ABSTRACT Despite the increasing accuracy of prenatal detection of birth defects and genetic disorders, necropsy still provides the
final diagnosis in many cases and serves as an “ultimate audit.” In Berg-er's (1978) view, “any single autopsy may not have
dramatic import for progress in medicine, but it may have profound and lifelong implications for helping the dead child's
family.” Necropsy results are of great importance to the parents of stillborn infants.
In recent years, a fall in intrapartum deaths has been observed as part of the decline in overall perinatal mortality rates
in developed countries [Georgsdottir et al. 1989; Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) 1997].
Thus a larger proportion of perinatal deaths is now attributable to antepartum causes. Ante-partum stillbirths may comprise
more than one third of perinatal deaths (Keeling 1987). To achieve even lower perinatal mortality rates, efforts should be
focused primarily on the investigation of antepartum deaths.
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ABSTRACT: Standards for body parameters and organ weights are important tools in fetal and perinatal pathology. Previously there has been only a weak emphasis on the effect of maceration on dimensions and weights. This study provides autopsy standards for body weight, body dimensions, and fresh organ weights for nonmacerated fetuses and for mildly, moderately, and markedly macerated fetuses at 12 to 43 weeks of gestation. Cases were selected from a consecutive series of 1800 fetal and perinatal autopsies. Cases with malformations, hydrops, infection, or chromosomal abnormality, fetuses from multiple births, and infants who lived longer than 24 h were excluded. In each case the maceration was graded and body weight and 4 body dimensions were recorded before organ examination. Organs were weighed immediately and before fixation. Growth curves were fitted according to appropriate mathematical methods and the effects of maceration on each value were tested statistically. We found that weights of the liver, thymus, and spleen markedly decrease with increasing maceration. The weights of the lungs, kidneys, and adrenals decreased modestly, whereas weights of the heart and brain changed only slightly. Body length increased slightly with maceration, whereas body weight and head circumference were unaffected. User-friendly charts and tables of mean values and standard deviations for nonmacerated and macerated fetuses are provided.Pediatric and Developmental Pathology 01/2005; 8(2):204-17. · 0.86 Impact Factor
Article: Investigation of stillbirth.[show abstract] [hide abstract]
ABSTRACT: The pathologic investigation of stillbirth is often frustrating, and may be viewed as unrewarding, because the reason for death of the infant frequently is not identifiable. This outline attempts to identify an approach to the examination of the stillborn and accompanying placenta, with appropriate use of ancillary studies that may uncover the cause of death and/or identify factors that could prejudice future pregnancies.Pediatric and Developmental Pathology 12/2000; 4(1):1-22. · 0.86 Impact Factor