively compared information gained by a specific autopsy protocol (Manchester and Shikes, Clinical Obstet. and Gynecol. 23: 1125, 1980) with that gained by review of clinical data by perinatal specialists. Our results document that perinatal autopsies provide important information not otherwise obtainable. Furthermore, they do so at a rate twice that reported for autopsies in adults.
For a 2 year period, all perinatal deaths (N=172, 75 fetal >20 weeks and 95 neonatal) at University Hospital were reviewed by a team of obstetric and pediatric specialists. Autopsies were performed in 139 cases (81%) by the general pathology service. Both clinicians and pathologists were asked to provide objective evidence for cause of death, if possible, and to indicate any need for genetic counseling. Clinical review alone established cause of death in 59 autopsied cases (42%). Autopsies established cause of death in 95 cases (68%) p<0.01. Despite extensive clinical review, autopsy alone was the only means by which cause of death could be determined in 36 cases. Among these, congenital malformations (15) were the most common objective findings. In addition, autopsy provided the only basis for genetic counseling in 30 of 62 cases where such followup was indicated.
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Manchester, D., Meier, P., Stewart, M. et al. PERINATAL DEATH: COMPARISON OF CLINICAL AND PATHOLOGICAL ANALYSES. Pediatr Res 18 (Suppl 4), 333 (1984). https://doi.org/10.1203/00006450-198404001-01442
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DOI: https://doi.org/10.1203/00006450-198404001-01442