{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:22:16Z","timestamp":1762917736570,"version":"3.37.3"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,10,25]],"date-time":"2016-10-25T00:00:00Z","timestamp":1477353600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NIHR Senior Investigator award"},{"name":"Great Ormond Street Hospital Children's Charity"},{"name":"NIHR Biomedical Research Centre at Great Ormond Street Hospital"},{"name":"Sands (Stillbirth and neonatal death society)"},{"name":"NIHR Clinician Scientist fellowship"},{"DOI":"10.13039\/501100009324","name":"Tommy's","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009324","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The postmortem fetal brain:liver weight ratio is commonly used as a marker of nutrition for diagnosis of fetal growth restriction (FGR). However, there are limited data regarding the effects of intrauterine retention, fetal maceration and postmortem interval on organ weights and their ratios at autopsy. Our aims were to examine the relationships between gestational\u2010age\u2010adjusted and sex\u2010adjusted fetal organ weights at autopsy, cause of intrauterine death and effects of intrauterine retention, and to determine whether the brain:liver weight ratio is a reliable marker of FGR in intrauterine death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>As part of a larger study examining autopsy findings in intrauterine death, data from two specialist centers in London were collated in a specially designed database. Autopsy and clinical information for &gt; 1000 intrauterine deaths between 2005 and 2013 were extracted. Adjusted (delta) organ weights were calculated by plotting against gestational age female and male brain, liver, thymus, heart, combined kidney, combined lung, spleen and combined adrenal gland weights. Polynomial regression was used to determine best fit and to calculate expected (50<jats:sup>th<\/jats:sup> centile) organ weights and deviations from expected. We compared adjusted organ weights and body:organ weight ratios in fetuses which were small\u2010for\u2010gestational age (SGA) at autopsy (birth weight &lt; 10<jats:sup>th<\/jats:sup> centile for normal live births) <jats:italic>vs<\/jats:italic> those in fetuses which were not, and in macerated <jats:italic>vs<\/jats:italic> non\u2010macerated fetuses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of fetal organs (brain, liver, heart, thymus, lungs, kidneys and thyroid) in SGA fetuses were significantly lighter than those in non\u2010SGA fetuses. Body:organ weight ratios for thymus, liver and spleen were significantly greater in SGA fetuses, indicating these organs to be disproportionately small. The majority of organs were significantly lighter in macerated compared with non\u2010macerated fetuses and body:organ weight ratios for most organs (liver, thymus, lung, pancreas, adrenal gland, kidney, heart) were significantly greater in macerated compared with non\u2010macerated fetuses. When SGA cases with demonstrable placental histological abnormalities were compared with other SGA cases, there was a significant difference in the brain:liver weight ratio (median, 6 <jats:italic>vs<\/jats:italic> 3.5).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Changes after intrauterine death lead to loss of fetal weight, with preferential weight loss of visceral organs such as the liver. Maceration therefore affects the brain:liver weight ratio and adjustment should be made for such changes during interpretation of ratios. Fetal organ weights may be affected significantly by mechanism of death and postmortem changes. The fetal brain:liver weight ratio may provide useful information regarding intrauterine growth status at time of death, provided that adjustment is made for effects of intrauterine retention and that appropriate cut\u2010off values are used. Copyright \u00a9 2016 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.16017","type":"journal-article","created":{"date-parts":[[2016,10,26]],"date-time":"2016-10-26T00:02:40Z","timestamp":1477440160000},"page":"585-590","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Organ weights and ratios for postmortem identification of fetal growth restriction: utility and confounding factors"],"prefix":"10.1002","volume":"48","author":[{"given":"J.","family":"Man","sequence":"first","affiliation":[{"name":"Department of Histopathology, Camelia Botnar Laboratories Great Ormond Street Hospital  London UK"},{"name":"University College London Institute of Child Health  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. C.","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Camelia Botnar Laboratories Great Ormond Street Hospital  London UK"},{"name":"University College London Institute of Child Health  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Ashworth","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Camelia Botnar Laboratories Great Ormond Street Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Jeffrey","sequence":"additional","affiliation":[{"name":"Department of Histopathology St George's Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. E.","family":"Heazell","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Manchester University  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. J.","family":"Sebire","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Camelia Botnar Laboratories Great Ormond Street Hospital  London UK"},{"name":"University College London Institute of Child Health  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,10,25]]},"reference":[{"unstructured":"The Royal College of Pathologists Guidelines on autopsy practice","key":"e_1_2_6_2_1"},{"doi-asserted-by":"publisher","key":"e_1_2_6_3_1","DOI":"10.1111\/dme.12272"},{"doi-asserted-by":"publisher","key":"e_1_2_6_4_1","DOI":"10.1136\/bmj.f108"},{"doi-asserted-by":"publisher","key":"e_1_2_6_5_1","DOI":"10.1136\/archdischild-2014-306576.474"},{"doi-asserted-by":"publisher","key":"e_1_2_6_6_1","DOI":"10.5694\/mja12.10125"},{"doi-asserted-by":"publisher","key":"e_1_2_6_7_1","DOI":"10.1136\/bmj.38629.587639.7C"},{"doi-asserted-by":"publisher","key":"e_1_2_6_8_1","DOI":"10.1007\/s00404-009-1317-4"},{"doi-asserted-by":"publisher","key":"e_1_2_6_9_1","DOI":"10.1080\/01443610802716042"},{"doi-asserted-by":"publisher","key":"e_1_2_6_10_1","DOI":"10.1097\/PAT.0000000000000188"},{"doi-asserted-by":"publisher","key":"e_1_2_6_11_1","DOI":"10.3109\/14767058.2016.1154525"},{"doi-asserted-by":"publisher","key":"e_1_2_6_12_1","DOI":"10.1136\/jcp.25.10.867"},{"doi-asserted-by":"publisher","key":"e_1_2_6_13_1","DOI":"10.1016\/j.bpobgyn.2009.06.006"},{"doi-asserted-by":"publisher","key":"e_1_2_6_14_1","DOI":"10.1038\/modpathol.3880251"},{"unstructured":"World Health Organization.Early years \u2010 UK\u2010WHO growth charts and resources.http:\/\/www.rcpch.ac.uk\/child\u2010health\/research\u2010projects\/uk\u2010who\u2010growth\u2010charts\/uk\u2010who\u2010growth\u2010chart\u2010resources\u20100\u20104\u2010years\/uk\u2010who\u20100[Accessed 5 July2016].","key":"e_1_2_6_15_1"},{"doi-asserted-by":"publisher","key":"e_1_2_6_16_1","DOI":"10.1002\/uog.16016"},{"doi-asserted-by":"publisher","key":"e_1_2_6_17_1","DOI":"10.1002\/uog.16019"},{"doi-asserted-by":"publisher","key":"e_1_2_6_18_1","DOI":"10.1007\/s10024-004-7084-0"},{"doi-asserted-by":"publisher","key":"e_1_2_6_19_1","DOI":"10.1002\/uog.5199"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fuog.16017","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.16017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T19:42:41Z","timestamp":1694634161000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.16017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,25]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2016,11]]}},"alternative-id":["10.1002\/uog.16017"],"URL":"https:\/\/doi.org\/10.1002\/uog.16017","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"type":"print","value":"0960-7692"},{"type":"electronic","value":"1469-0705"}],"subject":[],"published":{"date-parts":[[2016,10,25]]},"assertion":[{"value":"2016-05-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}