Perinatal Autopsy Guidance for the General Pathologist

PURPOSE: The purpose of this article is to highlight the unique aspects of the perinatal autopsy, compared to the autopsy of patients outside the perinatal period. This article focuses on what would be useful to general pathologists who perform autopsies as a small portion of their practice. We will also discuss in some detail the autopsy of the macerated fetus and determining time of death prior to delivery. BACKGROUND: General pathologists performing perinatal autopsies commonly lack specific training in perinatal autopsy techniques, where interpretation of detailed measurements and dissections are essential. Macerated fetuses provide an additional challenge, as planes of dissection are hard to see and microscopic examinations require interpretation of degenerated tissue. CONTENT: This article describes the basic steps to perform a perinatal autopsy including tips to streamline dissections, which are useful for the general pathologist. It includes how to recognize features of maceration to provide an accurate time of death prior to delivery and information about the classification of the cause of death in stillbirth.