Correlation of prenatal clinical findings with those observed in fetal autopsies: pathological approach

Our objective was to present a comprehensive description of the clinicopath ological findings of 173 abortions, including 121 therapeutic and 52 sponta neous ones in the period between 1992 and 1998. In all of these fetuses pat hological examination was carried out. immunohistochemistry, in situ hybrid ization, flow cytometry, and X-ray examination. In the 121 therapeutic abor tions the distribution of malformations was: 45 central nervous system anom alies (37%), 12 genitourinary anomalies (10%)? 25 gastrointestinal anomalie s (21%), two respiratory system anomalies (1.65%), eight cardiac anomalies (6.6%) and 28 other anomalies (17.2%) as revealed by autopsy. From the clin ically selected 52 spontaneous abortions, major malformations were seen in 15/52 cases. With the comparison of the pathological and clinical findings in 121 therapeutic abortions, the percentage of cases with correct clinical designation and no missed anomalies amounted for 49%. However in 51% addit ional or different lethal, severe, or major malformations were revealed or excluded by fetopathological examinations. In 4%, the clinical observation and diagnosis were modified, but without implications for the therapeutic t ermination of pregnancy. The clinical indication could not be supported in another 3% of the cases. Copyright (C) 2000 John Wiley & Sons, Ltd.