Parental acceptance of minimally invasive fetal and neonatal autopsy compared with conventional autopsy.

Abstract

To determine parental acceptance of minimally invasive autopsy (MIA) involving postmortem imaging and organ tissue sampling compared with conventional autopsy and to compare the acceptability of percutaneous versus laparoscopic-guided biopsy. Following termination of pregnancy parents were offered the option of traditional autopsy and subsequently interviewed about their acceptance of MIA. The McNemar test for paired samples was used to assess the difference in acceptance of MIA and conventional autopsy. The Wilcoxon signed-rank test for paired samples was used to compare the acceptance score for percutaneous versus laparoscopic-guided biopsy. Logistic regression was selected to study the association of parental acceptance of conventional autopsy and MIA with different variables. Conventional autopsy was accepted by 42 (60.0%) of the 70 parents. Regression analysis showed that non-Muslim faith was the only factor significantly associated with acceptance of conventional autopsy (p = 0.030). Of 28 parents who initially refused conventional autopsy, 13(46.4%) subsequently accepted MIA, increasing acceptance to 78.6% (p < 0.001). Regression analysis showed that none of the factors significantly affected MIA acceptance. Parents expressed no preference between postmortem percutaneous versus laparoscopic-guided biopsy (p = 0.061). Post-mortem imaging combined with systematic organ biopsies is highly acceptable among all parents independent of their religion and the method used for organ biopsy.