Diagnostic Yield of Post‐Mortem Fetal Micro‐CT for Thoracic Abnormalities

Objective This study aims to identify the imaging findings specifically for thoracic anomalies in 1200 Micro‐CT cases, independent of whether the abnormality contributed to the main diagnosis or cause of death. Method We analyzed 1200 Micro‐CT scans in an unselected, consecutive cohort between 2017 and 2024 to identify thoracic anomalies within the population. These were separated into cardiac and non‐cardiac with specific anomalies noted for in‐depth analysis. Results Cardiac or thoracic non‐cardiac anomalies were identified in 158/1200 (13.1%) fetuses of the total population, with a total of 250 individual cardiac or non‐cardiac anomalies identified, with 150/250 (60%) cardiac and 100/250 (40%) non‐cardiac, respectively. The most common cardiac defects were structural defects 137/150 (91.3%) with septal defects 52/150 (34.7%). Abnormal fluid collections 52/100 (52.0%) and wall defects 18/100 (18.0%) were the most commonly identified categories of thoracic anomalies. Non‐diagnostic scans due to a high maceration (grade 6) occurred in 14/1200 (1.2%) cases, with all other lower maceration scores (grade 1–5) allowing thoracic assessment in 1186/1200 (98.8%) of cases. Conclusion Micro‐CT post‐mortem imaging can identify a wide range of cardiac and non‐cardiac thoracic anomalies following pregnancy loss in early gestation fetuses even with severe maceration.