Clinical impact of systematically performing autopsies following selective termination of pregnancies: comparison between multiples and singletons.

Introduction:The aim of this study was to evaluate the clinical impact of systematically performing autopsies following selective termination of pregnancy. Material and Methods: A retrospective study of necropsies following medical termination of pregnancy performed in a tertiary referral hospital. A correlation between prenatal diagnosis and postmortem findings was performed. The cases were classified as having complete agreement, complete disagreement or major agreement with additional information. A comparison between multiples (n = 29) and singletons (n = 374) was undertaken. Results: The median gestational age at the time of termination/selective feticide was 19 (11-34) weeks in multiples and 18 (6-36) weeks in singletons (p = 0.190). In 5 cases (17.2%) of multiples (50.0% submitted to selective feticide) fetal autopsy was not possible, while in singletons autopsy was not feasible in only 1.3% (p < 0.005). Discussion: Contrarily to singleton pregnancies, in twin pregnancies with termination of 1 fetus it should not be possible to undertake an autopsy. When a selective termination is performed away from delivery, the time of retention may hinder the feasibility of the necropsy study. In those cases, it is crucial to make an exhaustive investigation previously to selective feticide. (C) 2014 S. Karger AG, Basel