Parental counselling and autopsy results: A retrospective diagnostic cohort study at a multidisciplinary fetal neurology clinic

Aim To examine the accuracy of prenatal counselling at a multidisciplinary fetal neurology clinic (FNC) that led to termination of pregnancy (TOP), to improve the quality of future consultations. Method This retrospective diagnostic cohort study compared the imaging (neurosonography and intrauterine magnetic resonance imaging) of fetuses evaluated at our FNC between 2009 and 2019, which underwent TOP because of brain anomalies, to the autopsy reports for concordance. The degrees of concordance were full, partial, and discordant. Results We identified 114 fetuses aborted because of brain anomalies, which underwent autopsy. All consultations were provided at the late stages of pregnancy, with 70% given in the third trimester and a mean gestational age of 29 weeks (range = 18–39, SD = 5). The imaging and autopsy results were fully or partially concordant in 96% of cases. Discordance was found in four fetuses, but termination was considered unjustified in only one. Microscopic evaluation of the fetal brain provided valuable information in 41% of fetuses and changed the diagnosis in 13%. Interpretation We found excellent concordance between the imaging and autopsy findings. We suggest that an autopsy is crucial for learning and delivering correct consultations to patients and planning their subsequent pregnancies.