ORIGINAL ARTICLE

Diagnostic value of radiography in cases of perinatal death: a population based study

Ø E Olsen¹, A Espeland^1,2, H Maartmann-Moe³, R S Lachman⁴ and K Rosendahl^1,2

¹ Department of Radiology, Haukeland University Hospital, Bergen, Norway
² Section of Radiology, Department of Surgery, University of Bergen Medical School
³ Department of Pathology, Haukeland University Hospital
⁴ International Skeletal Dysplasia Registry, Cedars-Sinai Medical Center, Los Angeles CA, USA

Correspondence to:
Correspondence to:
Dr Olsen
Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK; oeol{at}start.no

Objective: To examine the yield of radiographic abnormalities in a population based set of perinatal deaths, the diagnostic value of whole body postmortem radiographs in the same set, and previous factors that may increase the proportion of useful examinations.

Design: Retrospective population based study.

Setting: A region of Norway.

Patients: All infants from a well defined geographical area who were stillborn or had died soon after birth over an 11 year period (n=542), who had routinely undergone whole body radiography and autopsy.

Main outcome measures: (a) Proportion of cases with abnormal radiographic findings. (b) Proportion of abnormal radiographs providing new information that was useful for postmortem diagnosis.

Results: Radiographs were abnormal in 162/542 cases (30%). These provided new information about, but did not help to confirm, the pathological process leading to death in 14/162 (8.6%), may have helped to confirm, but not establish, the cause(s) of death in 1/162 (0.6%), and were of vital importance for establishing the cause(s) of death in 5/162 (3.1%). Among infants with external malformations, the proportion of useful radiographs was 12/100 (12%), and among the remainder it was 8/436 (1.8%), a difference of 10.2% (95% confidence interval 3.7% to 16.7%; data missing for six cases).

Conclusions: The diagnostic value of postmortem radiography in this population based set was low. However, radiographic findings were of vital importance for establishing the cause(s) of death in 5/542 cases (0.9%).

Keywords: radiography; diagnostic test; mortality; perinatal

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