Four Years of Foetal Autopsies in A Peripheral Teaching Hospital
A Retrospective Analysis
Keywords:
Congenital anomalies, Foetal autopsy, Intra uterine death, Placental abnormalities, Prenatal diagnosis
Abstract
Background: The aim of our study was to assess the prevalent causes of foetal demise in our region, so as to facilitate necessary prenatal measures to reduce the Intra uterine deaths. Methods: A retrospective study on 28 foetuses, received in the Department of Pathology, either because of intra uterine death or those which were medically terminated for various abnormal prenatal findings, for a period of 4 years from November 2011 to November 2015. Autopsy report findings including full external examination, anthropometric measurements, gross, microscopic details of different organs including placenta and ultrasound reports were analysed. Results: Total number of foetal autopsies was twenty eight. Most prevalent cause of death was congenital anomalies (39.3%) followed by placental insufficiency (17.8%) and umbilical cord anomaly (10.7%). The most frequent multiple system anomalies were central nervous system defect and musculoskeletal system malformations. Foetal autopsy provided additional findings in 8 cases (28.57%). Conclusion: Foetal autopsy is a vital procedure in confirming the cause of foetal death. It also provides additional findings not identified through prenatal ultrasound. It provides the treating clinician and parents with very crucial information on implications for future pregnancies.References
1. Fatima U, Sherwani R, Khan T, Zaheer S: Foetal Autopsy–Categories and Causes of Death. J Clin Diagn Res 2014; 8:FC05-08.
2. Ceylaner G, Ceylaner S, Gunyeli I, Ekici E, Celasun B, Danışman N: Evaluation of 2407 fetuses in a Turkish population. Prenat Diagn 2007; 27: 800-7.
3. Brodie M, Laing IA, Keeling JW, Meckenzie KJ: Ten years of neonatal autopsies in tertiary referral centre: retrospective study. BMJ 2002; 324:761–3.
4. Siebert JR: Perinatal, fetal and embryonic autopsy: in Gilbert-Barness E, Kapur RP, Oligny LL, Siebert JR, eds. Potter’s pathology of the fetus, infant, and child. Philadelphia: Mosby Elsevier; 2007, 685–729.
5. Cunninnham FG, Hollier LM: Fetal Death: in Cunninnham FG, Williams, Whitridge J, eds. Williams Obstetrics. Norwalk Ct: Appleteon & Lange; 1997.
6. Faye-Petersen OM, Guinn DA, Wenstrom KD: The value of perinatal Autopsy. Obstel Gynecol 1999; 94:915–20.
7. Shankar VH, Phadke SR: Clinical utility of fetal autopsy and comparison with prenatal ultrasound findings. J Perinatol 2006; 26:224–29.
8. Nielsen LA, Maroun LL, Broholm H, Laursen H, Graem N: Neural tube defect and associated anomalies in a fetal perinatal autopsy series. APMIS 2006; 114:239-46.
9. Ceylaner S, Ceylaner G, Gunyeli I,Ekici E,Tug M, Taner D, Ekerbicer H, Mollamahmutoglu L, Danisman N: Postmortem evaluation of 220 prenataly diagnoses fetuses with neural tube defect detection of associated anomalies in a Turkish population. Prenat Diagn 2006; 26:147–53.
10. Nayak SR, Garg N: Determination of antepartum fetal death. J Obstet Gynecol India 2010; 60:494-7.
11. Tuncbilek E, Boduroglu K, Alikasifoglu M: Results of the Turkish congenital malformation survey. Turk J Pedi atr 1999; 41:287-97.
12. Allessandri LM, Stanley FJ, Garner JB, Newham J, Walters BNJ: A case-control study of unexplained antepartum stillbirths. Br J Obstet Gynecol 1992; 99:711–8.
13. Bonetti LR, Ferrari P, Trani N, Maccio L, Laura S, Giuliana S, Facchinetti F, Rivasi F: The role of fetal autopsy and placental examination in the causes of fetal death: a retrospective study of 132 cases of stillbirths. Arch Gynecol Obstet 2011; 283:231–41.
14. Soma H, Yoshida K, Mukaida T, Tabuchi Y: Morphologic changes in the hypertensive placenta. Contrib. Gynecol. Obstet 1982; 9:58–75.
