Craven C M, Dempsey S, Carey J C, Kochenour N K
Department of Pathology, University of Utah, Salt Lake City.
Obstet Gynecol. 1990 Oct;76(4):684-8.
This study was designed to evaluate changes in the perinatal autopsy following the adoption of a new autopsy protocol. The University of Utah Medical Center has a Prenatal Diagnosis Conference Team composed of obstetricians, pediatricians, geneticists, and other health care professionals. These individuals are involved in the care of patients whose pregnancies are at risk for congenital malformations. An autopsy protocol was designed to increase the interaction of the pathologist with the Prenatal Diagnosis Conference Team in the evaluation of perinatal death. Two years, 1982 and 1987, before and after the protocol was implemented, were selected for retrospective review. The autopsies in 1987 made more specific diagnoses compared with those in 1982. Additional congenital anomalies were diagnosed, and increased numbers of patients were found to have well-described congenital disorders. The number of attempted postnatal autopsy chromosome studies increased and more chromosomal abnormalities were detected. The final autopsy diagnoses made in 1987 have provided more information to the physician for genetic or other patient counseling. After the protocol was adopted, increased numbers of cases were referred to the Medical Center for evaluation at autopsy. More of those who came to autopsy had been evaluated during life by members of the Prenatal Diagnosis Conference Team. Premortem sonograms had been done at an earlier gestational age and a greater number of anomalies were detected. Fewer of the fetuses had intrauterine death and more had pregnancy terminated by induction of labor. The gestational age at delivery declined.
本研究旨在评估采用新的尸检方案后围产期尸检的变化。犹他大学医学中心有一个由产科医生、儿科医生、遗传学家和其他医疗保健专业人员组成的产前诊断会议团队。这些人员参与对妊娠有先天性畸形风险的患者的护理。设计了一个尸检方案，以增加病理学家与产前诊断会议团队在评估围产期死亡方面的互动。选择了该方案实施前后的1982年和1987年这两年进行回顾性审查。与1982年相比，1987年的尸检做出了更具体的诊断。诊断出了更多的先天性异常，并且发现有更多患者患有描述详细的先天性疾病。尝试进行产后尸检染色体研究的数量增加，并且检测到更多的染色体异常。1987年做出的最终尸检诊断为医生提供了更多用于遗传咨询或其他患者咨询的信息。采用该方案后，被转介到医学中心进行尸检评估的病例数量增加。更多前来尸检的患者在生前已由产前诊断会议团队的成员进行了评估。生前超声检查在更早的孕周进行，并且检测到更多的异常。死产的胎儿减少，更多胎儿通过引产终止妊娠。分娩时的孕周下降。
