Clinical value of postnatal autopsy and genetics consultation in fetal death

Abstract

The aim of the present study was to investigate the clinical use of postnatal autopsy and genetics consultation in cases of fetal death in a teaching hospital. A retrospective analysis of medical records including pathology and genetics reports was performed in all cases of fetal death in which a woman delivered at Ben Taub General Hospital, Houston, Texas over a 2-year period. Cases were excluded when gestational age of the fetus was less than 20 weeks. Fetuses were only included when the 1- and 5-min Apgar scores were 0 and 0, respectively. There were 139 fetal deaths and 12,209 live born infants during the study period (stillbirth rate 1.125%). Although pathology services were used in 96.2%, a genetics consultation was obtained in only 12% of cases. Fetal autopsy provided a certain cause of fetal death in 19.4%, a probable cause for death in 36.3%, and was inconclusive in 44.3%. Among the cases in which a genetics consultation was obtained, a certain and probable cause for fetal death was found in 20% and 20% of cases, respectively. The utilization of genetics consultation was found to be independent of multiple clinical variables examined including ultrasound data, identification of maceration, and training level of resident. Our data show a frequent use of pathologic examination in cases of fetal death and an infrequent use of genetics consultation services. The request for genetics consultation seemed to have been made at random.

Accuracy of Prenatal Diagnosis in Elective Termination of Pregnancy: 385 Cases from 2000 to 2007

“…The diagnostic accuracy was improved in 80 cases (21%) which corroborate the need of a multidisciplinary team in prenatal centers, as already noted by other authors [2, 3, 6, 11–13]. …”

Pathology of the Central Autonomic Nervous System in Stillbirth

“…The importance of a thorough autopsy, in cases of fresh stillbirth, to individuate the morphological substrate of death, has been stressed [2,[21][22][23][24]. Nevertheless, the International Stillbirth Alliance (ISA) underlines that there is no standard method of performing autopsies and that guidelines for the neuropathologic investigation of stillbirth are needed [6].…”

Evaluation of clinicopathological profile of subjects with intrauterine fetal death

“…Majority of stillbirths (85-90%) in developed countries occur before the onset of labour, whereas this proportion is much lower and overall incidence of stillbirth is much higher in developing countries. 1 Only at later stages the important issue will be to understand and to know. To understand why their child was born dead and to know the risk for future pregnancies that most of them will experience.…”