Article Text

The role of multidetector CT in the evaluation of stillbirth: a feasibility study
  1. CP Sheridan1,
  2. JE Benson1,
  3. K O'Regan2,
  4. OJ O'Connor2,
  5. R Chopra2,
  6. N Moore2,
  7. M Murphy2,
  8. JR Higgins1,3,
  9. M Maher2,3,
  10. K O'Donoghue1,3
  1. 1Cork Uiniversity Maternity Hosptial, Cork, Ireland
  2. 2Cork University Hospital, Cork, Ireland
  3. 3University College Cork, Cork, Ireland

Abstract

Objective Autopsy is a key component in evaluating intrauterine death (IUD); however the number of parents consenting to autopsy is declining. This has undermined clinicians' ability to assess aetiology and limits counselling regarding recurrence. Consequently, this has led to a search for alternative methods of evaluating IUD, including postmortem radiological imaging. The aim of this study was to evaluate the role of CT in the assessment of IUD.

Study Design A collaborative prospective study recruited parents following third trimester IUD. Infants were scanned using multidetector CT (MDCT) and images were analysed for image quality, anthropomorphic measurements and pathologic findings. Findings were correlated with obstetric history and autopsy.

Results Nine third trimester stillborn infants were scanned (31+6 to 37+6/40). Biometric and organ-specific measurements were performed. Most internal organs were easily visualised and image quality was graded as good to excellent for most structures. Significant findings included hepatomegaly (not reported at autopsy) and abnormal renal/adrenals. Novel measurements included surface rendered muscle mass and volume. Autopsy was performed in four cases where findings correlated well. Limitations of CT resulted from cellular changes, such as putrefaction and clot formation.

Conclusion Preliminary data are encouraging and warrants further evaluation. This feasibility study has added weight to growing body of evidence which supports the use of radiologic imaging postmortem. The combination of MDCT and surface rendering offers high resolution images of the stillborn infant without disrupting the integrity of the body and yields this information in a timely manner.

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