Andruszkow J, Weichert W, Braunschweig T, Knüchel-Clarke R, Erlmeier F
Institut für Pathologie, Uniklinikum der RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.
Institut für Pathologie, Technische Universität München, München, Deutschland.
Pathologe. 2017 Sep;38(5):438-447. doi: 10.1007/s00292-017-0324-7.
Fetal autopsy rates are decreasing in Western countries although post-mortem examinations render important information for the parents concerning the cause of abortion and risk of recurrence in future pregnancies.
The intention of the presented study was to analyze the development of fetal autopsies in Germany during the last decade and to review accessible information obtained by fetal autopsy.
Reports of fetal autopsies conducted in two German university Institutes of pathology between 2005 and 2014 were evaluated retrospectively. Demographic data and the correlation between clinical diagnoses and autopsy findings were assessed. In addition, differences between spontaneous and induced cases of abortion and differences between the institutes were also documented.
Overall, 428 fetal autopsies were performed, whereby the number of autopsies decreased by 24.2% during the study period. Of the examined fetuses 29.7% were induced abortions which as expected exhibited different malformations compared to cases of spontaneous abortion (p < 0.001). There was no evidence of a malformation or other cause of death in 27.1% of the cases and 95.7% of these abortions occurred spontaneously. A discrepancy between clinical and autopsy findings was evident in 6.8% of cases and 3.5% of the autopsy examinations revealed at least one additional malformation compared to the prenatal clinical data.
Despite improvements in prenatal diagnostics, fetal autopsies remain an important diagnostic tool even today contributing additional information in a considerable number of cases potentially revising clinical diagnoses.
尽管尸检能为父母提供有关流产原因及未来妊娠复发风险的重要信息，但西方国家的胎儿尸检率仍在下降。
本研究旨在分析德国过去十年间胎儿尸检的发展情况，并回顾通过胎儿尸检获得的可获取信息。
对2005年至2014年间在德国两所大学病理研究所进行的胎儿尸检报告进行回顾性评估。评估人口统计学数据以及临床诊断与尸检结果之间的相关性。此外，还记录了自然流产和人工流产病例之间的差异以及各研究所之间的差异。
总体而言，共进行了428例胎儿尸检，在此研究期间尸检数量减少了24.2%。在接受检查的胎儿中，29.7%为人工流产，与自然流产病例相比，人工流产胎儿出现了不同的畸形（p < 0.001）。27.1%的病例未发现畸形或其他死亡原因，其中95.7%的流产为自然流产。6.8%的病例临床诊断与尸检结果存在差异，3.5%的尸检发现至少有一种与产前临床数据相比额外的畸形。
尽管产前诊断有所改善，但即使在今天，胎儿尸检仍然是一种重要的诊断工具，在相当数量的病例中能提供额外信息，可能会修正临床诊断。