15. Wentworth P: Placental infarction and Toxemia of pregnancy. Am J Obstet Gynecol 1967; 99:318–26.
16. Tenney B, Parker F: The placental in Toxemia of pregnancy. Am J Obstet Gynecol 1940; 39:1000-5.
17. Bengtson J.M, Van Marter LJ, Barss VA, Greene MF, Tuomala RE, Epstein MF: Pregnancy outcome after premature rupture of membranes at or before 26 weeks gestation. Obstet Gynaecol 1989; 73:921–7.
18. Grandjean H, Larroque D, Levi S: The performance of routine ultrasonographic screening of pregnancies in the Eurofetus study. Am J Obstet Gynaecol 1999; 81:446-54.
2. Ceylaner G, Ceylaner S, Gunyeli I, Ekici E, Celasun B, Danışman N: Evaluation of 2407 fetuses in a Turkish population. Prenat Diagn 2007; 27: 800-7.
3. Brodie M, Laing IA, Keeling JW, Meckenzie KJ: Ten years of neonatal autopsies in tertiary referral centre: retrospective study. BMJ 2002; 324:761–3.
4. Siebert JR: Perinatal, fetal and embryonic autopsy: in Gilbert-Barness E, Kapur RP, Oligny LL, Siebert JR, eds. Potter’s pathology of the fetus, infant, and child. Philadelphia: Mosby Elsevier; 2007, 685–729.
5. Cunninnham FG, Hollier LM: Fetal Death: in Cunninnham FG, Williams, Whitridge J, eds. Williams Obstetrics. Norwalk Ct: Appleteon & Lange; 1997.
6. Faye-Petersen OM, Guinn DA, Wenstrom KD: The value of perinatal Autopsy. Obstel Gynecol 1999; 94:915–20.
7. Shankar VH, Phadke SR: Clinical utility of fetal autopsy and comparison with prenatal ultrasound findings. J Perinatol 2006; 26:224–29.
8. Nielsen LA, Maroun LL, Broholm H, Laursen H, Graem N: Neural tube defect and associated anomalies in a fetal perinatal autopsy series. APMIS 2006; 114:239-46.
9. Ceylaner S, Ceylaner G, Gunyeli I,Ekici E,Tug M, Taner D, Ekerbicer H, Mollamahmutoglu L, Danisman N: Postmortem evaluation of 220 prenataly diagnoses fetuses with neural tube defect detection of associated anomalies in a Turkish population. Prenat Diagn 2006; 26:147–53.
10. Nayak SR, Garg N: Determination of antepartum fetal death. J Obstet Gynecol India 2010; 60:494-7.
11. Tuncbilek E, Boduroglu K, Alikasifoglu M: Results of the Turkish congenital malformation survey. Turk J Pedi atr 1999; 41:287-97.
12. Allessandri LM, Stanley FJ, Garner JB, Newham J, Walters BNJ: A case-control study of unexplained antepartum stillbirths. Br J Obstet Gynecol 1992; 99:711–8.
13. Bonetti LR, Ferrari P, Trani N, Maccio L, Laura S, Giuliana S, Facchinetti F, Rivasi F: The role of fetal autopsy and placental examination in the causes of fetal death: a retrospective study of 132 cases of stillbirths. Arch Gynecol Obstet 2011; 283:231–41.
14. Soma H, Yoshida K, Mukaida T, Tabuchi Y: Morphologic changes in the hypertensive placenta. Contrib. Gynecol. Obstet 1982; 9:58–75.
15. Wentworth P: Placental infarction and Toxemia of pregnancy. Am J Obstet Gynecol 1967; 99:318–26.
16. Tenney B, Parker F: The placental in Toxemia of pregnancy. Am J Obstet Gynecol 1940; 39:1000-5.
17. Bengtson J.M, Van Marter LJ, Barss VA, Greene MF, Tuomala RE, Epstein MF: Pregnancy outcome after premature rupture of membranes at or before 26 weeks gestation. Obstet Gynaecol 1989; 73:921–7.
18. Grandjean H, Larroque D, Levi S: The performance of routine ultrasonographic screening of pregnancies in the Eurofetus study. Am J Obstet Gynaecol 1999; 81:446-54.
Published
2019-02-26
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