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Benefits and Limitations of the Minimally Invasive Postmortem: A Review of an Innovative Service Development
Georgia Hyde1, Rachel Rummery2, Elspeth H Whitby1,3
1Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield, Sheffield, UK.
Summary
Minimally invasive pediatric postmortem (PM) examinations, including MRI and placental evaluation, are effective alternatives when traditional autopsies are refused. These methods identified relevant conditions in most cases, aiding in determining cause of death.
Area of Science:
- Perinatal pathology
- Medical imaging in forensics
- Minimally invasive autopsy techniques
Background:
- Declining pediatric postmortem (PM) rates necessitate alternatives to traditional autopsy.
- Parental wishes are a key consideration in choosing examination methods.
- This study reviews a minimally invasive fetal and neonatal PM service.
Purpose of the Study:
- To evaluate the effectiveness of a minimally invasive fetal and neonatal PM service.
- To identify the most informative components of the minimally invasive PM service.
- To assess the utility of the Relevant Condition at Death (ReCoDe) classification.
Main Methods:
- Analysis of cases from a mortuary electronic database (2012-2017).
- Minimally invasive service included external examination, MRI, and placental examination.
- Pathology reports were analyzed for identified conditions and ReCoDe classifications.
Main Results:
- 105 minimally invasive PMs (7% of 1498 perinatal PMs) were performed, primarily for intrauterine fetal deaths (75.24%).
- Relevant conditions were identified in 89.52% of cases, with ReCoDe classifications in 76.19%.
- Placental examination and MRI were the most informative elements, identifying conditions in 32.5% and 27.5% of cases, respectively.
Conclusions:
- Minimally invasive PMs are a viable alternative to traditional autopsy, especially when refused.
- Further analysis is required to address potential biases in classification codes.
- The service successfully identified relevant conditions in the majority of cases.
