Purpose or Case Report: To present the technique and the images obtain by postmortem ultrasound in the particular setting of fetal death and discuss its abilities and limitations.
To compare the diagnostic yields of joint analysis of ultrasound and X-Ray compared to autopsy in the setting of fetal death.

Methods & Materials: Retrospective study of postmortem fetal ultrasounds performed between January 2009 and December 2013 in addition to X-Ray in the work-up for cases of fetal death. Inclusion criteria were a complete anatomical ultrasound study and the availability the foetopathology report. Cases with autopsy refusals were excluded. When cases of TOP were included, antenatal imaging data (US, CT and/or MRI) were available. All scans were performed by a senior pediatric radiologist. Foetopahtology was performed by senior foetopathologists and pathologists aware of fetal medicine.

Results: We collected 169 patients. The gestational age was 27 weeks +/- 6 days [15-38WG]. The population consisted mainly of fetuses originating from TOP (164/169 [97%]). Only 5 cases involved in utero fetal deaths (IUFD). Half (49.2%) of the conditions involved were cerebral.
The duration of the exam was about 10-15 minutes.
Complete concordance between the findings of postmortem imaging and autopsy was observed in 81% [137/169] of cases.

Conclusions: Ultrasound allows a comprehensive post-mortem study complementary to standard X-Rays. In fetal deaths situations, ultrasound is much more relevant than in any other postmortem conditions. Ultrasound, although less effective than MRI, shows a benefit/drawback balance that proves very interesting, especially in the youngest fetuses. Besides it is more available and realistic to use it in a systematic practice.