Comprehensive post-mortem evaluation in Intrauterine deaths /still
births in improving uptake of autopsy and future pregnancy outcomes
Abstract
Objective: Post-mortem examination of a baby following spontaneous or
missed miscarriage in the second trimester or intrauterine death to
provide a complete or partial explanation of the pregnancy loss. Method:
A total of 100 cases of intrauterine deaths were consecutively collected
from January 2010-May 2019 for etiological diagnosis according to the
standard protocol and involved external examination, dysmorphological
examination, internal examination and full body antero-posterior and
lateral radiographs. Histopathology of placenta was done. Cases were
also subjected to genetic testing such as FISH/microarray. A clinical
correlation was done by a Obstetrician-geneticist to reach an
etiological diagnosis. Results: Two third of cases were referred after
intrauterine death post 30 weeks of gestation. 24/100 cases were with
fetal anomalies.Genetic causes present in 12% cases. 65.5% cases were
associated with the pathology of the placenta. 30% cases were with cord
lesions. The results were inconclusive in 14% of the cases.
Conclusions: In this study we looked for establishing etiological
diagnosis and tried to see contribution of each test in finding the
cause. This will help the obstetrician in counselling parents for the
utility of post-mortem excamination and thus better able to guide for
future recurrence risk and management.