Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth

O’Donoghue, Keelin; O’Regan, Kevin; Sheridan, Carmel; O’Connor, Owen J.; Benson, Jodie; McWilliams, Sebastian; Moore, Niamh; Murphy, Mary; Chopra, R; Higgins, John R.; Maher, Michael M.

doi:10.1016/j.ejrad.2011.03.093

Cited by 21 publications

(5 citation statements)

References 18 publications

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“…Non-contrast CT in foetuses is likely to be of limited value, except in certain specific diagnostic cases, such as in rare skeletal dysplasias, as has been suggested from a recent small study of 14 foetuses. 46 Nevertheless, CT may be useful in demonstrating skeletal injuries and abnormalities, particularly in forensic cases.…”

Section: Paediatric and Perinatal Post-mortem Ctmentioning

confidence: 99%

Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

Addison¹,

Arthurs²,

Thayyil³

2014

BJR

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Although post-mortem MRI (PMMR) was proposed as an alternative to conventional autopsy more than a decade ago, the lack of systematic validation has limited its clinical uptake. Minimally invasive autopsy (MIA) using PMMR together with ancillary investigations has now been shown to be as accurate as conventional autopsy in foetuses, newborns and infants and is particularly useful for cerebral, cardiac and genitourinary imaging. Unlike conventional autopsy, PMMR provides a permanent three-dimensional auditable record, with accurate estimation of internal organ volumes. MIA is becoming highly acceptable to parents and professionals, and there is widespread political support and public interest in its clinical implementation in the UK. In the short to medium term, it is desirable that a supraregional network of specialist centres should be established to provide this service within the current National Health Service framework.

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Section: Paediatric and Perinatal Post-mortem Ctmentioning

confidence: 99%

Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

Addison¹,

Arthurs²,

Thayyil³

2014

BJR

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“…A total of 1492 studies were included for full text review. Of these, 240 studies met the inclusion criteria, representing approximately 298 762 participants …”

Section: Resultsmentioning

confidence: 99%

Interventions, outcomes and outcome measurement instruments in stillbirth care research: A systematic review to inform the development of a core outcome set

Bakhbakhi

Siassakos

Davies

et al. 2023

BJOG

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Background A core outcome set could address inconsistent outcome reporting and improve evidence for stillbirth care research, which have been identified as an important research priority. Objectives To identify outcomes and outcome measurement instruments reported by studies evaluating interventions after the diagnosis of a stillbirth. Search strategy Amed, BNI, CINAHL, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, MEDLINE, PsycINFO, and WHO ICTRP from 1998 to August 2021. Selection criteria Randomised and non‐randomised comparative or non‐comparative studies reporting a stillbirth care intervention. Data collection and analysis Interventions, outcomes reported, definitions and outcome measurement tools were extracted. Main results Forty randomised and 200 non‐randomised studies were included. Fifty‐eight different interventions were reported, labour and birth care (52 studies), hospital bereavement care (28 studies), clinical investigations (116 studies), care in a multiple pregnancy (2 studies), psychosocial support (28 studies) and care in a subsequent pregnancy (14 studies). A total of 391 unique outcomes were reported and organised into 14 outcome domains: labour and birth; postpartum; delivery of care; investigations; multiple pregnancy; mental health; emotional functioning; grief and bereavement; social functioning; relationship; whole person; subsequent pregnancy; subsequent children and siblings and economic. A total of 242 outcome measurement instruments were used, with 0–22 tools per outcome. Conclusions Heterogeneity in outcome reporting, outcome definition and measurement tools in care after stillbirth exists. Considerable research gaps on specific intervention types in stillbirth care were identified. A core outcome set is needed to standardise outcome collection and reporting for stillbirth care research.

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“…Noninvasive components of fetal autopsy-external examination, examination of placenta, cord, cytogenetic and metabolic laboratory investigations and imaging (radiographs, photography), MRI, CT are some of the options available for investigating perinatal deaths when the family declines to give consent for standard autopsy [5,6]. In a developing country like India, the use of MRI routinely in postmortem fetal examination is not possible because of lack of resources and high cost and also because of lack of specialists.…”

Section: Discussionmentioning

confidence: 99%

At Least an Infantogram if not Perinatal Autopsy

Deka

Naha

Dadhwal

et al. 2014

Journal of Fetal Medicine

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To study the feasibility and value of postmortem fetal infantogram (X-ray film) in pregnancies terminated for prenatally diagnosed fetal congenital malformations and stillborn fetuses with congenital anomalies. Forty-two fetuses were diagnosed antenatally by ultrasonography to have fetal congenital malformation, 36 couples opted for medical termination of pregnancy (MTP) and intrauterine death (IUD) occurred in six cases. Informed written consent for autopsy including infantogram was given by 41 couples, one couple permitted only radiographs. On infantogram, the antenatal ultrasound diagnoses were confirmed in all the cases of central nervous system anomalies, but were not useful for genitourinary anomalies or cardiac anomalies. In five cases of antenatally suspected skeletal anomalies, radiographs changed the diagnosis of thanatophoric dwarf to osteogenesis imperfecta type llC in one case and achondrogenesis type 1B in another case. Infantogram made the syndromic diagnosis in three cases-sirenomelia, Roberts syndrome and caudal regression syndrome. Congenital diaphragmatic hernia was diagnosed at infantogram in a case missed on ultrasound. In three cases of nonimmune hydrops, X-ray films correlated with ultrasound findings, but could not find the cause. If autopsy, the 'goal standard' test is refused or cannot be done, at least an infantogram should routinely be done in pregnancies terminated for prenatally diagnosed fetal congenital malformations and stillborn fetuses with congenital anomalies, as it is noninvasive, easily available and consent given. It may change the diagnosis and counseling for future pregnancies, hence very useful in perinatal medicine.

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Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth

Cited by 21 publications

References 18 publications

Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

Interventions, outcomes and outcome measurement instruments in stillbirth care research: A systematic review to inform the development of a core outcome set

At Least an Infantogram if not Perinatal Autopsy

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