Minimally invasive perinatal and pediatric autopsy with laparoscopically assisted tissue sampling: feasibility and experience of the MinImAL procedure.
autopsy
histology
laparoscopy
minimally invasive autopsy
perinatal
Journal
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
19
10
2018
revised:
21
12
2018
accepted:
31
12
2018
pubmed:
9
1
2019
medline:
25
4
2020
entrez:
9
1
2019
Statut:
ppublish
Résumé
Less invasive autopsy techniques in cases of fetal or infant death have good acceptability among parents, but the published sampling adequacy in needle biopsy studies is generally poor. Minimally Invasive Autopsy with Laparoscopically assisted sampling (MinImAL) has the potential to increase the diagnostic yield of less invasive autopsy by improving the quality and quantity of tissue samples obtained, whilst permitting visualization, extraction and examination of internal organs through a small incision. The aim of this study was to present the findings of our experience with the MinImAL procedure in cases of fetal, neonatal and pediatric death. This was a retrospective analysis of 103 prospectively recruited unselected cases of fetal, neonatal or pediatric death that underwent the MinImAL procedure at a tertiary referral center over a 5-year period. Following preprocedure 1.5-T whole-body postmortem magnetic resonance imaging, MinImAL autopsy was performed. Procedure duration, sampling adequacy and cause of death were assessed. Chi-square analysis was used to compare the 'unexplained' rate of intrauterine deaths in the cohort with that in a previously published cohort of > 1000 cases of intrauterine death examined by standard autopsy. MinImAL autopsy was performed successfully in 97.8% (91/93) of the cases undergoing a complete procedure. There was a satisfactory rate of adequate histological sampling in most major organs; heart (100%, 91 cases), lung (100%, 91 cases), kidney (100%, 91 cases), liver (96.7%, 88 cases), spleen (94.5%, 86 cases), adrenal glands (89.0%, 81 cases), pancreas (82.4%, 75 cases) and thymus (56.0%, 51 cases). Procedure duration was similar to that of standard autopsy in a previously published cohort of intrauterine deaths. The unexplained rate in stillbirths and intrauterine fetal deaths that underwent MinImAL autopsy was not significantly different from that following standard autopsy. The MinImAL procedure provides good histological yield from major organs with minimal cosmetic damage and can be learned by an autopsy practitioner. The MinImAL procedure is an appropriate minimally invasive alternative for the investigation of perinatal and pediatric deaths in which consent to full autopsy is withheld, and may have applications in both high- and low/middle-income settings. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
661-669Subventions
Organisme : Medical Research Council
ID : MR/R002118/1
Pays : United Kingdom
Organisme : Department of Health
ID : CDF-2017-10-037
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/R00218/1
Pays : United Kingdom
Organisme : Department of Health
ID : HTA/14/168/02
Pays : United Kingdom
Organisme : Pathological Society of Great Britain and Northern Ireland
ID : SGS 2015/04/07
Organisme : National Institute for Health Research
ID : ICA-CDRF-2017-03-053
Organisme : Department of Health
ID : NIHR-CS-012-002
Pays : United Kingdom
Organisme : Department of Health
ID : ICA-CDRF-2017-03-053
Pays : United Kingdom
Informations de copyright
Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Références
Hickey L, Murphy A, Devaney D, Gillan J, Clarke T. The value of neonatal autopsy. Neonatology 2012; 101: 68-73.
Gordijn SJ, Erwich JJ, Khong TY. Value of the perinatal autopsy: critique. Pediatr Dev Pathol 2002; 5: 480-488.
Hutchinson JC, Arthurs OJ, Sebire NJ. Postmortem research: innovations and future directions for the perinatal and paediatric autopsy. Arch Dis Child Educ Pract Ed 2016; 101: 54-56.
Ernst LM. A pathologist's perspective on the perinatal autopsy. Semin Perinatol 2015; 39: 55-63.
Castillo P, Martinez MJ, Ussene E, Jordao D, Lovane L, Ismail MR, Carrilho C, Lorenzoni C, Fernandes F, Bene R, Palhares A, Ferreira L, Lacerda M, Mandomando I, Vila J, Hurtado JC, Munguambe K, Maixenchs M, Sanz A, Quinto L, Macete E, Alonso P, Bassat Q, Menendez C, Ordi J. Validity of a minimally invasive autopsy for cause of death determination in adults in Mozambique: An observational study. PLoS Med 2016; 13: e1002171.
Bassat Q, Castillo P, Martínez MJ, Jordao D, Lovane L, Hurtado JC, Nhampossa T, Santos Ritchie P, Bandeira S, Sambo C, Chicamba V, Ismail MR, Carrilho C, Lorenzoni C, Fernandes F, Cisteró P, Mayor A, Cossa A, Mandomando I, Navarro M, Casas I, Vila J, Munguambe K, Maixenchs M, Sanz A, Quintó L, Macete E, Alonso P, Menéndez C, Ordi J. Validity of a minimally invasive autopsy tool for cause of death determination in pediatric deaths in Mozambique: An observational study. PLoS Med 2017; 14: e1002317.
Manktelow B, Smith L, Evans T, Hyman-Taylor P, Kurinczuk J, Field D, Smith P, Mielewczyk F, Draper E; the MBRRACE-UK collaboration. MBRRACE-UK Perinatal Mortality Surveillance Report. UK Perinatal Death for Births from January to December 2013 - Supplementary Report: UK Trusts and Health Boards. The Infant Mortality and Morbidity Studies Group, Department of Health Sciences, University of Leicester: Leicester, 2015.
Lewis C, Hill M, Arthurs OJ, Hutchinson C, Chitty LS, Sebire NJ. Factors affecting uptake of postmortem examination in the prenatal, perinatal and paediatric setting. BJOG 2017; 125: 172-181.
