Is traditional perinatal autopsy needed after detailed fetal ultrasound and post-mortem MRI?
Journal
Prenatal diagnosis
ISSN: 1097-0223
Titre abrégé: Prenat Diagn
Pays: England
ID NLM: 8106540
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
15
01
2019
revised:
27
02
2019
accepted:
14
03
2019
pubmed:
21
3
2019
medline:
26
6
2020
entrez:
21
3
2019
Statut:
ppublish
Résumé
To determine the additional yield from autopsy following prenatal ultrasound and post-mortem magnetic resonance imaging (PMMR) for structural abnormalities. PMMR was performed on consecutive fetuses over a 6-year period. Prenatal ultrasound and PMMR findings were categorised as concordant, partially concordant or discordant findings. The yield of new and clinically significant information from autopsy was assessed. Diagnostic accuracies for both modalities were calculated, using autopsy as reference standard. Our study consisted of 81 fetuses. PMMR and prenatal ultrasound findings were concordant in 44/81 (54.3%), partially concordant in 26/81 (32.1%) and discordant in 11/81 (13.6%) cases. In 19/81 cases (23%), autopsy provided additional information, which appeared clinically significant in 12 cases. In 10 of those 12 cases, there was discordance between PMMR and ultrasound. In only 2 of 44 cases where ultrasound and PMMR were concordant, did autopsy provide clinically significant information. Diagnostic accuracy rates for ultrasound were sensitivity of 76.8% (66.6%, 84.6%), specificity of 92.5% (88.9%, 95.0%). For PMMR the sensitivity was 79.0% (68.9%, 86.5%), specificity 97.9% (95.5%, 99.0%). PMMR had a significantly higher concordance rate with autopsy than ultrasound (89.0 vs 93.8%; P < .001). Where PMMR and ultrasound are concordant, there is little additional yield from autopsy.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
818-829Subventions
Organisme : Department of Health
ID : 14/168/02
Pays : United Kingdom
Organisme : Medical Research Council (MRC)
ID : MR/R00218/1
Pays : International
Organisme : Medical Research Council
ID : MR/R002118/1
Pays : United Kingdom
Organisme : Department of Health
ID : SRF/01/018
Pays : United Kingdom
Organisme : Department of Health
ID : NIHR-CDF-2017-10-037
Pays : United Kingdom
Organisme : British Heart Foundation
ID : FS/11/76/29037
Pays : United Kingdom
Organisme : Department of Health
ID : CDF-2017-10-037
Pays : United Kingdom
Organisme : Department of Health
ID : 0550004
Pays : United Kingdom
Organisme : British Heart Foundation
ID : PG/16/99/32572
Pays : United Kingdom
Informations de copyright
© 2019 John Wiley & Sons, Ltd.
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