Approccio diagnostico al nato morto con anomalia. Studio prospettico di 102 nati.

A prospective study of 102 consecutive perinatal deaths (84 still borns and 18 new borns who died a few minutes after birth) was performed over a 3 -year period. The diagnostic protocol entailed: three-generation pedigree; ex ternal physical examination (100% of cases); autopsy (96 % ); chromosome an alysis (52%) ; full-body radio graphs (86%), and photography for malformations. Fetal anomalies were observed in 33 (including a pair of identical twins) of 102 subj ects (32%). Analysis of the various procedures used in our study and in the literature suggests that external physical examination, autopsy, radiography, and chromosome analysis should be performed in all cases of stil lbirth and early neonatal death. External physical examination is an efficacious diagnostic tool which cannot be substituted by other investigation. If technical difficulty exists, karyotyping may be used selectively in macerated still births. The importance of an attending coordinator, who formulates a diagnostic conclusion and informes the family, is stressed.