A recent study published in the American Journal of Obstetrics & Gynecology highlights the use of extrauterine cerebellar ultrasound as a reliable and cost-effective method to estimate gestational age after fetal or neonatal death, particularly beneficial in low-resource settings.
Perinatal mortality remains a challenge in low- and middle-income countries, with slow progress in reducing deaths. While complete autopsies are conventionally used to determine causes of death, their feasibility in LMICs is limited, necessitating innovative approaches for accurate gestational age evaluation.
Ultrasound emerges as a promising tool for gestational age assessment, with the cerebellum being measurable as early as 10 to 11 weeks of gestation. The study aimed to assess the feasibility of extrauterine percutaneous transfontanelle ultrasound cerebellum measurements for estimating postmortem gestational age in cases of fetal and neonatal deaths.
The research included patients with intrauterine fetal death, stillbirths, and neonatal deaths, with measurements such as transcerebellar diameter and cerebellar vermis length analyzed for accuracy in estimating gestational age. The study involved comparisons with intrauterine ultrasound postmortem measurements and autopsy data to validate the ultrasound measurements.
Results revealed a significant correlation between extrauterine ultrasound, intrauterine ultrasound, and autopsy measurements of cerebellar parameters, indicating the potential of ultrasound in accurately estimating gestational age postmortem. The study highlighted the reliability of ultrasound measurements in predicting gestational age, emphasizing the need for further validation in larger and diverse cohorts, especially in low-resource settings.
With a median gestational age of 20.5 weeks for fetal deaths, 23 weeks for stillbirths, and 28.5 weeks for neonatal deaths, the study showcased the utility of ultrasound in estimating gestational age across different scenarios. The success of extrauterine postmortem ultrasound measurements in assessing gestational age underscores its value as a cost-effective and feasible approach in postmortem evaluations.
Experts emphasize the importance of such innovative methods in improving healthcare quality, particularly in regions with limited resources. The study’s findings offer insights into the potential of ultrasound as a valuable tool in assessing gestational age accurately, paving the way for enhanced postmortem evaluations in diverse healthcare settings.
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