{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T15:31:42Z","timestamp":1770823902417,"version":"3.50.1"},"reference-count":26,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:p>\n                    <jats:italic>Context<\/jats:italic>\n                    .\u2014Management of second-trimester intrauterine fetal demise via dilation and evacuation results in nonintact specimens for pathologic examination. Surgical pathology examination is often mandated; however, evidence on expected findings and specimen evaluation guidelines are lacking.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Objectives<\/jats:italic>\n                    .\u2014To assess pathologic findings of nonintact, second-trimester fetal demise specimens, through comparison of anatomic abnormalities identified on standardized perinatal examination to individualized general pathology examinations.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Design<\/jats:italic>\n                    .\u2014Single institution, retrospective chart review of 14- to 24-week gestational size fetal demise cases was conducted from May 2006 to October 2010. Suspected abnormalities, chromosomal and pathologic diagnoses were collected. A general surgical pathology examination occurred between May 2006 and October 2008, while a perinatal pathologist examined specimens between October 2008 and October 2010. Statistical analysis consisted of\n                    <jats:italic>t<\/jats:italic>\n                    tests and \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    tests by Stata\/SE 12.1.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results<\/jats:italic>\n                    .\u2014One hundred eighteen specimens were included and mean gestational size was 16.0 weeks (standard deviation, 1.6 weeks). Perinatal pathologic evaluation diagnosed significantly more abnormalities than did general pathologic examination (77.3% [34 of 44] versus 9.5% [7 of 75],\n                    <jats:italic>P<\/jats:italic>\n                    &lt; .001). Forty-eight abnormalities were identified: 77.0% (n = 37) were placental and 23.0% (n = 11) were fetal. Chromosomal analysis was done on 73.7% (n = 87 of 118) with 12.6% (n = 11 of 87) showing abnormalities. Among aneuploid specimens, the perinatal pathologist confirmed abnormalities in 66.7% (n = 4 of 6) of cases while general pathologists confirmed abnormalities in 0% (n = 0 of 5) (\n                    <jats:italic>P<\/jats:italic>\n                    = .02).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    .\u2014Systematic surgical pathology examination of nonintact, second-trimester fetal demise specimens yields increased information on fetal or placental abnormalities, which may be clinically useful. Institutions with high-risk obstetrical practices and dilation and evacuation providers should consider integrating a standardized perinatal checklist into educational and practice guidelines.\n                  <\/jats:p>","DOI":"10.5858\/arpa.2012-0010-oa","type":"journal-article","created":{"date-parts":[[2013,7,30]],"date-time":"2013-07-30T16:10:06Z","timestamp":1375200606000},"page":"1083-1087","source":"Crossref","is-referenced-by-count":10,"title":["Perinatal Pathologic Examination of Nonintact, Second-Trimester Fetal Demise Specimens: The Value of Standardization"],"prefix":"10.5858","volume":"137","author":[{"given":"Lori M.","family":"Gawron","sequence":"first","affiliation":[{"name":"From the Section of Family Planning and Contraception, Department of Obstetrics and Gynecology (Drs Gawron and Hammond), and the Department of Pathology (Dr Ernst), Feinberg School of Medicine, Northwestern University, Chicago, Illinois."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassing","family":"Hammond","sequence":"additional","affiliation":[{"name":"From the Section of Family Planning and Contraception, Department of Obstetrics and Gynecology (Drs Gawron and Hammond), and the Department of Pathology (Dr Ernst), Feinberg School of Medicine, Northwestern University, Chicago, Illinois."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda M.","family":"Ernst","sequence":"additional","affiliation":[{"name":"From the Section of Family Planning and Contraception, Department of Obstetrics and Gynecology (Drs Gawron and Hammond), and the Department of Pathology (Dr Ernst), Feinberg School of Medicine, Northwestern University, Chicago, Illinois."