Virtual Autopsy in Perinatal Pathology: Current Practices and the Need for Standardization

Fetal/neonatal autopsy remains a cornerstone in the evaluation of perinatal losses, offering valuable insights into the causes of death. Couples may decline fetal/neonatal autopsy because of emotional distress, a wish to preserve their child's physical integrity, or cultural and religious beliefs, including body sanctity and burial traditions. Virtual autopsy, also known as virtopsy, has emerged as a promising noninvasive alternative to traditional autopsy techniques. However, the lack of standardized protocols limits their widespread adoption and comparability across studies. In this review, we aim to explore the current state of virtual autopsy techniques, emphasizing their utility in fetal and neonatal pathology. Key challenges include imaging parameters, data interpretation, and integration with clinical findings. These are highlighted. Furthermore, we propose a framework for developing standardized virtual autopsy protocols to improve reproducibility. By addressing these gaps, this review aims to contribute to the establishment of best practices, ultimately advancing the field of fetal and perinatal pathology.