[Autopsy techniques in congenital heart defects. Influence of prenatal diagnosis on the planning and carrying out of autopsies].
As a result of the quality of prenatal ultrasound and the expanded experience of prenatal diagnosticians, it is possible to observe congenital heart malformations in increasingly greater detail and at an ever earlier stage of gestation [4]. Since it is on the basis of ultrasound findings that decisions to terminate pregnancies are made, it is of cardinal importance that after termination monitoring and confirmation of the prenatal diagnosis be carried out. This need can only be adequately met by autopsy. There are different methods for carrying out autopsies when there is suspicion of a congenital heart defect: a) the Anderson sequential segmental analysis as modified according to the Berlin method; b) use of a special autoptic method corresponding to the ultrasound findings, based on defining a preferred sectional plane; c) stereomicroscopically; or d) microscopically after embedding and preparation of serial microscopic sections. For the pathologist the consequence is that he has to adapt his autopsy method to the ultrasound findings and the age of the fetus. This enables him to determine an optimal, case-based autopsy strategy for each type of cardiac defect, which is essential for monitoring of the prenatal diagnosis. The present paper discusses the various autoptic methods used in cases of congenital heart malformations and the consequences for the pathologist of the continuing improvements in prenatal diagnostics.
Tennstedt
C
C
Institut für Pathologie, Universitätsklinikum Charité, Medizinische Fakultät der Humboldt-Universität zu Berlin. cornelia-tennsted@charite.de
Meyer
R
R
Hufnagl
P
P
Vogel
M
M
Chaoui
R
R
Goltz
D
D
Dietel
M
M
D001344:Autopsy / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000196:embryology* / Q000473:pathology*; D006801:Humans; D009206:Myocardium / Q000473:pathology*; D011247:Pregnancy; D011296:Prenatal Diagnosis