[Fetal autopsies : Relic or still a gold standard?]

Area of Science:

• Pathology
• Perinatology
• Public Health

Background:

• Fetal autopsy rates are declining in Western countries.
• Post-mortem examinations provide vital information regarding abortion causes and recurrence risks for parents.
• This study focuses on the German context.

Purpose of the Study:

• To analyze trends in fetal autopsies in Germany over the past decade.
• To review information obtained from fetal autopsies.
• To assess the diagnostic value of fetal autopsies.

Main Methods:

• Retrospective evaluation of fetal autopsy reports from two German university pathology institutes (2005-2014).
• Assessment of demographic data, clinical diagnoses, and autopsy findings.
• Comparison of spontaneous vs. induced abortions and inter-institute differences.

Main Results:

• A 24.2% decrease in fetal autopsies was observed during the study period.
• Significant differences in malformations were noted between spontaneous and induced abortions (p < 0.001).
• Discrepancies between clinical and autopsy findings occurred in 6.8% of cases, with 3.5% revealing additional malformations.

Conclusions:

• Fetal autopsies remain essential diagnostic tools despite advancements in prenatal diagnostics.
• They contribute significant additional information, potentially revising clinical diagnoses.
• Autopsies aid in understanding fetal death and informing future reproductive decisions.