Retrospective assessment of fetal and neonatal autopsies

This study aims to reveal the general profile of fetal and neonatal autopsies, identify prominent clinical features and diagnoses, and explore the contribution of autopsy findings to clinical practice. A total of 784 autopsies examined at the Hacettepe University Faculty of Medicine İhsan Doğramacı Children's Hospital Pediatric and Perinatal Pathology Unit between 2013 and 2022 were evaluated, of which 724 (92.3%) were fetal and 60 (7.7%) were neonatal autopsies. Among them, 743 (94.8%) were from Hacettepe hospitals, and 41 (5.2%) were referred from other centers. 418 (57.7%) fetuses were terminated, and 298 (41.2%) were intrauterine deaths. The most common cause for termination (57.9%) was congenital malformations. In fetal autopsies, multiple system findings were observed in 247 (34%) fetuses, while central nervous system findings were seen in 293 (40.4%) fetuses, being the most common. Regarding the contribution to antenatal assessment, 41.6% of fetal autopsies were classified as category 1 due to full agreement or lack of additional findings, 42.8% as category 2 due to minor contributions, 11% as category 3 due to major contributions, 1.2% as category 4 due to disagreement, 1.8% as category 5 due to partial agreement with presence of some unconfirmed clinical diagnoses, and 1.5% as category 6 due to limited information that could not be assessed optimally. Among the neonates, 35 (60.3%) were preterm and 23 (39.7%) were term, with an average age of 4.63 days (0–24 days). The most common clinical diagnosis was congenital heart disease, seen in 20 patients (33.3%). Multiple system findings were detected in 56 (93.3%) of neonatal autopsies. Respiratory system findings were most common, present in 54 (90%) cases. As for classification regarding the contribution of neonatal autopsy findings to clinical assessment, 18.3% of cases were classified as category 1, 65% as category 2, 15% as category 3, and 1.7% as category 6. In addition to the supplementary findings provided by the autopsy, confirmation of clinical diagnoses by post mortem examination is also an important contribution. Clinicians should be aware of the possibility and contributions of autopsy examination following the death of a patient and present this option to the families. Keywords: Fetus, newborn, autopsy, postmortem examination