Lung aeration on post-mortem magnetic resonance imaging is a useful marker of live birth versus stillbirth

Abstract

Objective: Aim of this study was to investigate whether lung assessment on post-mortem magnetic resonance imaging (PMMR) can reliably differentiate between live birth and stillbirth. Materials and methods: We retrospectively assessed PMMR imaging features of a group of late foetal terminations following fetocide and stillbirths (without witnessed breathing) and early infant deaths (breathed spontaneously before death). PMMR images were reviewed for evidence of lung aeration and other features, blinded to the clinical and autopsy data. Results: Nineteen infant deaths (mean age 3.0 ± 6.5 post-natal weeks) and 23 foetal terminations or stillbirths (mean age 32.6 ± 10.2-week gestation) were compared. Subjective appearances of lung aeration on PMMR were the best indicator of live birth, with a sensitivity of 89.5 % (95 % confidence interval 68.6, 97.1 %) and specificity of 95.6 % (79.0, 99.2 %) and positive and negative predictive values of 94.4 % and 91.7 %, respectively. Conclusions: Lung aeration on PMMR appears to have high overall accuracy for confirmation of live birth versus intrauterine foetal death but now requires validating in a larger cohort of perinatal deaths.