Clinical value of postnatal autopsy and genetics consultation in fetal death

The aim of the present study was to investigate the clinical use of postnat al autopsy and genetics consultation in cases of fetal death in a teaching hospital. A retrospective analysis of medical records including pathology a nd genetics reports was performed in all cases of fetal death in which a wo man delivered at Ben Taub General Hospital, Houston, Texas over a 2-year pe riod. Cases were excluded when gestational age of the fetus was less than 2 0 weeks. Fetuses were only included when the 1- and 5-min Apgar scores were 0 and 0, respectively. There were 139 fetal deaths and 12,209 live born in fants during the study period (stillbirth rate 1.125%). Although pathology services were used in 96.2%, a genetics consultation was obtained in only 1 2% of cases. Fetal autopsy provided a certain cause of fetal death in 19.4% , a probable cause for death in 36.3%, and was inconclusive in 44.3%. Among the cases in which a genetics consultation was obtained, a certain and pro bable cause for fetal death was found in 20% and 20% of cases, respectively . The utilization of genetics consultation was found to be independent of m ultiple clinical variables examined including ultrasound data, identificati on of maceration, and training level of resident. Our data show a frequent use of pathologic examination in cases of fetal death and an infrequent use of genetics consultation services. The request for genetics consultation s eemed to have been made at random. (C) 2001 Wiley-Liss, Inc.