title: Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth.
abstract: BACKGROUND
  The number of parents agreeing to autopsy following stillbirth is declining, which has undermined clinicians' ability to assess causes of intrauterine death and can impact counselling regarding recurrence. Post-mortem radiological imaging is a potential alternative method of investigating perinatal loss. The aim of this study was to assess the role of multi-detector computed tomography (MDCT) in the investigation of stillbirth.
  
  
  METHODS
  Following ethical approval and written consent, parents were offered MDCT of the stillborn infant. MDCT was performed with 3D reconstruction, and images were analysed for image quality, anthropomorphic measurements and pathologic findings. Body part and organ-specific measurements were performed; including head, chest and abdominal circumferences, and muscle and liver mass was also measured. Findings were correlated with obstetric history, post-mortem skeletal survey (plain radiography), and formal autopsy.
  
  
  RESULTS
  Fourteen third-trimester stillborn infants were scanned. Image quality was moderate to excellent for most body structures. CT was better than plain radiography for imaging skeletal structures and large solid organs and demonstrated a range of pathologies including renal vein thrombosis, mesenteric calcification and skeletal hyperostosis that were not seen on plain radiographs. MDCT did not overlook autopsy findings and provided some additional information.
  
  
  CONCLUSIONS
  This study confirms the feasibility of MDCT in the investigation of third trimester stillbirth. MDCT image quality is acceptable and the examination can demonstrate a range of anatomic and pathologic findings. Initially, its value may be as an important adjunct to conventional autopsy.
authors.affiliation: Anu Research Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Wilton, Cork, Ireland. k.odonoghue@ucc.ie
authors.forename: Keelin
authors.initials: K
authors.lastname: O'Donoghue
authors.forename: Kevin N
authors.initials: KN
authors.lastname: O'Regan
authors.forename: Carmel P
authors.initials: CP
authors.lastname: Sheridan
authors.forename: Owen J
authors.initials: OJ
authors.lastname: O'Connor
authors.forename: Jodie
authors.initials: J
authors.lastname: Benson
authors.forename: Sebastian
authors.initials: S
authors.lastname: McWilliams
authors.forename: Niamh
authors.initials: N
authors.lastname: Moore
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Murphy
authors.forename: Raj
authors.initials: R
authors.lastname: Chopra
authors.forename: John R
authors.initials: JR
authors.lastname: Higgins
authors.forename: Michael M
authors.initials: MM
authors.lastname: Maher
mesh_terms: D001344:Autopsy / Q000379:methods*; D002423:Cause of Death; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D050497:Stillbirth; D014057:Tomography, X-Ray Computed / Q000379:methods*