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Diagnostic value of radiography in cases of perinatal death: a population based study
  1. Ø E Olsen1,
  2. A Espeland1,2,
  3. H Maartmann-Moe3,
  4. R S Lachman4,
  5. K Rosendahl1,2
  1. 1Department of Radiology, Haukeland University Hospital, Bergen, Norway
  2. 2Section of Radiology, Department of Surgery, University of Bergen Medical School
  3. 3Department of Pathology, Haukeland University Hospital
  4. 4International Skeletal Dysplasia Registry, Cedars-Sinai Medical Center, Los Angeles CA, USA
  1. Correspondence to:
    Dr Olsen
    Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK; oeolstart.no

Abstract

Objective: To examine the yield of radiographic abnormalities in a population based set of perinatal deaths, the diagnostic value of whole body postmortem radiographs in the same set, and previous factors that may increase the proportion of useful examinations.

Design: Retrospective population based study.

Setting: A region of Norway.

Patients: All infants from a well defined geographical area who were stillborn or had died soon after birth over an 11 year period (n=542), who had routinely undergone whole body radiography and autopsy.

Main outcome measures: (a) Proportion of cases with abnormal radiographic findings. (b) Proportion of abnormal radiographs providing new information that was useful for postmortem diagnosis.

Results: Radiographs were abnormal in 162/542 cases (30%). These provided new information about, but did not help to confirm, the pathological process leading to death in 14/162 (8.6%), may have helped to confirm, but not establish, the cause(s) of death in 1/162 (0.6%), and were of vital importance for establishing the cause(s) of death in 5/162 (3.1%). Among infants with external malformations, the proportion of useful radiographs was 12/100 (12%), and among the remainder it was 8/436 (1.8%), a difference of 10.2% (95% confidence interval 3.7% to 16.7%; data missing for six cases).

Conclusions: The diagnostic value of postmortem radiography in this population based set was low. However, radiographic findings were of vital importance for establishing the cause(s) of death in 5/542 cases (0.9%).

  • radiography
  • diagnostic test
  • mortality
  • perinatal

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