Minimally invasive autopsy in the evaluation of fetal malformations and stillbirths: A feasibility study

Abstract

AbstractBackgroundMinimally invasive autopsy (MIA) using post‐mortem magnetic resonance imaging with ancillary investigations is reported as accurate as conventional autopsy. This study assesses MIA's feasibility and accuracy compared to conventional autopsy.MethodMIA and/or conventional autopsy were performed on malformed fetuses (14–20 weeks gestation) and stillbirths (>20 weeks gestation), with/without malformation. Concordance in diagnostic accuracy (95% confidence interval [CI]) and agreement (Kappa coefficient [k]) were assessed in malformed cases where both MIA and autopsy were conducted.ResultsWe enrolled 200 cases, including 100 malformed fetuses (<20 weeks) and 100 stillbirths (with/without malformations). Concordance of 97.3% was observed between MIA and autopsy in 156 malformed cases. The overall diagnostic accuracy of MIA was 96.04%.ConclusionWhile conventional autopsy remains the gold standard, MIA is feasible in tertiary care settings. It can be considered a potential alternative for post‐mortem assessment, particularly in settings with limited facility of conventional autopsy and parental refusal.