Diagnostic Yield of Post-Mortem Fetal Micro-CT for Abdominal and Pelvic Anomalies

This study aims to document the abdominal and pelvic anomalies that can be demonstrated using post mortem Micro-CT, independent of whether the anomaly contributed to the main diagnosis or cause of death.

We retrospectively analyzed 1200 whole body post-mortem fetal Micro-CT scans in an unselected, consecutive cohort between 2017 and 2024. Abdominal or pelvic anomalies were categorized into internal or external anomalies.

Overall, 277 individual abdominal/pelvic anomalies were identified in 196/1200 (16.3%) fetuses with a mean gestational age of 17 weeks (range 10-24; median 17, interquartile range 4), and a mean fetal body weight 96.5 g (range 0.25-484.2; median 48.3, interquartile range 105.6). Of these, 100/277 (36.1%) were abdominal only, 61/277 (22.0%) pelvic only, 27/277 (9.7%) were both, and 96/277 (34.7%) were external anomalies. The most common anomalies were abdominal-pelvic wall defects 84/277 (30.3%), and renal anomalies 77/277 (27.8%), with horseshoe kidneys 16/77 (20.8%) and cystic kidneys 13/77 (16.9%) being the most common renal anomalies. Severe maceration was identified in 80 fetuses (grade 5 or 6), although imaging was still diagnostic in most cases, with only 17/1200 (1.4%) non-diagnostic scans.

Post-mortem Micro-CT imaging can identify a wide range of abdominal/pelvic anomalies following pregnancy loss in early gestation fetuses, even in the presence of severe maceration.