Minimally invasive autopsy in the evaluation of fetal malformations and stillbirths: A feasibility study
Neerja Gupta, Nitika Langeh, Aparna Sharma, Asit Mridha, Manisha Jana, Adarsh Barwad, Kalaivani Mani, Vatsla Dadhwal, Atin Kumar, Dipika Deka, Madhulika Kabra- Health, Toxicology and Mutagenesis
- Developmental Biology
- Toxicology
- Embryology
- Pediatrics, Perinatology and Child Health
Abstract
Background
Minimally invasive autopsy (MIA) using post‐mortem magnetic resonance imaging with ancillary investigations is reported as accurate as conventional autopsy. This study assesses MIA's feasibility and accuracy compared to conventional autopsy.
Method
MIA and/or conventional autopsy were performed on malformed fetuses (14–20 weeks gestation) and stillbirths (>20 weeks gestation), with/without malformation. Concordance in diagnostic accuracy (95% confidence interval [CI]) and agreement (Kappa coefficient [k]) were assessed in malformed cases where both MIA and autopsy were conducted.
Results
We enrolled 200 cases, including 100 malformed fetuses (<20 weeks) and 100 stillbirths (with/without malformations). Concordance of 97.3% was observed between MIA and autopsy in 156 malformed cases. The overall diagnostic accuracy of MIA was 96.04%.
Conclusion
While conventional autopsy remains the gold standard, MIA is feasible in tertiary care settings. It can be considered a potential alternative for post‐mortem assessment, particularly in settings with limited facility of conventional autopsy and parental refusal.