A Retrospective Study on Perinatal Post Mortems

Abstract

A detailed post mortem examination is the key to the recognition of pathologies related to perinatal deaths. Post mortem findings assist the clinical team in confirming their clinical and radiological findings and the family for future pregnancy planning. However, this facility is still underutilized in Sri Lanka. Furthermore, examination of the placentas is an important aspect in recognizing the cause of perinatal death. The department of pathology, faculty of medicine, University of Kelaniya provides the perinatal pathology service to the Obstetrics and Gynaecology unit and the neonatal unit of the Teaching Hospital Ragama. This study was carried out in view of improving and expanding the perinatal pathology service provided by the department. Objectives were (1). To identify the number of perinatal post mortems (PPMs) reported over a period of six years. (2). To identify the number of PPMs that showed multiple congenital anomalies (3). To identify the number of PPMs accompanied by a placenta and the number of placentas with identifiable pathology. This was a retrospective study on already reported PPMs in the Department of Pathology, Faculty of medicine, University of Kelaniya, From January 2011 to August 2016. The PPM databases maintained in the department were used to extract data. A total of 118 PPMs were reported (2011-17, 2012-16, 2013- 17, 2014-21, 2015-31, 2016-16). 65 % (75/118) were premature deliveries. 56% (67/118) were performed following intrauterine deaths. 14 % (16/118) of PPMs showed multiple congenital anomalies. Placentas ware submitted for examination in 31 PPMs (31/118) and clinically significant placental pathologies were noted in 7/31 placentas (23%). 76/118 (64%) showed no gross abnormality in the fetus/baby and placenta was not available for examination in 72% (55/76). Major congenital anomalies were detected in 14% of PPMs. In majority of the PPMs, the placenta was not available for examination, therefore cannot exclude the possibility of placental pathology which might have led to the death.