Berger C, Pierre F, Moraine C
Département de Gynécologie-Obstétrique, CHU Bretonneau, Tours.
Rev Fr Gynecol Obstet. 1990 Jul-Sep;85(7-9):445-52.
The authors studied two series of deaths (437 cases in all), one from a prospective study on the Centre region and the other from a retrospective study on the Tourangelle region; they compared the clinical and paraclinical data recorded during pregnancy, labour and the neonatal period to the autopsy results and those of the different tissue examinations, and strived to define the most judicious indications for autopsies in case of perinatal death. From their conclusions, based on the clinical context of the death, 5 different types of situations can be distinguished: for two of them, namely the medico-legal context and the malformation context, the post mortem examination seems indispensable for different reasons. In case of "obvious clinical diagnosis", the need for an autopsy has not been proven. However, when the clinical diagnosis seems "probable" or when the aetiology has not been found clinically, the post mortem examination of the foetal body is recommended, although certain particular situations, related to the age of the mother, the parity, the interest shown by the couple about the result, to ethnic or religious factors, may lead to the request of only a limited examination, which is much less expensive.