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"issue":"2, pt 1","key":"i1543-2165-137-8-1083-b01","series-title":"Obstet Gynecol","first-page":"307","article-title":"Uterine evacuation for second-trimester fetal death and maternal morbidity","volume":"117","author":"Edlow\n              AG,","year":"2011","unstructured":"Edlow\n              AG, \n            \n              Hou\n              MY, \n            \n              Maurer\n              R, \n            \n              Benson\n              C, \n            \n              Delli-Bovi\n              L, \n            \n              Goldberg\n              AB. \n          \n          Uterine evacuation for second-trimester fetal death and maternal morbidity. Obstet Gynecol. 2011;117(2, pt 1):307\u2013316."},{"issue":"2","key":"i1543-2165-137-8-1083-b02","series-title":"BJOG","first-page":"148","article-title":"Mifepristone and misoprostol versus dilation and evacuation for midtrimester abortion: a pilot randomised controlled trial","volume":"111","author":"Grimes\n              DA,","year":"2004","unstructured":"Grimes\n              DA, \n            \n              Smith\n              MS, \n            \n              Witham\n              AD. \n          \n          Mifepristone and misoprostol versus dilation and evacuation for midtrimester abortion: a pilot randomised controlled trial. BJOG. 2004;111(2):148\u2013153."},{"issue":"2","key":"i1543-2165-137-8-1083-b03","series-title":"Obstet Gynecol","first-page":"185","article-title":"Second-trimester abortion by dilatation and evacuation: an analysis of 11,747 cases","volume":"62","author":"Peterson\n              WF,","year":"1983","unstructured":"Peterson\n              WF, \n            \n              Berry\n              FN, \n            \n              Grace\n              MR, \n            \n              Gulbranson\n              CL. \n          \n          Second-trimester abortion by dilatation and evacuation: an analysis of 11,747 cases. Obstet Gynecol. 1983;62(2):185\u2013190."},{"issue":"2","key":"i1543-2165-137-8-1083-b04","series-title":"Pediatr Dev Pathol","first-page":"131","article-title":"Correlation of prenatal ultrasound diagnosis and pathologic findings in fetal anomalies","volume":"2","author":"Sun\n              CC,","year":"1999","unstructured":"Sun\n              CC, \n            \n              Grumbach\n              K, \n            \n              DeCosta\n              DT, \n            \n              Meyers\n              CM, \n            \n              Dungan\n              JS. \n          \n          Correlation of prenatal ultrasound diagnosis and pathologic findings in fetal anomalies. Pediatr Dev Pathol. 1999;2(2):131\u2013142."},{"issue":"9","key":"i1543-2165-137-8-1083-b05","series-title":"Prenat Diagn","first-page":"800","article-title":"Evaluation of 2407 fetuses in a Turkish population","volume":"27","author":"Ceylaner\n              G,","year":"2007","unstructured":"Ceylaner\n              G, \n            \n              Ceylaner\n              S, \n            \n              Gunyeli\n              I, \n            \n              Ekici\n              E, \n            \n              Celasun\n              B, \n            \n              Danisman\n              N. \n          \n          Evaluation of 2407 fetuses in a Turkish population. Prenat Diagn. 2007;27(9):800\u2013807."},{"issue":"4","key":"i1543-2165-137-8-1083-b06","series-title":"Acta Obstet Gynecol Scand","first-page":"284","article-title":"Diagnostic evaluation of intrauterine fetal deaths in Stockholm 1998\u201399","volume":"81","author":"Petersson\n              K,","year":"2002","unstructured":"Petersson\n              K, \n            \n              Bremme\n              K, \n            \n              Bottinga\n              R, \n            et al\n          . Diagnostic evaluation of intrauterine fetal deaths in Stockholm 1998\u201399. Acta Obstet Gynecol Scand. 2002;81(4):284\u2013292."},{"issue":"6","key":"i1543-2165-137-8-1083-b07","series-title":"Aust NZJ Obstet Gynaecol","first-page":"445","article-title":"The role of autopsy following pregnancy termination for fetal abnormality","volume":"47","author":"Dickinson\n              JE,","year":"2007","unstructured":"Dickinson\n              JE, \n            \n              Prime\n              DK, \n            \n              Charles\n              AK. \n          \n          The role of autopsy following pregnancy termination for fetal abnormality. 