title: When is a post-mortem skeletal survey of the fetus indicated, and when not?
abstract: OBJECTIVE
  Radiography after fetal or perinatal death has become a routine part of post-mortem diagnostics. However, only a selected subset of these babygrams or fetal post-mortem skeletal surveys (FPSSs) provides useful information. We investigated the indication for a FPSS.
  
  
  METHODS
  Inclusion consisted of the routinely made FPSS (2002-2012) in our university hospital in cases of fetal or perinatal death up to 7 days after birth. We categorized the diagnostic value of the FPSS as no, minor, major or pathognomonic. Regression analysis was used to determine the selection criteria for a useful FPSS.
  
  
  RESULTS
  Three hundred and thirty-seven FPSS were included. Three hundred and five (91%) FPSS showed no or minor skeletal malformations. Fourteen (4.2%) FPSS had major skeletal malformations. In 18 (5.3%) cases the diagnosis was based on the pathognomonic skeletal malformations on the FPSS. Two cases were false positive after major birth trauma. The presence of multiple skeletal malformations on prenatal ultrasound or at post-mortem external inspection was highly indicative of a diagnostic FPSS (p < 0.001).
  
  
  CONCLUSIONS
  The majority of the babygrams/FPSS has no contribution to the diagnostic process. Multiple skeletal malformations on prenatal ultrasound or post-mortem external inspection are indicative for a diagnostic FPSS, and this should be the main selection criterion.
authors.affiliation: a Department of Radiology and Nuclear Medicine .
authors.forename: Karin
authors.initials: K
authors.lastname: Kamphuis-van Ulzen
authors.affiliation: a Department of Radiology and Nuclear Medicine .
authors.forename: Desirée H J L M
authors.initials: DH
authors.lastname: Koopmanschap
authors.affiliation: b Department of Clinical Genetics , and.
authors.forename: Carlo L M
authors.initials: CL
authors.lastname: Marcelis
authors.affiliation: c Department of Obstetrics and Gynecology , Radboud University Medical Center , Nijmegen , The Netherlands.
authors.forename: John M G
authors.initials: JM
authors.lastname: van Vugt
authors.affiliation: a Department of Radiology and Nuclear Medicine .
authors.forename: Willemijn M
authors.initials: WM
authors.lastname: Klein
mesh_terms: D001344:Autopsy / Q000706:statistics & numerical data*; D005260:Female; D005333:Fetus / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012863:Skeleton / Q000000981:diagnostic imaging*
keywords: Babygram; fetal; neonatal