Susan C Shelmerdine1, Melissa Hickson2, Neil J Sebire2,3, Owen J Arthurs2,3. 1. Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom, susan.shelmerdine@gosh.nhs.uk. 2. Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom. 3. UCL Great Ormond Street Institute of Child Health, London, United Kingdom.
Abstract
OBJECTIVE: The aim of this study was to characterise the imaging features seen in fetuses having undergone feticide by intracardiac potassium chloride injection compared to those of non-terminated fetuses at post-mortem magnetic resonance imaging (PMMRI). METHODS: A case-control study was performed comparing PMMRI findings between two groups of patients - those having undergone feticide were matched to a control group of miscarried/stillborn fetuses. The groups were matched according to gestational age, weight, and time since death. Two independent readers reviewed the PMMRI for thoracic, abdominal, and musculoskeletal imaging features. The Fishers exact test was conducted for differences between the patient groups. RESULTS: Twenty-six cases of feticide (mean gestation 25 weeks [20-36]) and 75 non-terminated fetuses (mean gestation 26.7 weeks [19-36]) were compared. There was a higher proportion of feticide cases demonstrating pneumothorax (23.1 vs. 1.3%, p = 0.001), haemothorax (42.3 vs. 4%, p = 0.001), pneumopericardium (30.8 vs. 5.3%, p = 0.002), and haemopericardium (34.6 vs. 0%, p = 0.0001). Intracardiac gas and intra-abdominal findings were higher in the feticide group, but the differences were not statistically significant. CONCLUSION: Characteristic PMMRI features of feticide can help improve reporter confidence in differentiating iatrogenic from physiological/pathological processes.
OBJECTIVE: The aim of this study was to characterise the imaging features seen in fetuses having undergone feticide by intracardiac potassium chloride injection compared to those of non-terminated fetuses at post-mortem magnetic resonance imaging (PMMRI). METHODS: A case-control study was performed comparing PMMRI findings between two groups of patients - those having undergone feticide were matched to a control group of miscarried/stillborn fetuses. The groups were matched according to gestational age, weight, and time since death. Two independent readers reviewed the PMMRI for thoracic, abdominal, and musculoskeletal imaging features. The Fishers exact test was conducted for differences between the patient groups. RESULTS: Twenty-six cases of feticide (mean gestation 25 weeks [20-36]) and 75 non-terminated fetuses (mean gestation 26.7 weeks [19-36]) were compared. There was a higher proportion of feticide cases demonstrating pneumothorax (23.1 vs. 1.3%, p = 0.001), haemothorax (42.3 vs. 4%, p = 0.001), pneumopericardium (30.8 vs. 5.3%, p = 0.002), and haemopericardium (34.6 vs. 0%, p = 0.0001). Intracardiac gas and intra-abdominal findings were higher in the feticide group, but the differences were not statistically significant. CONCLUSION: Characteristic PMMRI features of feticide can help improve reporter confidence in differentiating iatrogenic from physiological/pathological processes.
Authors: Susan Cheng Shelmerdine; Dean Langan; Uday Mandalia; Neil James Sebire; Owen John Arthurs Journal: Prenat Diagn Date: 2019-11-29 Impact factor: 3.050
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Authors: Christina Ashby; Abrahim N Razzak; Ann Kogler; Ahmad Amireh; John Dempsey; Keldon K Lin; Joseph Waller; Pinky Jha Journal: Cureus Date: 2022-09-06