Comprehensive post-mortem evaluation in Intrauterine deaths /still births in improving uptake of autopsy and future pregnancy outcomes

Objective: Post-mortem examination of a baby following spontaneous or missed miscarriage in the second trimester or intrauterine death to provide a complete or partial explanation of the pregnancy loss. Method: A total of 100 cases of intrauterine deaths were consecutively collected from January 2010-May 2019 for etiological diagnosis according to the standard protocol and involved external examination, dysmorphological examination, internal examination and full body antero-posterior and lateral radiographs. Histopathology of placenta was done. Cases were also subjected to genetic testing such as FISH/microarray. A clinical correlation was done by a Obstetrician-geneticist to reach an etiological diagnosis. Results: Two third of cases were referred after intrauterine death post 30 weeks of gestation. 24/100 cases were with fetal anomalies.Genetic causes present in 12% cases. 65.5% cases were associated with the pathology of the placenta. 30% cases were with cord lesions. The results were inconclusive in 14% of the cases. Conclusions: In this study we looked for establishing etiological diagnosis and tried to see contribution of each test in finding the cause. This will help the obstetrician in counselling parents for the utility of post-mortem excamination and thus better able to guide for future recurrence risk and management.