Less‐invasive autopsy for early pregnancy loss

Author:

Simcock Ian C.123ORCID,Lamouroux Audrey1456ORCID,Sebire Neil J.237,Shelmerdine Susan C.123ORCID,Arthurs Owen J.123ORCID

Affiliation:

1. Department of Clinical Radiology Great Ormond Street Hospital for Children London UK

2. UCL Great Ormond Street Institute of Child Health Great Ormond Street Hospital for Children London UK

3. NIHR Great Ormond Street Hospital Biomedical Research Centre London UK

4. Obstetrical Gynaecology Department Nîmes University Hospital Nîmes France

5. Clinical Genetics Department Montpellier University Hospital Montpellier France

6. ICAR Research Team LIRMM, CNRS and Charles Coulomb Laboratory UMR 5221 CNRS‐UM BNIF User Facility Imaging University of Montpellier Nîmes and Montpellier Montpellier France

7. Department of Histopathology Great Ormond Street Hospital for Children London UK

Abstract

AbstractAutopsy investigations provide valuable information regarding fetal death that can assist in the parental bereavement process, and influence future pregnancies, but conventional autopsy is often declined by parents because of its invasive approach. This has led to the development of less‐invasive autopsy investigations based on imaging technology to provide a more accessible and acceptable choice for parents when investigating their loss. Whilst the development and use of more conventional clinical imaging techniques (radiographs, CT, MRI, US) are well described in the literature for fetuses over 20 weeks of gestational age, these investigations have limited diagnostic accuracy in imaging smaller fetuses. Techniques such as ultra‐high‐field MRI (>3T) and micro‐focus computed tomography have been shown to have higher diagnostic accuracy whilst still being acceptable to parents. By further developing and increasing the availability of these more innovative imaging techniques, parents will be provided with a greater choice of acceptable options to investigate their loss, which may in turn increase their uptake. We provide a narrative review focussing on the development of high‐resolution, non‐invasive imaging techniques to evaluate early gestational pregnancy loss.

Funder

Programme Grants for Applied Research

Publisher

Wiley

Subject

Genetics (clinical),Obstetrics and Gynecology

Reference115 articles.

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