Sreenivas Athira, Lewis Leslie, Purkayastha Jayashree, Lakshmi R Vani, Mathew Mary
Centre for Foetal and Perinatal Pathology, Department of Pathology, Kasturba Medical College, Manipal, India.
Manipal Academy of Higher Education, Manipal, Karnataka, India.
Forensic Sci Med Pathol. 2025 Aug 21. doi: 10.1007/s12024-025-01069-6.
Neonatal mortality is a significant public health concern which requires accurate identification of the cause of death (CoD). There has been a decline in conventional diagnostic autopsy (CDA) globally due to ethical and cultural barriers, resulting in lack of comprehensive data on neonatal deaths. Minimally invasive tissue sampling (MITS) of organs has emerged as an innovative alternative to CDA as it is less invasive and feasible. This study evaluates the effectiveness of MITS versus CDA in determining the cause of death in neonates.
This was a single-center observational study conducted on 100 neonatal autopsies. The demographic, clinical, imaging data and ancillary tests were analyzed prior to performing both the techniques. Sensitivity, specificity, positive predictive value, negative predictive value, and interrater reliability were assessed.
The concordance rate for lesions in the brain, lung, and liver in MITS versus CDA was 79%, 84%, and 94% respectively. There was high sensitivity and specificity for intraventricular hemorrhage (IVH) and hyaline membrane disease (HMD) by the MITS technique, however it was not useful in detecting focal and peripheral lesions in organs.
MITS is a promising alternative to CDA with comparable diagnostic accuracy in determining causes of death in neonates.
新生儿死亡率是一个重大的公共卫生问题，需要准确确定死因。由于伦理和文化障碍，全球传统诊断性尸检（CDA）数量有所下降，导致缺乏关于新生儿死亡的全面数据。器官的微创组织采样（MITS）作为一种创新性替代方法已出现，因为它侵入性较小且可行。本研究评估了MITS与CDA在确定新生儿死因方面的有效性。
这是一项针对100例新生儿尸检的单中心观察性研究。在进行这两种技术之前，对人口统计学、临床、影像学数据及辅助检查进行了分析。评估了敏感性、特异性、阳性预测值、阴性预测值及评分者间信度。
MITS与CDA在脑、肺和肝脏病变方面的一致性率分别为79%、84%和94%。MITS技术对脑室内出血（IVH）和透明膜病（HMD）具有较高的敏感性和特异性，然而在检测器官的局灶性和周边病变方面并无作用。
MITS是CDA的一种有前景的替代方法 在确定新生儿死因方面具有相当的诊断准确性。
