When is a post-mortem skeletal survey of the fetus indicated, and when not?

The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
Karin Kamphuis-van UlzenWillemijn M Klein

Abstract

Radiography after fetal or perinatal death has become a routine part of post-mortem diagnostics. However, only a selected subset of these babygrams or fetal post-mortem skeletal surveys (FPSSs) provides useful information. We investigated the indication for a FPSS. Inclusion consisted of the routinely made FPSS (2002-2012) in our university hospital in cases of fetal or perinatal death up to 7 days after birth. We categorized the diagnostic value of the FPSS as no, minor, major or pathognomonic. Regression analysis was used to determine the selection criteria for a useful FPSS. Three hundred and thirty-seven FPSS were included. Three hundred and five (91%) FPSS showed no or minor skeletal malformations. Fourteen (4.2%) FPSS had major skeletal malformations. In 18 (5.3%) cases the diagnosis was based on the pathognomonic skeletal malformations on the FPSS. Two cases were false positive after major birth trauma. The presence of multiple skeletal malformations on prenatal ultrasound or at post-mortem external inspection was highly indicative of a diagnostic FPSS (p < 0.001). The majority of the babygrams/FPSS has no contribution to the diagnostic process. Multiple skeletal malformations on prenatal ultrasound or post-mortem extern...Continue Reading

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Citations

Aug 23, 2019·Insights Into Imaging·Susan C ShelmerdineOwen J Arthurs
Mar 20, 2019·Insights Into Imaging·Susan C ShelmerdineOwen J Arthurs
Apr 21, 2018·European Journal of Pediatrics·L J P SonnemansUNKNOWN Dutch post-mortem imaging guideline group
May 8, 2020·American Journal of Obstetrics and Gynecology·Xin KangJacques C Jani
Apr 8, 2020·Clinical Radiology·C ReidS C Shelmerdine

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