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Updated: Jan 3, 2026
Murine Fetal Echocardiography
Published on: February 15, 2013
Maceration determines diagnostic yield of fetal and neonatal whole body post-mortem ultrasound
Susan Cheng Shelmerdine1,2, Dean Langan2, Uday Mandalia1
1Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, UK.
Objectives:
To determine factors in nondiagnostic fetal and neonatal post-mortem ultrasound (PMUS) examinations.
Methods:
All fetal and neonatal PMUS examinations were included over a 5-year study period (2014-2019). Nondiagnostic image quality by body parts (brain, spine, thorax, cardiac, and abdomen) was recorded and correlated with patient variables. Descriptive statistics and logistic regression analyses were performed to identify significant factors for nondiagnostic studies.
Results:
Two hundred sixty-five PMUS examinations were included, with median gestational age of 22 weeks (12-42 wk), post-mortem weight of 363 g (16-4033 g), and post-mortem interval of 8 days (0-39 d). Diagnostic imaging quality was achieved for 178/265 (67.2%) studies. It was high for abdominal (263/265, 99.2%), thoracic (264/265, 99.6%), and spine (265/265, 100%) but lower for brain (210/265, 79.2%) and cardiac imaging (213/265, 80.4%). Maceration was the best overall predictor for nondiagnostic imaging quality (P < .0001). Post-mortem fetal weight was positively associated with cardiac (P = .0133) and negatively associated with brain imaging quality (P = .0002). Post-mortem interval was not a significant predictor.
Conclusions:
Fetal maceration was the best predictor for nondiagnostic PMUS, particularly for brain and heart. Fetuses with marked maceration and suspected cardiac or brain anomalies should be prioritised for post-mortem MRI.
Insights
Fetal maceration significantly impacts post-mortem ultrasound (PMUS) diagnostic quality, especially for brain and cardiac imaging. Prioritize fetuses with maceration for MRI when brain or heart anomalies are suspected.
Area of Science:
- Medical Imaging
- Pathology
- Neonatal Medicine
Background:
- Post-mortem ultrasound (PMUS) is a valuable tool in fetal and neonatal examination.
- Nondiagnostic examinations can limit the diagnostic yield of PMUS.
- Identifying factors contributing to nondiagnostic PMUS is crucial for improving examination quality.
Purpose of the Study:
- To identify factors associated with nondiagnostic fetal and neonatal post-mortem ultrasound examinations.
- To correlate image quality with specific body parts and patient variables.
Main Methods:
- A retrospective analysis of 265 fetal and neonatal PMUS examinations from 2014-2019.
- Assessment of image quality for brain, spine, thorax, cardiac, and abdomen.
- Statistical analysis including descriptive statistics and logistic regression to determine predictors of nondiagnostic studies.
Main Results:
- Overall diagnostic imaging quality was achieved in 67.2% of studies.
- Abdominal, thoracic, and spine imaging quality was high (99.2-100%).
- Brain (79.2%) and cardiac (80.4%) imaging quality was lower. Fetal maceration was the strongest predictor of nondiagnostic imaging (P < .0001).
- Post-mortem fetal weight influenced cardiac and brain imaging quality, while post-mortem interval was not significant.
Conclusions:
- Fetal maceration is the primary factor leading to nondiagnostic PMUS, particularly affecting brain and cardiac imaging.
- Fetuses exhibiting marked maceration with suspected cardiac or brain anomalies warrant prioritized post-mortem MRI.
- Optimizing PMUS protocols and considering advanced imaging modalities are essential for challenging cases.
