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Post‐mortem apparent resolution of fetal ventriculomegaly: evidence from magnetic resonance imaging
Author(s) -
Sebire Neil J.,
Miller Sarah,
Jacques Thomas S.,
Taylor Andrew M.,
Rennie Janet M.,
Kendall Giles,
Chitty Lyn S.
Publication year - 2013
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4065
Subject(s) - ventriculomegaly , autopsy , medicine , magnetic resonance imaging , radiology , prenatal ultrasound , fetus , pregnancy , prenatal diagnosis , pathology , biology , genetics
Objective This study aims to determine the accuracy of post‐mortem magnetic resonance imaging (MRI) and autopsy for confirmation of sonographically detected fetal ventriculomegaly. Methods This study uses retrospective review of fetuses with sonographically diagnosed ventriculomegaly, where the pregnancy was terminated and post‐mortem examination was performed during a period in which post‐mortem MRI was being offered. Results Sixteen cases were identified. In nine (56%), autopsy and/or post‐mortem MRI confirmed the prenatal findings. In the other seven, both autopsy and post‐mortem MRI demonstrated no ventriculomegaly, but antenatal MRI confirmed the ultrasound findings in 6/7 cases where it had been performed. Post‐mortem investigations confirmed antenatal findings in 8/9 cases with severe ventriculomegaly (posterior horn measurement >15 mm), whereas only 2/7 in which ventriculomegaly was not confirmed had severe ventriculomegaly. Conclusions Post‐mortem examination, both by traditional neuropathological examination, and post‐mortem MRI may fail to confirm prenatal ventriculomegaly in around half of cases. The post‐mortem MRI findings indicate that this is due to resolution of ventriculomegaly rather than autopsy artefact, and is presumably a consequence of post‐mortem fluid redistribution. Parents should be advised before termination of pregnancy that post‐mortem confirmation of ventriculomegaly, especially in mild cases, may not be possible. Antenatal MRI may be a better approach for confirming prenatal ultrasound findings. © 2013 John Wiley & Sons, Ltd.