Antenatal ultrasound for fetal anomalies: importance of perinatal autopsy.
Sixty-one instances of congenital anomalies identified prenatally by ultrasound were reviewed to determine whether autopsy provided important additional information. An important finding was defined as one which would affect: 1) genetic counseling; 2) diagnosis of a syndrome; 3) determination of etiology or pathogenetic mechanism of the anomaly; or 4) interpretation of severity of the anomalies. In 28 cases (46%), post-mortem examination provided such information. All of these infants had multiple anomalies; correlations with oligohydramnios and poor fetal outcome were noted. Autopsy provided no additional meaningful information in 30 cases (49%), the majority (77%) of whom had isolated anomalies. In 3 cases (5%), due to tissue autolysis, autopsy provided less information than the previous ultrasound. Although most fetal anomalies are readily diagnosed by ultrasound, we found that post-mortem examination is still necessary: 1) to confirm a prenatal diagnosis; 2) to delineate multiple anomalies; 3) when the ultrasound examination is limited by oligohydramnios; and 4) to obtain tissue for microscopic examination, cytogenetic and biochemical analysis, if these studies have not been performed prenatally.
Shen-Schwarz
S
S
Department of Pathology, Magee-Women's Hospital, Pittsburgh, Pennsylvania.
Neish
C
C
Hill
L M
LM
D000015:Abnormalities, Multiple / Q000175:diagnosis* / Q000401:mortality; D001344:Autopsy; D005260:Female; D005333:Fetus / Q000473:pathology*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D014463:Ultrasonography