Could MRIs Make Baby Autopsies More Acceptable?

The majority of parents who lose their babies during or soon after birth refuse to allow a conventional autopsy, but scientists have found that less invasive options such as post-mortem MRIs could prove to be more acceptable to bereaved parents, according to NBC News. The so-called minimally invasive autopsy (MIA) was found to be just as effective in determining the cause of death as a conventional procedure.

Researchers suggested that the MIA could improve rates of autopsy uptake as well as reduce the distress of parents while offering clear answers to the cause of their baby's death. Scientists used a combination of full body scans and sample tests in studying the MIA's effectiveness, as the less-invasive option uses magnetic resonance imaging and blood tests as opposed to the conventional autopsy, which involves a detailed external examination as well as dissection of organs from the different body cavities - cranial, thoracic, abdominal and pelvic," according to an article in the Journal Of The Royal Society Of Medicine (JRSM).

The JRSM article says that in many countries where the relatives' consent is required, including the U.K., "clinical autopsy rates (i.e. autopsies other than those required by law) have been declining since the 1950s," causing clinical autopsies and the pathologists who perform them to face extinction from the medical field. According to the article, the future of the autopsy "lies in promoting public support for autopsies." The new MIA may help with such promotion and public acceptance of the procedure.

Andrew Taylor, a consultant radiologist at London's Great Ormond Street Hospital and University College Hospital, co-led the recent MIA study.

"Autopsies not only help us to establish the cause of death, but they often play an important role in advancing medical research and knowledge," he told NBC. "If we can find ways to continue to carry them out using less invasive methods, such as post-mortem MRI, we can boost our understanding of the many ways in which the body can go wrong."

The study, which involved 400 cases of fetuses, babies, and children under 16, involved blood samples being taken by needle, which were used in visual examinations of the body and genetic and metabolic tests. The study, which was published in the medical journal the Lancet, compared the accuracy of standard autopsies with MIAs, or whole-body, post-mortem MRIs "with or without other minimally invasive tests."

Researchers found that the MIA identified the full cause of death for 92 percent of the fetuses and babies studied. For children between the ages of  0ne to 16, the MIAs were less accurate, with only 54 of the two types of autopsies agreeing on the cause of their deaths.

Researchers attributed the difference in accuracy to the MRI, explaining that it was "good at picking up abnormalities in organ structure or function, which are more likely to be causes of death in young babies, but unable to detect infections, which are more likely to be a cause of death in older children."

"In a state of shock and grief, parents are asked if they will consent, and while they desperately want answers about why their baby died, many simply cannot contemplate what a post mortem entails," said Charlotte Bevan of Sands, a charity that campaigns for more research into stillbirth and neonatal death. "Giving parents the option to have a less invasive but equally informative investigation will not only make the decision easier ... but could lead to an increase in post mortem up-take and vastly improved research into why so many babies are stillborn or die shortly after birth."