Fetal and Neonatal Autopsy: A Morphological Study and Correlation with Prenatal Anomaly Scan

Background: Congenital malformations are the leading factor of perinatal death and childhood morbidity. Present study was aimed to compare congenital malformations detected prenatally by ultrasonography and postnatally by fetal autopsy and also the quantum of additional information autopsy can provide. Material and Methods: Present study was hospital based cross sectional studyof fetal and neonatal autopsies conducted in cases terminated for anomalies, intrauterine fetal demise and stillbirths in the second and third trimester. First trimester cases were excluded. Results: Eighty one fetal / neonatal autopsies were studied. Majority were terminated pregnancies before 24 weeks of gestation for congenital anomalies (93 %) and birth weight less than 1000 grams (75.3 %). Ultrasonography(USG) showed concordance with autopsy in 78% cases, discordance in 5% cases and additional findings were seen in 6% cases. Common congenital anomalies were central nervous system (CNS) defects (41.4 %), genitourinary(GU) defects (21.9 %), congenital heart defects (CHD) (4.9%), gastrointestinal(GI) defects (9.75%), musculoskeletal defects (14.6%), respiratory defects (7.3 %), cystic hygroma (1.23%) and fetal hydrops (1.23%). Autopsy added diagnosis in 05 cases (6 %) as bilobed right lung (2), omphalocele (1), anencephaly (1) and horseshoe shaped kidney (1).Conclusion: Parents should be encouraged for autopsy in view of counseling for future pregnancies. Anomaly scan predicts the malformations in the fetus but autopsy is necessary to confirm the anomaly and also to look for additional malformations. Thus autopsy can help parents in planning and management of future pregnancies.