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Updated: May 21, 2026
Murine Fetal Echocardiography
Published on: February 15, 2013
Cardiac findings in routine fetal autopsies: more than meets the eye?
Carla Ramalho1, Otília Brandão, José Monterroso
1Center of Prenatal Diagnosis, Department of Gynecology and Obstetrics, Faculty of Medicine, University of Porto, Porto, Portugal. carlaramalho@med.up.pt
Insights
Cardiac anomalies are common in fetal loss, with septal defects and complex anomalies being most frequent. Thorough fetal autopsy is crucial, as prenatal diagnosis accuracy varies, especially when not performed by specialists.
Area of Science:
- Cardiovascular Pathology
- Fetal Medicine
- Autopsy
Background:
- Cardiac anomalies represent a significant finding in fetal loss.
- Routine fetal autopsies are essential for understanding the spectrum of these conditions.
Purpose of the Study:
- To evaluate the range of cardiac anomalies identified in fetal autopsies.
- To correlate prenatal diagnoses with postmortem findings.
Main Methods:
- A retrospective analysis of fetal autopsies was conducted.
- Cardiac defects were categorized and classified as isolated or associated anomalies.
- Prenatal and postmortem diagnoses were compared.
Main Results:
- Abnormal cardiac findings occurred in 13.6% of fetuses.
- Septal defects and complex anomalies were the most prevalent categories (21.2% each).
- Prenatal diagnosis showed complete agreement with postmortem findings in 72% of cases, with higher disagreement rates when echocardiograms were not performed by specialists.
Conclusions:
- Cardiac defects are prevalent in pregnancy losses.
- The study underscores the importance of comprehensive cardiac examination in all fetal autopsies.
- Improving prenatal diagnostic accuracy, particularly specialist echocardiography, is vital.
Objective:
The main objective of this study was to evaluate the spectrum of cardiac anomalies found in routinely performed fetal autopsies and to establish the correlation between prenatal and postmortem diagnosis.
Study Design:
A retrospective study of fetal autopsies was performed. Cases with cardiac anomalies were analyzed. Seven main categories were established and each case was assigned to a single group. Cardiac defects were also classified as isolated or with associated anomalies. In the cases with prenatal diagnosis, we performed a correlation between prenatal and postmortem findings.
Results:
Abnormal cardiac findings were identified in 99 fetuses (13.6%). The two most common categories were septal defects and complex anomalies, each occurring in 21 fetuses (21.2%). Sixty-seven (67.7%) had associated anomalies. Septal anomalies were more frequent in cases with associated anomalies (p=0.012). Prenatal diagnosis had been performed in 50 cases. There was complete agreement between prenatal and postmortem diagnosis in 36 cases (72%), and major agreement with additional information in ten (20%). When the echocardiogram was not performed by a specialist, the number of cases classified with complete disagreement was higher (33.3% vs 2.4%) (p=0.002).
Conclusion:
The high prevalence of cardiac defects in lost pregnancies, some of them lacking prenatal diagnosis, highlights the importance of examining the heart in all cases.
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