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Background: Ultrasound screening has been part of antenatal care for several decades, and warrants high expertise to meet the criteria for a worthwhile screening program. In particular, the rate of false positives should be low. Purpose: To examine time trends of pregnancy terminations for fetal abnormality after 12 weeks' gestation, and to assess the agreement between antenatal ultrasound and post-termination autopsy findings for the main pathologies leading to termination. Material and Methods: During the period 1988 to 2002, 198 pregnancies were terminated for fetal abnormality after 12 weeks' gestation. We reviewed the case notes for those 151 who were autopsied (male/female/undetermined ;= ;91/56/4). Annual rates of live births and stillbirths were retrieved from the Medical Birth Registry of Norway. Results: Antenatal ultrasound provided a correct diagnosis of the major abnormality in 149/151 cases (99%), based on post-termination autopsy findings. The annual rate of terminations after 12 weeks' gestation varied between 0.6 and 3.4 (mean 1.8) per 1000 live births, with a trend toward higher rates over the study period (P=0.001, chi-square test for linear-by-linear association). Conclusion: The specificity of antenatal ultrasound for major abnormalities was high, as compared to postnatal autopsy findings. The mean annual rates of termination after 12 weeks' gestation tended to increase over the 14-year study period. [ABSTRACT FROM AUTHOR]

Radiography of the perinatally dead infant provides detailed information about the skeleton and is valuable as an adjunct to autopsy. This article reviews the potential benefits and discusses the pitfalls in assessment of growth stage. Reference charts for individual bone lengths and secondary ossification centers are presented. [ABSTRACT FROM AUTHOR]

Objective: To examine the yield of radiographic abnormalities in a population based set of perinatal deaths, the diagnostic value of whole body postmortem radiographs in the same set, and previous Factors that may increase the proportion of useful examinations. Design: Retrospective population based study. Setting: A region of Norway. Patients: All infants from a well defined geographical area who were stillborn or had died soon after birth over an 11 year period (n = 542), who had routinely undergone whole body radiography and autopsy. Main outcome measures: (a) Proportion of cases with abnormal radiographic findings. (b) Proportion of abnormal radiographs providing new information that was useful for postmortem diagnosis. Results: Radiographs were abnormal in 162/542 cases (30%). These provided new information about, but did not help to confirm, the pathological process leading to death in 14/162 (8.6%), may hove helped to confirm, but not establish, the cause(s) of death in 1/162 (0.6%), and were of vital importance For establishing the cause(s) of death in 5/162 (3.1%). Among infants with external malformations, the proportion of useful radiographs was 12/100 (12%), and among the remainder it was 8/436 (1.8%), a difference of 10.2% (95% confidence interval 3.7% to 16.7%; data missing for six cases). Conclusions: The diagnostic value of postmortem radiography in this population based set was low. However, radiographic findings were of vital importance for establishing the cause(s) of death in 5/542 cases (0.9%). [ABSTRACT FROM AUTHOR]