Hasegawa Junichi, Wakasa Tomoko, Matsumoto Hiroshi, Takeuchi Makoto, Kanayama Naohiro, Tanaka Hiroaki, Katsuragi Shinji, Nakata Masahiko, Murakoshi Takeshi, Osato Kazuhiro, Nakamura Masamitsu, Sekizawa Akihiko, Ishiwata Isamu, Ikeda Tomoaki
a Department of Obstetrics and Gynecology , St. Marianna University School of Medicine , Kanagawa , Japan.
b Department of Diagnostic Pathology , Nara Hospital, Kindai University Faculty of Medicine , Ikoma , Japan.
J Matern Fetal Neonatal Med. 2018 Feb;31(3):333-338. doi: 10.1080/14767058.2017.1285890. Epub 2017 Feb 14.
To clarify the necessity for and problems related to autopsy for determining the cause of maternal death in Japan.
Women who died during pregnancy or within a year after delivery were analyzed by the Maternal Death Exploratory Committee between 2012 and 2015 in Japan. Maternal deaths were analyzed to verify the requirement of autopsy in cases in which autopsy was performed and the need for autopsy in cases in which it was not performed.
Among the 49 cases performed autopsy, the final diagnosis was compatible with the clinical course in 24 cases, while the autopsy diagnosis was incompatible with the clinical course in 13 cases. In two cases, the final diagnosis was based on the clinical course, but an autopsy could exclude other possible causes. In three cases, no exact cause of maternal death was identified after autopsy. On the other hand, in cases without an autopsy, the final diagnosis was made using ante-mortem operating findings and surgical specimens in twenty-one cases. Though, thirty-one cases were estimated diagnosis based on post-mortem imaging or ante-mortem examinations, the exact original cause of death was not determined in 25 cases, and the cause of death could not be identified in eight cases without autopsy.
Because in most cases the autopsy provides an exact cause of death, the necessity of autopsies should be more widely accepted in Japan.
阐明在日本进行尸检以确定孕产妇死亡原因的必要性及相关问题。
日本孕产妇死亡探索委员会对2012年至2015年期间在孕期或分娩后一年内死亡的女性进行了分析。对孕产妇死亡病例进行分析，以核实已进行尸检病例中尸检的必要性以及未进行尸检病例中进行尸检的必要性。
在49例进行了尸检的病例中，最终诊断与临床病程相符的有24例，而尸检诊断与临床病程不符的有13例。在2例中，最终诊断基于临床病程，但尸检可排除其他可能原因。在3例中，尸检后未确定确切的孕产妇死亡原因。另一方面，在未进行尸检的病例中，21例根据生前手术所见和手术标本做出最终诊断。不过，31例是基于死后影像学检查或生前检查做出的推测性诊断，25例未确定确切的原始死亡原因，8例未进行尸检则无法确定死亡原因。
由于在大多数情况下尸检能提供确切的死亡原因，在日本应更广泛地接受尸检的必要性。
