Standardization of minimally invasive tissue sampling (MITS) technique for intestinal sampling in neonatal autopsies

Conventional diagnostic autopsy (CDA) is the gold standard for determining the cause of death but is limited by sociocultural constraints. Minimally invasive tissue sampling (MITS) is a feasible alternative for CDA. This study aimed to standardize the intestinal MITS technique for neonatal autopsies. This prospective study included 20 deceased neonates, in which the feasibility and diagnostic utility of intestinal minimally invasive tissue sampling (MITS) using a transabdominal Bard Monopty 16G needle were compared with CDA. Diagnostic accuracy was measured with 95% confidence intervals, and measures of agreement were evaluated. Small intestinal and large intestinal tissue retrieval was successful in 95% and 85% of cases, respectively. MITS showed high sensitivity and specificity for detecting normal histology, early intestinal ischemic changes and small-intestinal necrotizing enterocolitis (NEC). The standardized intestinal MITS is feasible and a reliable alternative to CDA, particularly in culturally sensitive or low-resource settings.