Dilemma after termination of pregnancy due to urogenital fetal anomalies: Discrepancy between prenatal ultrasonographic diagnosis and autopsy

Objective

To evaluate the agreement and disagreement between prenatal ultrasonography (USG) and fetal autopsy findings in pregnancy terminations due to urogenital anomalies

Method

Of 453 pregnancy terminations performed due to fetal anomalies, 82 cases with urogenital anomalies on either prenatal USG or fetal autopsy were included in this retrospective study. The discrepancy between prenatal USG and fetal autopsy findings on urogenital anomaly findings was evaluated.

Results

Complete agreement between prenatal USG and fetal autopsy findings was noted in 33 (40.2%) cases (particularly for megacystis, bilateral renal agenesis and infantile polycystic kidney), while partial agreement (anal atresia and horseshoe kidney as additional minor findings) and altered diagnosis were noted in 12 (14.6%) and 8 (9.8%) cases, respectively. Disagreement was noted in 29 (35.4%) cases including anomaly only on autopsy in 20 (24.3%) cases (renal agenesis, horseshoe kidney and multicystic dysplastic kidney in particular) and anomaly only on USG in 9 (10.9%) cases.

Conclusion

Accordingly, our findings indicate fetal autopsy to be a method of vital importance in complementing prenatal diagnosis which may add valuable information that may improve future pregnancy management and counseling of parents, and thus prenatal USG and fetal autopsy should be regarded as complementary techniques.

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