Comparision of Needle Autopsy With Conventional Autopsy in Neonates

Abstract

Tru-cut needle biopsy postmortems were compared with the standard conventional autopsy in neonates. Twenty-five fresh deceased neonates between 33 weeks of gestation to below 28 days of life were examined by both the techniques. Tissue collection by needle biopsy varied from 92% for liver to 20% for spleen while lung, brain, and kidney gave intermediate results. The cause of death could be determined in 17 cases (68%) by needle biopsy and in 24 cases (96%) by conventional postmortem. In 14 of the 17 cases (56%) cause of death could be determined by biopsy which was in full concordance with the findings of the full autopsy, whereas 3 (12%) cases showed only partial concordance and the diagnosis were discrepant in 32% cases. Needle autopsy missed diagnosis of various congenital malformations, which can be discerned only after meticulous gross examination. Needle autopsy is of value when permission for a complete autopsy cannot be obtained.

Diagnostic contribution of postmortem needle biopsies in neonates

“…42 (55.2%) of our cases were premature (smaller than 37 weeks according to gestational age). A study in India found a history of prematurity in 48% of patients and other studies where most subjects were premature have also been reported (9).…”

“…However, autopsy rates are declining (9). Th e most common method used in cases where an autopsy is not allowed is postmortem needle necropsy (10).…”

Detection of coronary thrombosis after multi-phase postmortem CT-angiography

“…Roberts et al [37] recently reported the results of a study performed on 182 adult death cases for which whole-body CT and [13,35,36,[47][48][49][50][51][52][53][54]. Postmortem angiography and/or targeted postmortem coronary angiography techniques are currently being developing, hence large-scale studies comparing imaging-based diagnoses and postmortem findings are still not available.…”

Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

“…40 The second included 25 newborn infants and reported adequate tissue volumes collected for liver, lungs and brain biopsy in 92%, 84% and 68% of cases, respectively, but only 56%, 24% and 20% for right kidney, left kidney and spleen. 41 Final diagnosis could be made from the needle biopsy samples in 68% of cases with 56% full concordance with conventional autopsy. 41 Needle biopsy appears to be more accurate in neonates than foetuses, but complications such as the small size of foetuses, neonates and infants and the added complication of maceration in foetuses makes accurate blinded needle biopsy sampling difficult and not suited for postmortem investigations in this population.…”

“…41 Final diagnosis could be made from the needle biopsy samples in 68% of cases with 56% full concordance with conventional autopsy. 41 Needle biopsy appears to be more accurate in neonates than foetuses, but complications such as the small size of foetuses, neonates and infants and the added complication of maceration in foetuses makes accurate blinded needle biopsy sampling difficult and not suited for postmortem investigations in this population.…”