Postmortem axial skeletal radiography can reveal fetal CNS malformations

The routinely performed autopsy of a macerated fetus will often be of dubious value, particularly as regards the examination of the central nervous system (CNS). Former studies have demonstrated a close relationship between certain CNS malformations and axial skeletal malformations revealed radiographically. In the present report a postmortem examination of a severely macerated fetus demonstrates a transsphenoidal encephalocele. A supplementary histological examination confirmed this condition and furthermore revealed absence of the pituitary gland. The findings were related to a strongly elevated serum alphafetoprotein level in the 18th gestational week. This report emphasizes the value of postmortem axial skeletal radiography of autolyzed fetuses suspected for CNS malformations.