Virtual autopsy and confirmation of normal fetal heart anatomy in the first trimester using three-dimensional (3D) reconstruction of histological sections

Abstract

Objective: In this pilot study we tested the feasibility of cardiac structures reconstruction from histologic sections in 12-13 weeks normal fetuses. Conventional autopsy is hampered at this gestational age because of the small size of the heart anatomical structures, while alternative non-invasive methods for pathology examination of the fetus are expensive, rarely available and lack accuracy data regarding the con rmation of rst trimester heart defects.Method: Normal hearts from fetuses aged 12-13 gestational weeks were removed for histological preparation, virtual reconstruction and cardiac structures analysis. All sections have been scanned and a three-dimensional (3D) reconstruction of the whole organ has been rendered.Results: 5 cases were investigated. Visualization of the normal heart cavities, including atrio-ventricular septum was very good in all fetuses. The entire course of right and left ventricle out ow tracts was con dently con rmed, along the and branching pattern of aorta and pulmonary artery trunk. Conclusion:The use of 3D reconstruction of fetal heart histological sections in rst trimester may serve as an important audit to con rm the normalcy of heart structures. The histological and post processed information is retained, and this volume can be stored, reanalyzed or sent online for a second opinion.

Confirmation of Heart Malformations in Fetuses in the First Trimester Using Three-Dimensional Histologic Autopsy

“…Before termination, at 12–13 weeks of gestation, a detailed ultrasound examination was performed by a team of experienced maternal–fetal medicine subspecialists using transabdominal ultrasonography following a previously published protocol 6 using color or high-definition directional power Doppler. 21 A transvaginal approach was used when transabdominal imaging was inadequate. Voluson E10 and E8 systems equipped with RM6C and RIC5-9-D convex transducers were used for the ultrasound examinations.…”

Virtopsy as a Breakthrough in Non-Invasive Autopsy: Its Principles and Potential of Application in Developing Countries During the Covid-19 Pandemic

“…Congenital malformations affect 8.3% of pregnancies, with the central nervous system, cardiovascular, musculoskeletal, and genitourinary systems being commonly affected (77). A pilot study showed that the fetal heart can be accurately imaged using PM-US, including atria, ventricles, and septum (78). Non-invasive imaging tools can serve as an audit for first-trimester anomalies.…”