Review of pediatric autopsies performed at a university hospital in Ribeirão Preto, Brazil.
BACKGROUND
Autopsy continues to provide important data for quality assurance, teaching, scientific purposes, and health planning, especially if performed according to a comprehensive protocol.


OBJECTIVE
To describe and analyze data from all perinatal and pediatric autopsies performed at a university hospital in Brazil.


METHODS
Review of data from 1716 autopsies performed between April 1993 and April 1999, consisting of age at death, congenital defects, gender, and cause of death.


RESULTS
Age at death distribution: early neonatal deaths, 31.7%; stillbirth, 25.7%; 1 to 11 months, 19.6%; 1 to 5 years, 10.3%; late neonatal deaths, 6.3%; 11 to 15 years, 4%; 6 to 10 years, 2.5%. Cause of death: perinatal conditions, 51%; congenital malformation(s), 24.4%; infection, 11.9%; neoplasm, 3%; hematologic/immunologic, 2.3%; neurologic, 1.6%; gastrointestinal, 1.5%; cardiovascular, 0.7%; respiratory, 0.6%; genitourinary, 0.3%; other disorders, 0.5%. Gender distribution: male, 54.31%; female, 45.22%; indeterminate, 0.41%; data unavailable, 0.06%. Congenital anomalies were found in 31.5% of the autopsies and were the cause of death in 24.41% of the autopsies.


CONCLUSIONS
High autopsy rates, combined with a comprehensive autopsy protocol, allowed the characterization of perinatal and pediatric deaths. The high proportion of perinatal deaths and stillbirths indicates the need for improvement in the prenatal care program. Congenital anomalies were highly prevalent because few pregnancies are interrupted in Brazil. The low number of cancer cases autopsied was attributed to the fact that most patients die at home, and to the high level of trust between the oncology team and the family, with the erroneous assumption that no relevant information would be provided.
Peres
Luiz Cesar
LC
Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil. lcperes@fmrp.usp.br
D000293:Adolescent; D000328:Adult; D001344:Autopsy; D001938:Brazil; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000175:diagnosis; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011295:Prenatal Care; D012189:Retrospective Studies; D050497:Stillbirth