Ugiagbe EE, Osifo OD. Postmortem examinations on deceased neonates: a rarely utilized procedure in an African referral center. Pediatr Dev Pathol 2012; 15: 1-4.
Lishimpi K, Chintu C, Lucas S, Mudenda V, Kaluwaji J, Story A, Maswahu D, Bhat G, Nunn AJ, Zumla A. Necropsies in African children: consent dilemmas for parents and guardians. Arch Dis Child 2001; 84: 463-467.
Maixenchs M, Anselmo R, Zielinski-Gutierrez E, Odhiambo FO, Akello C, Ondire M, Zaidi SS, Soofi SB, Bhutta ZA, Diarra K, Djiteye M, Dembele R, Sow S, Minsoko PC, Agnandji ST, Lell B, Ismail MR, Carrilho C, Ordi J, Menendez C, Bassat Q, Munguambe K. Willingness to know the cause of death and hypothetical acceptability of the minimally invasive autopsy in six diverse African and Asian settings: A mixed methods socio-behavioural study. PLoS Med 2016; 13: e1002172.
Roberts ISD, Benamore RE, Benbow EW, Lee SH, Harris JN, Jackson A, Mallett S, Patankar T, Peebles C, Roobottom C, Traill ZC. Post-mortem imaging as an alternative to autopsy in the diagnosis of adult deaths: a validation study. Lancet 2012; 379: 136-142.
Sebire NJ, Weber MA, Thayyil S, Mushtaq I, Taylor A, Chitty LS. Minimally invasive perinatal autopsies using magnetic resonance imaging and endoscopic postmortem examination (``keyhole autopsy"): feasibility and initial experience. J Matern Fetal Neonatal Med 2012; 25: 513-518.
Thayyil S, Sebire NJ, Chitty LS, Wade A, Chong WK, Olsen O, Gunny RS, Offiah AC, Owens CM, Saunders DE, Scott RJ, Jones R, Norman W, Addison S, Bainbridge A, Cady EB, Vita ED, Robertson NJ, Taylor AM. Post-mortem MRI versus conventional autopsy in fetuses and children: a prospective validation study. Lancet 2013; 382: 223-233.
Lewis C, Hill M, Arthurs OJ, Hutchinson JC, Chitty LS, Sebire N. Health professionals' and coroners' views on less invasive perinatal and paediatric autopsy: a qualitative study. Arch Dis Child 2018; 103: 572.
Lewis C, Latif Z, Hill M, Riddington M, Lakhanpaul M, Arthurs OJ, Hutchinson JC, Chitty LS, Sebire NJ. “We might get a lot more families who will agree”: Muslim and Jewish perspectives on less invasive perinatal and paediatric autopsy. PLoS One 2018; 13: e0202023.
Ben Taher M, Pearson J, Cohen M, Offiah AC. Acceptability of post-mortem imaging among Muslim and non-Muslim communities. Br J Radiol 2018; 91: 20180295.
Breeze AC, Jessop FA, Set PA, Whitehead AL, Cross JJ, Lomas DJ, Hackett GA, Joubert I, Lees CC. Minimally-invasive fetal autopsy using magnetic resonance imaging and percutaneous organ biopsies: clinical value and comparison to conventional autopsy. Ultrasound Obstet Gynecol 2011; 37: 317-323.
Garg S, Punia RP, Basu S, Mohan H, Bal A. Comparison of needle autopsy with conventional autopsy in neonates. Fetal Pediatr Pathol 2009; 28: 139-150.
Bansal MG, Punia RS, Sachdev A. Clinical and needle autopsy correlation evaluation in a tertiary care teaching hospital: a prospective study of 50 cases from the emergency department. Am J Forensic Med Pathol 2012; 33: 194-196.
Castillo P, Ussene E, Ismail MR, Jordao D, Lovane L, Carrilho C, Lorenzoni C, Lacerda MV, Palhares A, Rodríguez-Carunchio L, Martínez MJ, Vila J, Bassat Q, Menéndez C, Ordi J. Pathological methods applied to the investigation of causes of death in developing countries: Minimally invasive autopsy approach. PLoS One 2015; 10: e0132057.
Norman W, Jawad N, Jones R, Taylor AM, Arthurs OJ. Perinatal and paediatric post-mortem magnetic resonance imaging (PMMR): sequences and technique. Br J Radiol 2016; 89: 20151028.
Arthurs OJ, Thayyil S, Pauliah SS, Jacques TS, Chong WK, Gunny R, Saunders D, Addison S, Lally P, Cady E, Jones R, Norman W, Scott R, Robertson NJ, Wade A, Chitty L, Taylor AM, Sebire NJ; Magnetic Resonance Imaging Autopsy Study (MaRIAS) Collaborative Group. Diagnostic accuracy and limitations of post-mortem MRI for neurological abnormalities in fetuses and children. Clin Radiol 2015; 70: 872-880.
Man J, Hutchinson JC, Ashworth M, Heazell AE, Jeffrey I, Sebire NJ. Stillbirth and intrauterine fetal death: contemporary demographic features of > 1000 cases from an urban population. Ultrasound Obstet Gynecol 2016; 48: 591-595.
Hutchinson JC, Kang X, Shelmerdine SC, Segers V, Lombardi CM, Cannie MM, Sebire NJ, Jani JC, Arthurs OJ. Postmortem microfocus computed tomography for early gestation fetuses: a validation study against conventional autopsy. Am J Obstet Gynecol 2018; 218: 441-445.
Man J, Hutchinson JC, Ashworth M, Judge-Kronis L, Levine S, Sebire NJ. Stillbirth and intrauterine fetal death: role of routine histological organ sampling to determine cause of death. Ultrasound Obstet Gynecol 2016; 48: 596-601.