Purpose or Case Report: Stillbirth is a sad complication of pregnancy. Establishing the cause of death in intrauterine fetal demise (IUFD) is important to bring psychological closure to the family and crucial for reproductive counseling. The gold standard to establish the cause of IUFD is perinatal autopsy. However, perinatal autopsy rates are falling worldwide, largely attributed to patients and physicians discomfort with death and discussion of postmortem examinations as well as social and religious reasons. There is a lack of experience with minimally invasive perinatal autopsy in the United States and even more limited publications in the subject. Our main goal was to investigate the added value of postmortem MRI to conventional autopsy in the clinical setting. Our program has had successes and failures, of which learning opportunities exist for other institutions that desire to implement similar programs. This paper will discuss the timeline of our progress and share examples of potential roadblocks and keys to success in implementing such a program.
Methods & Materials: In 2013, our research team at Beaumont Health realized that we have the capability to implement a postmortem MRI program here in the United States, similar to those already underway in the United Kingdom. We sought out a partnership with the anatomic pathology department to brainstorm how we could work together to contribute to the growing body of research in the postmortem diagnostic branch of medicine. We received IRB approval in 2014 and started meeting with the bereavement specialists and maternal fetal medicine physicians to identify prospective subjects.
Results: Since then, we have continued to adjust our protocol and inclusion criteria to optimize our number of subjects. This paper will discuss the hurdles that we have overcome and detail ways we have optimized this project in hopes of smoothing the transition period for institutions that aspire to contribute to this growing field of research.
Conclusions: Through our experiences with implementation of a post mortem MRI program at Beaumont Health, we have found early successes and failures. We have worked closely with the multidisciplinary team involved to overcome the early roadblocks that we had faced and continue to fine-tune our program in order to further the knowledge in this growing field. We hope that our experiences will be enlightening to other institutions that wish to join us in this venture.