Diagnosis of congenital abnormalities with post-mortem ultrasound in perinatal death - 08/03/18

Doi : 10.1016/j.diii.2017.11.005

L. Tuchtan ^a,^b,^c,^⁎ , E. Lesieur ^d , C. Bartoli ^a,^b , C. Delteil ^a,^b , L. Sarda-Quarello ^c , J. Torrents ^a,^c , S. Sigaudy ^d , M.-D. Piercecchi ^a,^b , G. Gorincour ^d,^e
^a Department of forensic pathology, CHU Timone, AP–HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
^b CNRS, EFS, ADES UMR 7268, Aix-Marseille university, 13916 Marseille, France
^c Department of fetopathology, CHU Timone, AP–HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
^d Center for prenatal diagnosis, children hospital, CHU Timone, AP–HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
^e Department of pediatric and prenatal imaging, La-Timone children hospital, Aix-Marseille university, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France

^⁎Corresponding author at: Department of forensic pathology, CHU Timone, AP–HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.

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Abstract

Purpose

To determine the sensitivity and specificity of post-mortem ultrasound in the diagnosis of major congenital abnormalities of fetuses using conventional autopsy as the standard of reference.

Material and methods

All fetuses coming from terminations of pregnancy or intrauterine fetal deaths in a single institution were included. A total of 75 fetuses were included during the study period. The results of post-mortem ultrasound examinations were compared to those of conventional autopsy that served as standard of reference.

Results

Gestational age of the fetuses ranged from 15 to 38 weeks gestation. A complete post-mortem ultrasound assessment was possible in all fetuses. Regarding detection of brain abnormalities, post-mortem ultrasound had a sensitivity of 81.5% or 4/5 (95% CI: 63.3–91.8%), and a specificity of 97.9% (95% CI: 89.1–99.6%). Specificities for the diagnosis of thoracic, cardiac, urinary tract, spinal and bone abnormalities were 100%.

Conclusion

Post-mortem ultrasound shows high sensitivity and specificity for the diagnosis of congenital structural abnormalities as compared to conventional autopsy, with the exception of congenital cardiac diseases.

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Keywords : Post-mortem imaging, Fetal ultrasound, Termination of pregnancy, Intrauterine fetal death, Autopsy

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Vol 99 - N° 3

P. 143-149 - mars 2018 Retour au numéro

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Diagnosis of congenital abnormalities with post-mortem ultrasound in perinatal death - 08/03/18

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Material and methods

Results

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