Related Experiment Video
Updated: Nov 28, 2025
Author Spotlight: Collecting the Brain and Serum from the Same Mice Fetus to Study Brain Tumor Development
Published on: May 17, 2024
Post-mortem confirmation of fetal brain abnormalities: challenges highlighted by the MERIDIAN cohort study
P D Griffiths1, D Jarvis1, C Mooney2
1Academic Unit of Radiology, Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK.
Objectives:
To assess and analyse the concordance between post-mortem findings and in utero magnetic resonance imaging (iuMRI) in the MERIDIAN (MRI to enhance the diagnosis of fetal developmental brain abnormalities in utero) cohort.
Design:
Prospective cohort study.
Setting:
Fetal medicine units in the UK.
Population:
Pregnant women with a diagnosis of fetal brain abnormality identified on ultrasound at 18 weeks of gestation or later.
Methods:
All pregnancies from the MERIDIAN study that resulted in a abortion were included and the rate of uptake and success of post-mortem examinations were calculated. In the cases in which diagnostic information about the fetal brain was obtained by post-mortem, the results were compared with the diagnoses from iuMRI.
Main Outcome Measure:
Outcome reference diagnosis from post-mortem examination.
Results:
A total of 155 from 823 pregnancies (19%) ended in a termination of pregnancy and 71 (46%) had post-mortem brain examinations, 62 of which were diagnostically adequate. Hence, the overall rate of successful post-mortem investigation was 40%, and for those cases there was a concordance rate of 84% between iuMRI and post-mortem examination. Detailed information is provided when the results of the post-mortem examination and the iuMRI study differed.
Conclusions:
We have shown tissue-validation of radiological diagnosis is hampered by a low rate of post-mortem studies in fetuses aborted with brain abnormalities, a situation further compounded by a 12% rate of autopsy being technically unsuccessful. The agreement between iuMRI and post-mortem findings is high, but our analysis of the discrepant cases provides valuable clues for improving how we provide information for parents. TWEETABLE ABSTRACT: iuMRI should be considered a reliable indicator of fetal brain abnormalities when post-mortem is not performed.
