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Maceration determines diagnostic yield of fetal and neonatal whole body post‐mortem ultrasound

Shelmerdine, SC; Langan, D; Mandalia, U; Sebire, NJ; Arthurs, OJ; (2019) Maceration determines diagnostic yield of fetal and neonatal whole body post‐mortem ultrasound. Prenatal Diagnosis 10.1002/pd.5615. (In press). Green open access

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Abstract

OBJECTIVES: To determine factors in non-diagnostic fetal and neonatal post-mortem ultrasound (PMUS) examinations. METHODS: All fetal and neonatal PMUS examinations were included over a 5 year study period (2014 - 2019). Non-diagnostic image quality by body parts (brain, spine, thorax, cardiac, abdomen) were recorded, and correlated with patient variables. Descriptive statistics and logistic regression analyses were performed to identify significant factors for non-diagnostic studies. RESULTS: 265 PMUS examinations were included, with median gestational age of 22 weeks (12 - 42 weeks), post-mortem weight 363g (16 - 4033g) and post-mortem interval of 8 days (0 - 39 days). Diagnostic imaging quality was achieved for 178/265 (67.2%) studies. It was high for abdominal (263/265, 99.2%); thoracic (264/265, 99.6%) and spine (265/265, 100%), but lower for brain (210/265, 79.2%) and cardiac imaging (213/265, 80.4%). Maceration was the best overall predictor for non-diagnostic imaging quality (p<0.0001). Post-mortem fetal weight was positively associated with cardiac (p =0.0133), and negatively associated with brain imaging quality (p =0.0002). Post-mortem interval was not a significant predictor. CONCLUSIONS: Fetal maceration was the best predictor for non-diagnostic PMUS, particularly for brain and heart. Fetuses with marked maceration and suspected cardiac or brain anomalies should be prioritised for post-mortem MRI.

Type: Article
Title: Maceration determines diagnostic yield of fetal and neonatal whole body post‐mortem ultrasound
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/pd.5615
Publisher version: https://doi.org/10.1002/pd.5615
Language: English
Additional information: Copyright © 2019 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10087219
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