Correlation between prenatal ultrasound and autopsy findings: a study of second‐trimester abortions

Kaasen, Anne; Tuveng, J.; Heiberg, Arvid; Scott, Helge; Haugen, Guttorm

doi:10.1002/uog.3871

Cited by 48 publications

(50 citation statements)

References 27 publications

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“…One false-positive US diagnosis of renal aplasia has been reported in a case of oligohydramnios similar to one of our cases. 4 Akgun et al 3 and Kaasen et al 7 have reported false-positive diagnosis of associated …”

Section: Discussionmentioning

confidence: 97%

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

Phadke

Gupta

2010

J of Clinical Ultrasound

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Section: Discussionmentioning

confidence: 97%

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

Phadke

Gupta

2010

J of Clinical Ultrasound

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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%

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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“…However, more recent studies have demonstrated that increased efficacy of prenatal ultrasound diagnosis resulted in more efficient planning for correction, immediate neonatal care and decreased hospital admissions. 6,11,20 Our results show increased efficacy (73.6%) of prenatal diagnosis of GI anomalies, which provided the opportunity to plan for anomalous births and postpartum intervention. Presently, 2D ultrasound is the most used modality in prenatal screening for anatomical development and con genital anomalies.…”

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confidence: 62%

The Role of 2D and 3D Ultrasound in Evaluation of Fetal Gastrointestinal Anomalies

Stanojević¹,

Hughes²,

Zaputović³

et al. 2014

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Aim:To evaluate the role of second mid-trimester ultrasound in prenatal detection of gastrointestinal (GI) fetal anomalies and compare the ultrasonographic findings with postnatal diagnosis. Materials and methods:A 5-year retrospective study included 16,334 neonates delivered at a tertiary referral center. All neo nates were evaluated by a second midtrimester 2D ultrasound fetal anatomy scan. Patients with abnormal findings on 2D scan were also examined by 3D ultrasound. Postnatally confirmed GI anomalies were compared with prenatal ultrasound assessment of two sections of fetal abdomen which had analyzed the presence, size and position of the stomach, umbilical cord insertion and have assessed the amniotic fluid index (AFI). Results:Prenatal ultrasound revealed 28 out of 38 fetal GI anomalies (73.6%). All GI anomalies initially diagnosed with 2D ultrasound were confirmed by 3D ultrasound. The major advantage of multiplanar imaging was more comprehensive anatomical information about GI anomalies. Surface rendering provided additional information in evaluating fetuses with anterior abdominal wall defects. Conclusion:Our data indicate that standard planes obtained by 2D ultrasound can rule out a majority of fetal GI anomalies. Assessment of AFI should be an integral part of prenatal ultrasound scan in detection of GI anomalies, particularly in GI obstruction.

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Correlation between prenatal ultrasound and autopsy findings: a study of second‐trimester abortions

Abstract: Objective To evaluate discrepancies between sonographic and autopsy findings following termination of pregnancy (TOP)

Cited by 48 publications

References 27 publications

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

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

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

The Role of 2D and 3D Ultrasound in Evaluation of Fetal Gastrointestinal Anomalies

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