title: A comparative study of prenatal ultrasound findings and post-mortem examination in a tertiary referral centre.
abstract: This retrospective study compares the findings of prenatal ultrasound, performed in a tertiary fetal medicine centre, with the results of post-mortem examination in pregnancies complicated by suspected fetal abnormality that results in fetal loss. The study was carried out over a year at a teaching hospital, Fetal Medicine Centre and Regional Centre for Perinatal Pathology. Results were directly compared and the level of agreement between the ultrasound and post-mortem findings described. These were classified as having complete agreement; major agreement or major disagreement. The group of cases with major agreement between findings was further divided into those with significant, or minor, additional findings at post-mortem examination. Over the 12-month period, 153 ultrasound cases were identified, of which 47 were also examined by autopsy and were thus suitable for comparison in this study (30.7%). Complete agreement between ultrasound and post-mortem findings was found in 22 cases (46.8%). In 24 cases (51.1%), major agreement between ultrasound and post-mortem findings was seen. Of these, 11 had minor additional findings at post-mortem examination and 13 were found to have significant additional findings at post-mortem (27.7%), adding to the eventual diagnosis. In 12.8% of cases, post-mortem examination provided a definitive diagnosis. Only in one case was there complete discordance in the findings of the ultrasound examination and the autopsy (2.1%). No major disagreement between ultrasound and post-mortem findings was seen in 98% of cases. This study confirms the accuracy of prenatal ultrasound diagnosis in specialist centres, whilst emphasising the continuing importance of post-mortem examination in cases of fetal malformation to refine and, in some cases, define the diagnosis.
authors.affiliation: Department of Fetal Medicine, Division of Reproductive and Child Health, Birmingham Women's Hospital, University of Birmingham, UK.
authors.forename: Nina
authors.initials: N
authors.lastname: Johns
authors.forename: Wasim
authors.initials: W
authors.lastname: Al-Salti
authors.forename: Phillip
authors.initials: P
authors.lastname: Cox
authors.forename: Mark D
authors.initials: MD
authors.lastname: Kilby
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging* / Q000196:embryology / Q000453:epidemiology / Q000473:pathology; D001344:Autopsy; D004739:England / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D008499:Medical Records; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal