Correlation between clinical diagnoses at the time of death and autopsy findings in critically sick neonates at a regional neonatal intensive care unit in India.

Abstract

This study was carried out to examine the correlation between clinical diagnoses at the time of death and autopsy findings in newborn babies who died in the regional Neonatal Intensive Care Unit (NICU) of King Edward VII Memorial Hospital affiliated to Bombay University. A consecutive sample of 240 newborns that died during the study period constituted the study cohort. Of these 240 (172 born in the hospital and 68 born outside) newborns who died during the study period, 197 (82.1 per cent) had autopsies performed. The mean Rushton's score for all the autopsies was 307+/-25.8 (range 300-400). There were 24 cases (12.2 per cent) where autopsy revealed a major finding (class I) that, if known prior to death, would have altered clinical management and could have resulted in cure or prolonged survival. In 53 patients (26.9 per cent) the autopsy revealed a major finding (class II) that, if known prior to death, would not have altered clinical management because specific therapy was unavailable or the patient had received appropriate therapy. It is concluded that a good quality autopsy continues to yield valuable and unsuspected information in a substantial number of newborn deaths.