Postmortem MRI characteristics of nonimmune fetal hydrops

Tumanova U.N., Lyapin V.M., Bychenko V.G., Serova N.S., Shchegolev A.I.

Рurpose.Post-mortem MRI characteristics of the distribution and severity of nonimmune fetal hydrops (NFH). Materials and methods. The analysis of autopsy material of 2 stillborn and 22 newborns, divided into three groups was carried out. Group I consisted of the bodies of the dead due to NFH, group II - the bodies of newborns who died with the presence of general edema syn-drome in the absence of NFH, group III (control) - the bodies of deceased newborns in the ab-sence of NFH and general edema syndrome. Before autopsy, MRI was performed. On T1- and T2-weighted images was determined by the thickness and signal intensity of the skin with subcuta-neous tissue and the subsequent calculation of the tissue hydration index. The vol-ume of fluid in the pericardial cavity, pleural and abdominal cavities determined when using three-dimensional processing of the obtained tomograms and calculated their specific volume in the corresponding cavities. Results. The values of the specific volume of free fluid in the pleural cavities and ab-dominal cavity less than 8% should be considered a natural postmortem sign, rather than the life-time accumulation of transudate, when examining the bodies of deceased newborns on the first day after death. The mean values of absolute and specific volumes of pleural fluid had the maxi-mum values in the NFH observations, exceeding the values of the control group by 6.3 and 5.1 times, respectively. The highest values of the absolute amount of ascites were observed in the group with general edema syndrome. In the NFH group, all cases had hydro-thorax, 85.7% of cases had ascites, and 42.9% had hydropericardium. In the group of new-borns with general ede-ma syndrome, hydrothorax was detected in 57.1%, ascites - in 85.7%, and hydropericardium - in 42.9% of cases. The thickness of the skin with subcutaneous tis-sue depended on the localization and group of research. The most pronounced deviations from the control level were recorded for the average values of the skin thickness of the anteri-or chest wall in group I and the scalp of the fronto-parietal region in group II. The mean val-ues of the tissue hydration index were higher in the group with NFH, and the lowest in the control group. Conclusion. Postmortem MRI performing, allows an objective assessment of the nature and severity of anasarca and pathological fluid accumulations in the serous cavities of dead fe-tuses and newborns. In this regard, postmortem MRI is recommended as a mandatory component of the autopsy of the bodies of fetuses and newborns that died as a result of nonimmune fetal hydrops.

1 - V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology. 2 - I.M. Sechenov First Moscow State Medical University (Sechenov Uni-versity). Moscow, Russia.



Keywords:anasarca, ascites, autopsy, hydrothorax, nonimmune fetal hydrops, newborn, postmortem MRI, edema syndrome.


Corresponding author:Tumanova U.N., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation: Tumanova U.N., Lyapin V.M., Bychenko V.G., Serova N.S., Shchegolev A.I. Postmortem MRI characteristics of nonimmune fetal hydrops. REJR 2018; 8(4):172-183. DOI:10.21569/2222-7415-2018-8-3-172-183

Received: 20.10.18 Accepted: 21.11.18