The importance of perinatal autopsy. Review of the literature and series of cases.

Perinatal autopsy remains the gold-standard procedure used to establish the fetal, neonatal or infant abnormalities. Progressively, perinatal pathology has become a specialized field with important roles of audit for fetal prenatal diagnostic tools, in parents counseling regarding future pregnancies, in scientific research, for epidemiology of congenital abnormalities and teaching. The differences between prenatal ultrasound and autopsy reports represent a strong argument for the autopsy examination following termination of pregnancy. The reasons for such discrepancies are related to the ultrasonographic or pathological examination conditions, the type of the anomalies, the expertise and availability of the operators. Several facts led to an undesirable increase of refusals from parents to consent to a conventional invasive autopsy: the centralization of pathology services, the poor counseling provided by non-experts in fetal medicine and the clinicians' over-appreciation of the importance of the ultrasound diagnostic investigation. Although non-invasive alternatives have been tested with promising results, conventional autopsy remains the gold standard technique for the prenatal diagnosis audit. We report and analyze several cases of prenatally diagnosed malformed fetuses with different particularities that underline the necessity of perinatal autopsy. We discuss the antenatal findings and management and post-mortem autopsies in the respective pregnancies.

Macroscopic deciduosis in pregnancy is finally a common entity.

OBJECTIVE: The primary aim of our study was to determine the prevalence of macroscopic deciduosis Found randomly in Cesarean sections and the secondary objective to determine the association with any obstetrical complications or adverse effects. METHODS: This is a unicenter prospective study from 01/08/2011 to 01/02/2014. During the study period 307 consecutive Cesarean sections were performed with 31 biopsy proven cases of macroscopic deciduosis in the ovary, uterine and fallopian tube serosa. RESULTS: The mean age of the patients was 31.2 ± 5.4 years (range 13-43), the mean Body Mass Index was 26.3 ± 5.8 (range 15-48)kg/m(2), the mean term of Cesarean was 270 ± 25 days, and the mean fetal weight was 3094 ± 809 g. The majority of patients were Caucasian (n=175, 57.0%). Patients with deciduosis had a greater BMI (28.4 ± 5.3 kg/m(2) vs 25.7 ± 5.8 kg/m(2), p<0.05). The presence of pain was more frequent in the deciduosis group (10.1%, OR 5.78, 95%, CI [2.41-13.87], p<0.001). CONCLUSION: Deciduosis is a benign lesion during pregnancy that is not correlated with obstetrical complications. Our study has shown that this physiological phenomenon is more frequent that originally thought, being present in 10% of the Cesarean sections, and is associated with abdominal pain during pregnancy.