Monday, April 18, 2005

Post-mortem MRI as an adjunct to fetal or neonatal autopsy.

Griffiths PD, Paley MN, Whitby EH.
CONTEXT: Understanding what was wrong with a dead fetus or why a newborn child died can help the parents to grieve, while any findings can be used to inform the parents if there is a risk to future pregnancies and the level of risk. This information is mainly obtained from autopsies, but the number of parents agreeing to autopsy has dropped, which has prompted the search for adjuncts to autopsy.
STARTING POINT: The UK's Chief Medical Officer outlined the rationale for exploring alternatives to autopsy in 2000 and 2001. After wide consultation, MRI was deemed to offer the most realistic chance of making a contribution. Results so far are promising, but of insufficient depth and quality to make firm recommendations about providing a service in the future. In 2004, the UK Department of Health therefore tendered for this research to be done in fetal and neonatal (and adult) cases, and this work is due to start in 2005.
WHERE NEXT? High-quality anatomical information about the brain and spine of fetuses and neonates can be easily obtained with standard MRI scanners. Most developmental and acquired abnormalities can be seen on post-mortem MRI. More work needs to be done on organs not in the central nervous system, and heart malformations, in particular, might present diagnostic problems. A possible outcome could be whole-body MRI plus targeted biopsies of abnormalities taken under image guidance as an adjunct to formal autopsy.
Lancet. 2005 Apr;365(9466):1271-3.

2 comments:

sids said...

thanks sumer! well this is a good technique for these still borns,especially ones with trisomy or holoprosencephaly as daignosing these abnormalitites in these failed pregnancies has prognostic implications for future pregnancies.
for diagnosing a posterior fossa abnormality,when should we get an MRI in the mother antenatally?
recenty we had a child with a posterior fossa abnormality in our hospital

Anonymous said...

usual antenatal posterior fossa abnormalities are usually picked up by good quality antenatal US... wat was the abnormality in ur case??

Sumer Sethi

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