Autopsy. High yield in neonatal population
H. Craft and J. E. Brazy
The value of the autopsy in the practice of clinical medicine continues to
be debated. While the yield of the autopsy in adults is well documented,
similar studies in infants and children are lacking. To understand how
frequently the neonatal autopsy provides useful information, we studied all
deaths in a level III neonatal Intensive care unit over a three-year
period. Clinically active problems at the time of death were tabulated and
compared with the final diagnoses obtained from the autopsy report. During
the three-year study period, there were 113 deaths with autopsies performed
in 71 (63%) of the cases. Significant findings were noted in 39% of
patients. These included congenital anomalies (16 patients), Infections
(nine patients), unsuspected iatrogenic complications (five patients), and
others (11 patients). In 16% of the cases, the autopsy provided the
definitive explanation for the cause of death by substantiating an unproved
or unsuspected diagnosis. In an additional 18.3% of the cases, the autopsy
findings influenced genetic counseling or were important in monitoring
patient care. The gross examination was the most useful component of the
autopsy, providing 63% of the significant findings. This high rate of
return supports a continued high rate of neonatal autopsy.
