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Fetal Autopsies and its Significance: A Tertiary Care Center Study

Clement Wilfred Devdass, Associate Professor, Department of Pathology, M.S. Ramaiah Medical College, Bengaluru, Karnataka 560054, India. , Ramya Krishna Dondeti* , Clement Wilfred Devdass** , Prasanna Shetty Badila***

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Indian Journal of Pathology: Research and Practice 6(4 (Part-1)):p 925-931, Oct-Dec 2017. | DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.6417.15

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Abstract

Introduction: Perinatal mortalityworldwide accounts for about 53/1000 total births [1], in which preterm births contribute to a major proportion, followed by other fetal, placental and maternal factors [2]. Hence, analyzing the perinatal deaths by a detailed postmortem examination is indispensable in identifying the specific disorder for which targeted strategies could be implemented for prevention in further pregnancies and counseling regarding the risk of recurrence. Aims: 1. To analyze the spectrum of etiologies which account for the fetal death. 2. To study the various congenital anomalies 3. To correlate the pathological diagnosis with antenatal ultrasound findings and karyotyping wherever feasible. Materials and Methods: Fetal autopsies were performed on all deceased fetuses received in the Department of Pathology over a period of 4 years from June 2012 to June 2016. A total of 65 cases were included in this retrospective study. The findings were correlated with available antenatal ultrasound findings and with karyotyping reports wherever feasible. Results: Of the 65 cases, the predominant cause of fetal loss was found to be due to MTP following congenital anomalies in 26 cases ( 40% ), then by intrauterine deaths in 24 ( 36% ), ARDS with perinatal asphyxia in 8 (12%), spontaneous abortionsin 5 ( 7%) and miscellaneous conditions in 2 cases ( 5% ). Male fetuses were found to be more affected (62%) than females (38%). A 90% correlation between antenatal USG and pathological diagnosis was found. In 6 out of 65 cases which had karyotyping reports, 66% correlation was noted. Conclusion: The present study proves that an organized postmortem examination of the fetus helps in identifying the cause of death which along with appropriate antenatal history, radiological findings and karyotyping would give a definitive diagnosis and aids in estimating its risk of recurrence.

Keywords: Congenital Anomalies; Karyotyping; Perinatal Death. 

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DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.6417.15

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