Significance and Acceptance of Fetal Autopsy: A Study From a Tertiary Care Hospital in North India

Parul Jaiswal, Alka Sehgal, Bharti Goel, Anupriya Kaur

Abstract

Background and Aim: The diagnosis of preventable causes of neonatal mortality, such as congenital malformations, is a big challenge in developing countries. Fetal autopsy helps refine ultrasonographic (USG) findings and add more to the available knowledge that may be pertinent for counseling before planning the next conception.

Materials and Methods: Our study enrolled 86 antenatal mothers whose fetuses were found to have congenital defects on USG. Factors associated with fetal malformations and acceptance of fetal autopsy were assessed. The USG findings were compared with the autopsy findings.

Results: Of the 86 couples, 53 couples (61.62%) were convinced for autopsy, while the remaining 33 couples (38.37%) refused. Of the 53 fetuses that underwent autopsy, the autopsy findings matched with that of the USG in 43 (81.13%) cases. Of the 53 couples who consented for fetal autopsy, 71.79% of them were in the age group of 20 to 25 years. Of the 38 couples, 18 couples (47.37%) that belong to class V socioeconomic strata refused autopsy. Of those who consented for autopsy, 100% (5/5) had a history of pregnancies with malformation and 54.16% were those with the history of previous abortion. There were 10 cases in which fetal malformations were detected at > 34 weeks of gestation, of which 8 (80%) refused autopsy.

Conclusions: Fetal autopsy should be a mandatory part of the workup to confirm the USG findings and to look for additional minor malformations. Counseling should be done by dedicated counselors to increase the acceptance of fetal autopsy in developing countries.