We assess the feasibility and the performance of a post-mortem examination protocol including Polaroid® photographs, radiographs, karyotyping, gross and microscopic necropsy, and genetic expertise. This protocol was applied to the 1019 consecutive foetal or perinatal deaths that occurred between January 1984 and June 1987 in the Marseille district (France). The feasibility for the routine use of such a protocol was low; all five components of the protocol were completed in only 9% of the cases. Gross autopsy was performed in 85% of the cases, histologic examination in 48%, successful karyotyping in 17%, radiography in 52% and genetic expertise in all the cases. Of the 1019 consecutive cases reviewed, 227 lethal congenital anomalies were detected (22.3%). Each element's contribution to the establishment of the aetiology of congenital anomalies was assessed. Alone or combined with the information given by other elements of the protocol, gross necropsy gave the cause of death in 58% of all cases, karyotyping in 38%, radiography in 3% and genetic expertise in 38%. If the protocol had been applied to malformed Infants only, it would have detected 86% of the aetiologies of congenital anomalies.
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Julian‐Reynier et al. (1993) studied this question.