Role of fetal autopsy and its importance in intrauterine fetal death: Histopathological diagnosis

 Intrauterine fetal death (IUFD)/stillbirth accounts for a significant portion of perinatal mortality and is thus a good indicator of healthcare system quality. Autopsy is a well-known specialized surgical procedure used to determine the cause of death. The study's goal is to learn the cause of death, the prevalence of congenital anomalies, and to confirm the diagnosis histopathologically.

 The study included 32 cases of all terminated pregnancies from 12 to 38 weeks due to abnormal prenatal findings and IUFDs received for autopsy in the department of pathology over a four-year period from 2018 to 2022. Autopsies were carried out in accordance with standard protocol, and included external and internal examinations with photography, as well as gross and microscopic examinations of various organs and the placenta.

 Over a four-year period, Abnormalities detected via autopsy are 32 (80%) out of 40 cases, whereas ultrasound findings detected about 11(27.5%) out of 40 cases. Thus, autopsy added to the diagnosis about 47.5%. External anomalies noted in 9 cases and internal anomalies noted in 14 cases. Gestational age of fetuses in intrauterine deaths in our study is early deaths (55%). The most common cause of death was fetal causes (37.5%), followed by placental causes (35%) and two amniotic fluid causes (5%). In congenital causes central nervous system anomalies [(6 cases) which include Arnold Chiari malformation (2 cases), Potter syndrome (1 case), hydrocephalus (3 cases)] were the most common followed by cardiovascular system malformations [(4 cases) which include VSD (2 cases), dextrocardia (1 case), hypoplastic left heart syndrome (1)]. Placental lesions were present in 14 (27.5%) of the cases.

 The most common cause of death was congenital anomalies. Though the number of perinatal autopsies has decreased in recent years, fetal autopsies continue to play an important role in determining the cause of disease. It is considered the gold standard for diagnosis, giving parents hope for the future.