Exploring minimally invasive tissue sampling as an alternative to conventional autopsy in neonatal deaths.

IF 1.4 4区医学 Q2 MEDICINE, LEGAL

Forensic Science, Medicine and Pathology Pub Date : 2025-08-21 DOI:10.1007/s12024-025-01069-6

Athira Sreenivas, Leslie Lewis, Jayashree Purkayastha, Vani Lakshmi R, Mary Mathew

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引用次数: 0

Abstract

Purpose: Neonatal mortality is a significant public health concern which requires accurate identification of the cause of death (CoD). There has been a decline in conventional diagnostic autopsy (CDA) globally due to ethical and cultural barriers, resulting in lack of comprehensive data on neonatal deaths. Minimally invasive tissue sampling (MITS) of organs has emerged as an innovative alternative to CDA as it is less invasive and feasible. This study evaluates the effectiveness of MITS versus CDA in determining the cause of death in neonates.

Methods: This was a single-center observational study conducted on 100 neonatal autopsies. The demographic, clinical, imaging data and ancillary tests were analyzed prior to performing both the techniques. Sensitivity, specificity, positive predictive value, negative predictive value, and interrater reliability were assessed.

Results: The concordance rate for lesions in the brain, lung, and liver in MITS versus CDA was 79%, 84%, and 94% respectively. There was high sensitivity and specificity for intraventricular hemorrhage (IVH) and hyaline membrane disease (HMD) by the MITS technique, however it was not useful in detecting focal and peripheral lesions in organs.

Conclusions: MITS is a promising alternative to CDA with comparable diagnostic accuracy in determining causes of death in neonates.

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探索微创组织取样作为常规尸检在新生儿死亡中的替代方法。

目的：新生儿死亡率是一个重大的公共卫生问题，需要准确确定死亡原因（CoD）。由于伦理和文化障碍，全球常规诊断性尸检（CDA）的使用有所下降，导致缺乏关于新生儿死亡的全面数据。微创器官组织取样（MITS）因其侵入性小且可行而成为CDA的一种创新替代方法。本研究评估了MITS与CDA在确定新生儿死亡原因方面的有效性。方法：这是一项对100例新生儿尸检进行的单中心观察性研究。在实施这两种技术之前，对人口统计学、临床、影像学数据和辅助测试进行分析。评估敏感性、特异性、阳性预测值、阴性预测值和判据间信度。结果：与CDA相比，MITS对脑、肺和肝脏病变的符合率分别为79%、84%和94%。MITS技术对脑室内出血（IVH）和透明膜病（HMD）有很高的敏感性和特异性，但对器官局灶性和外周性病变的检测效果较差。结论：MITS是一种有希望的替代CDA的方法，在确定新生儿死亡原因方面具有相当的诊断准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Forensic Science, Medicine and Pathology MEDICINE, LEGAL-PATHOLOGY

CiteScore

3.90

自引率

5.60%

发文量

114

审稿时长

6-12 weeks

期刊介绍： Forensic Science, Medicine and Pathology encompasses all aspects of modern day forensics, equally applying to children or adults, either living or the deceased. This includes forensic science, medicine, nursing, and pathology, as well as toxicology, human identification, mass disasters/mass war graves, profiling, imaging, policing, wound assessment, sexual assault, anthropology, archeology, forensic search, entomology, botany, biology, veterinary pathology, and DNA. Forensic Science, Medicine, and Pathology presents a balance of forensic research and reviews from around the world to reflect modern advances through peer-reviewed papers, short communications, meeting proceedings and case reports.