Comparison of postmortem ultrasound and X-Ray with autopsy in fetal death: Retrospective study of 169 cases

ObjectiveTo compare the diagnostic yields of joint analysis of ultrasound and X-Ray compared to autopsy in the setting of fetal death.Material and methodsRetrospective study of postmortem fetal ultrasounds performed between January 2009 and December 2013 in addition to X-Ray in the work-up for cases of fetal death. Inclusion criteria were a complete anatomical ultrasound study and the availability the foetopathology report. Cases with autopsy refusals were excluded. When cases of TOP were included, antenatal imaging data (US, CT and/or MRI) were available. All scans were performed by a senior pediatric radiologist.ResultsWe collected 169 patients. The gestational age was 27 weeks ±6 days [15–38 WG]. The population consisted mainly of fetuses originating from TOP (164/169 [97%]). Only 5 cases involved in utero fetal deaths (IUFD). Half (50%) of the conditions involved were cerebral. Others were polymalformative syndromes (20%), kidney diseases (10%) and miscellaneous (20%). The duration of the exam was about 10–15 min. Complete concordance between the findings of postmortem imaging and autopsy was observed in 81% [137/169] of cases.ConclusionUltrasound allows a comprehensive post-mortem study complementary to standard X-Rays. In fetal deaths situations, US is much more relevant than in any other postmortem conditions. Ultrasound, although less effective than MRI, shows a benefit/drawback balance that proves very interesting, especially in the youngest fetuses. Besides it is more available and realistic to use it in a systematic practice.