Benefits and Limitations of the Minimally Invasive Postmortem: A Review of an Innovative Service Development. (December 2020)

• Record Type: Journal Article
• Authors: Hyde, Georgia; Rummery, Rachel; Whitby, Elspeth H; Bloor, Jessica; Raghavan, Ashok; Cohen, Marta C
• Is Part Of: Pediatric and developmental pathology. Volume 23:Number 6(2020)
• Page Start: 431
• Page End: 437
• Publication Date: 2020-12
• Subjects: autopsy -- fetal -- histopathology -- minimally invasive postmortem -- magnetic resonance imaging -- postmortem magnetic resonance imaging; Pediatric pathology -- Periodicals; Children -- Diseases -- Periodicals; Diagnosis, Laboratory -- Periodicals; Abnormalities, Human -- Periodicals; Child development -- Periodicals; Pediatrics -- Periodicals; 616.07
• DOI: 10.1177/1093526620956797
• Languages: English
• ISSNs: 1093-5266

Abstract

Introduction: Pediatric postmortem (PM) rates have significantly declined, creating a need for effective minimally invasive alternatives to correlate with parental wishes. We review the use of a minimally invasive fetal and neonatal PM service further to preliminary findings published in 2015. Materials and Methods: Cases taken from the mortuary electronic database from 2012 to 2017 are analyzed. The minimally invasive service consisted primarily of external examination, magnetic resonance imaging (MRI), and placental examination. Any significant conditions found noted. All pathology reports include a Re levant Co ndition at De ath (ReCoDe) obstetric classification. Reports analyzed to determine which aspects of the service provided positive information. Results: Of 1498 perinatal postmortems, 105 (7%) were PM MRI, of which 75.24% were intrauterine fetal deaths. Relevant conditions were identified in 94 cases (89.52%), and ReCoDe categories in 80 cases (76.19%). Moreover, 90% of cases had a ReCoDe condition, with 10% unclassified. Seven cases had more than 1 ReCoDe. Main conditions related to placenta (32.5%) and umbilical cord (27.5%). The most informative elements were placental examination and MRI. Conclusion: Minimally invasive PMs are a viable alternative to traditional autopsy when this option is refused. However, further case analysis is needed to determine potential bias toward certain classification codes.