Comparison of prenatal ultrasound findings and autopsy findings in fetuses terminated after prenatal diagnosis of malformations: An experience of a clinical genetics center

Phadke, Shubha R.; Gupta, Ashutosh

doi:10.1002/jcu.20688

Cited by 21 publications

(30 citation statements)

References 15 publications

(20 reference statements)

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“…OF D&E SPECIMENS There are several studies 18,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] that have reviewed the correlation between prenatal ultrasound and autopsy findings, all based on examination of intact fetuses. Agreement between prenatal ultrasound findings and autopsy diagnosis when autopsy is performed on an intact fetus ranges from 45% to 91.2%.…”

Section: Value Of Careful Examinationmentioning

confidence: 99%

“…These data are typically used to indicate the quality of the prenatal diagnoses, with the autopsy findings representing the gold standard. In addition, several studies 33,35,42,43,46 indicate that the intact fetal autopsy reveals additional important findings not diagnosed prenatally, thus establishing the importance of fetal autopsy both for quality assurance and for diagnosis of disease, with potential implications for family planning, recurrence risk, and genetic counseling.…”

Section: Value Of Careful Examinationmentioning

confidence: 99%

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Pathologic Examination of Fetal and Placental Tissue Obtained by Dilation and Evacuation

Ernst

Gawron

Fritsch

2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Dilation and evacuation (D&E) is an alternative method to induction of labor for pregnancy termination and intrauterine fetal demise, and it is the most common mode of second-trimester uterine evacuation in the United States. Many D&E specimens are examined in surgical pathology, and there is little information available in surgical pathology textbooks or the literature to assist pathologists in these examinations.Objective.-To provide an overview of the D&E procedure, discuss related legal issues, provide guidelines for routine pathologic examination of D&E specimens, and demonstrate the importance of careful pathologic examination of D&E specimens.Data Sources.-Case-derived material and literature review.Conclusions.-Pathologic examination of D&E specimens has been understudied. However, the available literature and our experience support the fact that careful pathologic examination of D&E specimens can identify significant fetal and placental changes that can confirm clinical diagnoses or provide definitive diagnosis, assist in explaining the cause of intrauterine fetal demise, and identify unexpected anomalies that may provide further clues to a diagnostic syndrome or mechanism of anomaly formation.(Arch Pathol Lab Med. 2013;137:326-337; doi: 10.5858/ arpa.2012-0090-RA) P athologic examination of products of conception in routine surgical pathology practice consists largely of the gross and microscopic examination of fragmented fetal and placental tissue from first-trimester missed or induced abortions. The majority of these pathology specimens are handled grossly by technicians, and for the most part, the main goal is the pathologic documentation of chorionic villi and fetal parts. However, pathologists, especially at large academic medical centers, are encountering an increasing number of disrupted, second-trimester fetal specimens for examination. Prior to the 1970s, uterine evacuation in the second trimester was accomplished via labor induction methods, such as prostaglandin or saline instillation, or by hysterotomy, and resulted in an intact fetus. The development of the dilation and evacuation (D&E) procedure during this time period gave an alternative to these methods. In 1974, only 36% of all midtrimester abortions were managed via D&E, but the safety and popularity of this method increased that number to 96% in 2005. 1 The development of a fellowship in family planning in 1991 has trained a new generation of academic D&E providers. This is a 2-year postgraduate training program for obstetrician-gynecologists and focuses on advanced clinical skills, research, and teaching in the field of contraception and abortion. A total of 179 fellows have graduated, with 79% holding positions in academic centers.2 The addition of a trained fellow to an institution will increase access to D&E services and allow women options for management of an unintended or abnormal pregnancy. Women have been shown to preferentially choose management via D&E over labor induction in the second trimester, avoiding an unpr...

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Section: Value Of Careful Examinationmentioning

confidence: 99%

Section: Value Of Careful Examinationmentioning

confidence: 99%

Pathologic Examination of Fetal and Placental Tissue Obtained by Dilation and Evacuation

Ernst

Gawron

Fritsch

2013

Archives of Pathology &Amp; Laboratory Medicine

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“…Their participation improved the diagnostic skills in 45% of cases, in our department. This can be also supported by the study of Phadke and Gupta They found in their study that support from dysmorphologists and geneticists in fetal evaluation changed or improved the diagnosis in 33% of cases (13) and that is plays a crucial role in specific etiologic diagnosis and genetic counseling [11]. …”

Section: Discussionmentioning

confidence: 78%

“…Phadke and Gupta referred to 72.5% of total concordance, Ramalho et al 61.1%, Kaasen et al 40%, Kaiser et al 49%, and Boyd et al 55% [4, 7, 8, 11, 12]. …”

Section: Discussionmentioning

confidence: 99%

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

Ramos¹,

Maia²,

Branco³

et al. 2011

ISRN Obstetrics and Gynecology

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Objective. To evaluate the quality of prenatal results in all cases of termination of pregnancy (TOP) due to fetal abnormalities in a tertiary prenatal diagnosis center. Material and Methods. Retrospective analysis of the 385 TOP performed on our department due to fetal abnormalities between January 1, 2000, and December 31, 2007. We compared all data for agreement between the ultrasound, genetic, and postmortem findings, regarding the abnormalities identified in the etiological diagnosis and its prognosis. Results. Chromosome abnormalities were the most common indication for TOP (39%), followed by abnormalities of CNS (20%), monogenic disorders (11%), sequences (9.6%), polimalformative syndromes (5.2%), and isolated congenital heart diseases (4%). Total agreement was 21%. Further abnormalities were identified in 79%. The data collected after TOP changed the etiologic diagnosis in 21% but the prognosis was changed in only one fetus. Discussion. This study corroborates the necessity of a multidisciplinary team in prenatal diagnosis centers. Their work remarkably improves the genetic counseling and represents an important aspect in quality control of the information given to a couple previously to a TOP.

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“…Ashutosh Gupta in his study states that 72.5% cases, there was complete concordance (Category 1) between prenatal and autopsy findings; in 1.09%, no malformation was found at autopsy (Category 3). [13] A number of studies have tried to value the diagnostic accuracy of USG examination with very different results. The study conducted by Antonella Vimercati et al showed the 'sensitivity' (i.e.…”

Section: Discussionmentioning

confidence: 99%

Comparison Between Prenatal and Perinatal Imaging and Foetal Autopsy Results in a Tertiary Care Hospital in South India

Shali¹,

Feroze²

2017

jemds

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BACKGROUNDEvaluation of a congenital anomaly starts from antenatal period by the assessment of the maternal and family risk factors and ultrasonogram evaluation. Postnatal evaluation includes morphologic, radiologic, histopathological and karyotypic studies with investigations for infectious, genetic and metabolic causes. Although, some anomalies can be detected by ultrasonogram and xrays, a foetal autopsy has to be done to confirm the diagnosis and look for associated anomalies. Objectives-To assess the efficacy of foetal autopsy over prenatal ultrasound and post-mortem x-ray examination.

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Comparison of prenatal ultrasound findings and autopsy findings in fetuses terminated after prenatal diagnosis of malformations: An experience of a clinical genetics center

Abstract: The present study emphasizes the importance of autopsy in providing accurate etiologic diagnosis necessary for genetic counseling.

Cited by 21 publications

References 15 publications

Pathologic Examination of Fetal and Placental Tissue Obtained by Dilation and Evacuation

Pathologic Examination of Fetal and Placental Tissue Obtained by Dilation and Evacuation

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

Comparison Between Prenatal and Perinatal Imaging and Foetal Autopsy Results in a Tertiary Care Hospital in South India

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