The value of perinatal post-mortem radiography. Experience of 514 cases

A post-mortem radiological study of 514 perinatally dead infants was carried out in order to evaluate the role of the radiological findings in the diagnosis of abnormal conditions and the cause of death. The study was performed in the Department of Radiology of Oulu University Central Hospital, where the records and radiograms of the cases were sent from 22 Finnish central hospitals and a maternity hospital. The radiograms were taken according to a standardized technique. The cases were collected in a period of 20 months from July 1980 to February 1982, and the number corresponds roughly to the number of perinatal deaths during one year in Finland. In the analysis of the radiograms, special attention was paid to skeletal changes and soft tissue abnormalities. For the measurement of skull, femur and pelvic angles, reference values were calculated from 167 cases of various gestational ages, in which no abnormalities had been detected. Pathological radiological findings were seen in 156 cases, which is 30% of the whole material. 99 of these were congenital defects, while the rest showed other skeletal or soft tissue abnormalities. Of the 99 congenital defects with radiological findings there were six cases of osteochondrodysplasias, 16 cases of chromosomal malformation syndromes, 13 cases of autosomally recessively inherited malformation syndromes and 18 cases of multiple malformation syndromes of unknown aetiology. There were 18 malformation cases with radiological findings, which were considered to represent malformation sequences. Single malformations with radiological findings were found in 10 cases. Congenital defects due to disruptions were detected in 12 cases and defects due to deformations in seven cases. In addition there were 55 cases of different types of congenital disorders, in which no radiological abnormalities could be seen. The rest of the radiological findings were not related to congenital defects, but represented other skeletal changes (22 cases) or soft tissue changes (35 cases), such as teratoma, calcifications, pneumothorax and pneumopericardium. The proportion of congenital defects among the perinatal deaths is remarkable. In the present material they were the primary cause of death in 123 cases (24%). Despite their heterogeneous nature, an increasing number of aetiologically specific entities are being delineated. This is partly due to the increasing use of radiology in the study of perinatal deaths, as was the case in the delineation of the hydrolethalus syndromes in the present study. This is often important to the parents who need information on the recurrence risks of the defects for future pregnancies.(ABSTRACT TRUNCATED AT 400 WORDS)