Comparison of the prenatal imaging findings at the second and third trimester of pregnancy to the autopsy findings in fetuses with brain anomalies

The fetal neurology clinic (FNC) is a multidisciplinary clinic that utilises the advancements in prenatal imaging (US and MRI) and genetic testing to identify brain anomalies and prognosticate the neurodevelopmental outcome of fetuses to provide consultation to couples regarding pregnancy management in cases with suspected severe outcomes. In high-risk cases, termination of pregnancy (TOP) is permitted according to the law. Only a few studies compared the concordance between prenatal imaging and the autopsy report; most were done in the early stages of pregnancy. A retrospective cohort in which pathology reports were compared to imaging studies in all fetuses screened in our fetal neurology clinic and underwent TOP due to brain anomaly between 2009 and 2019. The rate of concordance was rated on a scale. We identified 113 cases of TOP due to brain malformations. All consultations were given from the second trimester onward and most in the third trimester. We found an agreement in 94% of cases: Full agreement was found in 56% and partial in 38%. In the partial agreement group, in 80% of the cases, the autopsy added information that would not have changed the final consultation. Disagreement between the imaging and the autopsy results was seen in only 8 cases. In 6 of them, the TOP was justified, and in only 2 cases, the TOP was unjustified. This is the largest study comparing pathology findings to prenatal imaging in fetuses screened in the advanced stages of pregnancy. We found high agreement rates between the imaging and the autopsy findings, and even in cases of disagreement, TOP was justified in most of them. The autopsy report added valuable information that enabled more accurate consultation. Despite the high concordance rate in our study, we conclude that the postmortem examination is of great significance. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.