An Approach to the Examination of the Fetal Congenitally Malformed Heart at Autopsy

Abstract

AbstractExamination of the congenitally malformed fetal heart at autopsy presents many unique challenges. A systematic approach is needed to identify accurately the underlying morphology of the fetal heart, with adjustment to the routine cardiac exam as necessary in the most extreme malformed cases. In situ examination can provide details of pre-mortem function, based on what is seen externally, and direct the internal examination. Ultimately, an accurate morphological description of the fetal heart at any gestational age is necessary for correct diagnosis. Information that confirms or adds to prenatal imaging or testing provides a bridge for communication in diverse clinical settings including the care of other patients with similar presentations. The heart findings should be integrated into interdisciplinary discussions of major findings and during counseling sessions with parents who seek explanations for fetal loss and risk of recurrence in future pregnancies.