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%).
Full Text
The Full Text of this article is available as a PDF (159.9 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Cremin B. J., Draper R. The value of radiography in perinatal deaths. Pediatr Radiol. 1981;11(3):143–146. doi: 10.1007/BF00971816. [DOI] [PubMed] [Google Scholar]
- Foote G. A., Wilson A. J., Stewart J. H. Perinatal post-mortem radiography--experience with 2500 cases. Br J Radiol. 1978 May;51(605):351–356. doi: 10.1259/0007-1285-51-605-351. [DOI] [PubMed] [Google Scholar]
- Griscom N. T., Driscoll S. G. Radiography of stillborn fetuses and infants dying at birth. AJR Am J Roentgenol. 1980 Mar;134(3):485–489. doi: 10.2214/ajr.134.3.485. [DOI] [PubMed] [Google Scholar]
- Grønvall J., Graem N. Radiography in post-mortem examinations of fetuses and neonates. Findings on plain films and at arteriography. APMIS. 1989 Mar;97(3):274–280. doi: 10.1111/j.1699-0463.1989.tb00788.x. [DOI] [PubMed] [Google Scholar]
- Mueller R. F., Sybert V. P., Johnson J., Brown Z. A., Chen W. J. Evaluation of a protocol for post-mortem examination of stillbirths. N Engl J Med. 1983 Sep 8;309(10):586–590. doi: 10.1056/NEJM198309083091004. [DOI] [PubMed] [Google Scholar]
- Olsen Øystein E., Lie Rolv T., Lachman Ralph S., Maartmann-Moe Helga, Rosendahl Karen. Ossification sequence in infants who die during the perinatal period: population-based references. Radiology. 2002 Oct;225(1):240–244. doi: 10.1148/radiol.2251011130. [DOI] [PubMed] [Google Scholar]
- Olsen Øystein E., Lie Rolv T., Maartmann-Moe Helga, Pirhonen Jouko, Lachman Ralph S., Rosendahl Karen. Skeletal measurements among infants who die during the perinatal period: new population-based reference. Pediatr Radiol. 2002 Jul 26;32(9):667–673. doi: 10.1007/s00247-001-0627-x. [DOI] [PubMed] [Google Scholar]
- Reinus W. R. Expanding the sphere of outcomes of research in radiology. Radiology. 1997 Apr;203(1):13–15. doi: 10.1148/radiology.203.1.9122380. [DOI] [PubMed] [Google Scholar]
- Seppänen U. The value of perinatal post-mortem radiography. Experience of 514 cases. Ann Clin Res. 1985;17 (Suppl 44):1–59. [PubMed] [Google Scholar]
- Skjaerven R., Gjessing H. K., Bakketeig L. S. Birthweight by gestational age in Norway. Acta Obstet Gynecol Scand. 2000 Jun;79(6):440–449. [PubMed] [Google Scholar]
- Stempflé N., Huten Y., Fondacci C., Lang T., Hassan M., Nessmann C. Fetal bone age revisited: proposal of a new radiographic score. Pediatr Radiol. 1995;25(7):551–555. doi: 10.1007/BF02015793. [DOI] [PubMed] [Google Scholar]
- Thornbury J. R. Eugene W. Caldwell Lecture. Clinical efficacy of diagnostic imaging: love it or leave it. AJR Am J Roentgenol. 1994 Jan;162(1):1–8. doi: 10.2214/ajr.162.1.8273645. [DOI] [PubMed] [Google Scholar]
- Winter R. M., Sandin B. M., Mitchell R. A., Price A. B. The radiology of stillbirths and neonatal deaths. Br J Obstet Gynaecol. 1984 Aug;91(8):762–765. doi: 10.1111/j.1471-0528.1984.tb04846.x. [DOI] [PubMed] [Google Scholar]