Perinatal and Pediatric Autopsy
Perinatal and pediatric autopsies provide important information for quality improvement, education, medical management of future pregnancies and future reproductive choices. In recent studies, major unexpected findings were discovered in 20 to 30 percent of pediatric autopsies, clarifying the cause of death or differential diagnosis in approximately 50 to 65 percent of the autopsies. Permission for autopsy should especially be requested for cases that involve:
- Intrauterine fetal demise or other adverse pregnancy outcomes
- Unexpected death at any age
- Undiagnosed disorder leading to death
- Unexpected complications of a disorder or treatment
- Unanswered clinical questions regarding nature or extent of disease, cause of death or effects of treatment
- Multiple malformations without a defined syndrome
- Undefined, possible familial disorder
- Indications of potential medicolegal issue
We are experts in a wide range of pediatric autopsies including stillborn fetuses, sudden unexpected deaths in infants and older children, complex congenital disorders and patients with solid organ and bone marrow transplants. Autopsies are routinely performed on patients up to 18 years of age. Autopsies are also performed on older patients with pediatric disorders who have been followed by Nationwide Children's physicians.
The following facilities and expertise are available for performing perinatal and pediatric autopsies:
- Radiographic evaluation of the entire skeletal system in infants and intrauterine fetal deaths
- Detailed in situ examination, using a dissecting microscopic when needed
- Digital photography for documentation of external and internal findings
- On-site consultation with Medical Genetics with utilization of Cytogenetics and Molecular Genetics Laboratory as necessary
- Ancillary studies (microbiologic cultures, toxicology, other tests)
- Experienced pathologist's assistants
- Neuropathologists with expertise in pediatric pathology
- Expertise in congenital heart disease as well as diseases of the lungs, liver, gastrointestinal system, hematopoietic system, kidneys, musculoskeletal system and placenta (placenta examination in all cases, when available)
Please contact Nationwide Children's Laboratory Services at (800)934-6575 with any questions.
1. Feinstein JA, Ernst LM, Ganesh J, Feudtner C. What new information pediatric autopsies can provide: a retrospective evaluation of 100 consecutive autopsies using family-centered criteria. Archives of Pediatrics & Adolescent Medicine. 2007;161(12):1190-6.
2. Newton D, Coffin CM, Clark EB, Lowichik A. How the pediatric autopsy yields valuable information in a vertically integrated health care system. Archives of Pathology & Laboratory Medicine. 2004;128(11):1239-46.
3. Cardoso MP, Bourguignon DC, Gomes MM, Saldiva PH, Pereira CR, Troster EJ. Comparison between clinical diagnoses and autopsy findings in a pediatric intensive care unit in Sao Paulo, Brazil. Pediatric Critical Care Medicine. 2006;7(5):423-7.