title: Minimally invasive fetal autopsy using ultrasound: a feasibility study.
abstract: OBJECTIVE
  To evaluate postmortem ultrasound (PM-US) for minimally invasive autopsy, and to demonstrate its feasibility, sensitivity and specificity, as compared with conventional autopsy, in detecting major congenital abnormalities.
  
  
  METHODS
  Over a 19-month study period from 1 March 2012 to 30 September 2013, we recruited from a referral hospital 88 consecutive fetuses, at 11-40 weeks' gestation, which had undergone termination, miscarriage or intrauterine fetal death. We performed PM-US using different transducers and compared the data with those from conventional autopsy. The latter was performed, according to the Societé Francaise de Foetopathologie (France) guidelines, by experienced perinatal pathologists who were blinded to the ultrasound data.
  
  
  RESULTS
  Complete virtual autopsy by ultrasound was possible in 95.5% of the cases. The sensitivity of PM-US for detecting brain abnormalities was 90.9% (95% CI, 58.7-99.8%) and the specificity was 87.3% (95% CI, 75.5-94.7%). In 20% of cases, a neuropathological examination was not possible due to severe maceration. The sensitivity for detection of thoracic abnormalities was 88.9% (95% CI, 65.3-98.6%) and the specificity was 92.8% (95% CI, 84.1-97.6%), and the sensitivity for detection of abdominal anomalies was 85.7% (95% CI, 57.2-98.2%) and the specificity was 94.6% (95% CI, 86.7-98.5%).
  
  
  CONCLUSIONS
  This pilot study confirms the feasibility of PM-US for virtual autopsy as early as 11 weeks' gestation. This new technique shows high sensitivity and specificity in detecting congenital structural abnormalities as compared with conventional autopsy. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.
authors.affiliation: Departments of Obstetrics and Gynaecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Votino
authors.affiliation: Departments of Obstetrics and Gynaecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: T
authors.initials: T
authors.lastname: Cos Sanchez
authors.affiliation: Department of Feto-Pathology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.|Départment de Génétique Histologie-Embryologie-Cytogénétique, Hopital Necker-Enfant Malade, AP-HP, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Bessieres
authors.affiliation: Department of Feto-Pathology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: V
authors.initials: V
authors.lastname: Segers
authors.affiliation: Department of Neuropathology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Kadhim
authors.affiliation: Départment de Génétique Histologie-Embryologie-Cytogénétique, Hopital Necker-Enfant Malade, AP-HP, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Razavi
authors.affiliation: Departments of Obstetrics and Gynaecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Condorelli
authors.affiliation: Departments of Obstetrics and Gynaecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Votino
authors.affiliation: Departments of Obstetrics and Gynaecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: V
authors.initials: V
authors.lastname: D'Ambrosio
authors.affiliation: Departments of Obstetrics and Gynaecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Jani
mesh_terms: D001344:Autopsy / Q000295:instrumentation* / Q000379:methods; D000013:Congenital Abnormalities / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D010865:Pilot Projects; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*
keywords: fetal autopsy; high-frequency linear probe; imaging; postmortem ultrasound