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Pathol Res Pract. 2007;203(7):525\u2013531."},{"issue":"1","key":"i1543-2165-137-8-1083-b09","series-title":"J Ultrasound Med","first-page":"69","article-title":"Correlation of prenatal sonographic diagnosis and morphologic findings of fetal autopsy in fetuses with trisomy 21","volume":"26","author":"Szigeti\n              Z,","year":"2007","unstructured":"Szigeti\n              Z, \n            \n              Csaba\n              A, \n            \n              Pete\n              B, \n            \n              Hajdu\n              J, \n            \n              Papp\n              Z, \n            \n              Papp\n              C. \n          \n          Correlation of prenatal sonographic diagnosis and morphologic findings of fetal autopsy in fetuses with trisomy 21 [quiz inJ Ultrasound Med. 2007;26(1):69\u201370.] J Ultrasound Med. 2007;26(1):61\u201368."},{"issue":"1","key":"i1543-2165-137-8-1083-b10","series-title":"J Perinat Med","first-page":"59","article-title":"Correlation between ultrasound and autopsy findings after 2nd trimester terminations of pregnancy","volume":"36","author":"Antonsson\n              P,","year":"2008","unstructured":"Antonsson\n              P, \n            \n              Sundberg\n              A, \n            \n              Kublickas\n              M, \n            et al\n          . 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Am J Clin Pathol. 1995;103(4):415\u2013418."},{"issue":"17","key":"i1543-2165-137-8-1083-b12","series-title":"New Engl J Med","first-page":"1000","article-title":"The value of the autopsy in three medical eras","volume":"308","author":"Goldman\n              L,","year":"1983","unstructured":"Goldman\n              L, \n            \n              Sayson\n              R, \n            \n              Robbins\n              S, \n            \n              Cohn\n              LH, \n            \n              Bettmann\n              M, \n            \n              Weisberg\n              M. \n          \n          The value of the autopsy in three medical eras. New Engl J Med. 1983;308(17):1000\u20131005."},{"issue":"12","key":"i1543-2165-137-8-1083-b13","series-title":"Arch Pediatr Adolesc Med","first-page":"1190","article-title":"What new information pediatric autopsies can provide: a retrospective evaluation of 100 consecutive autopsies using family-centered criteria","volume":"161","author":"Feinstein\n              JA,","year":"2007","unstructured":"Feinstein\n              JA, \n            \n              Ernst\n              LM, \n            \n              Ganesh\n              J, \n            \n              Feudtner\n              C. \n          \n          What new information pediatric autopsies can provide: a retrospective evaluation of 100 consecutive autopsies using family-centered criteria. Arch Pediatr Adolesc Med. 2007;161(12):1190\u20131196."},{"issue":"2, pt 1","key":"i1543-2165-137-8-1083-b01","series-title":"Obstet Gynecol","first-page":"307","article-title":"Uterine evacuation for second-trimester fetal death and maternal morbidity","volume":"117","author":"Edlow\n              AG,","year":"2011","unstructured":"Edlow\n              AG, \n            \n              Hou\n              MY, \n            \n              Maurer\n              R, \n            \n              Benson\n              C, \n            \n              Delli-Bovi\n              L, \n            \n              Goldberg\n              AB. \n          \n          Uterine evacuation for second-trimester fetal death and maternal morbidity. Obstet Gynecol. 2011;117(2, pt 1):307\u2013316."},{"issue":"2","key":"i1543-2165-137-8-1083-b02","series-title":"BJOG","first-page":"148","article-title":"Mifepristone and misoprostol versus dilation and evacuation for midtrimester abortion: a pilot randomised controlled trial","volume":"111","author":"Grimes\n              DA,","year":"2004","unstructured":"Grimes\n              DA, \n            \n              Smith\n              MS, \n            \n              Witham\n              AD. \n          \n          Mifepristone and misoprostol versus dilation and evacuation for midtrimester abortion: a pilot randomised controlled trial. BJOG. 2004;111(2):148\u2013153."},{"issue":"2","key":"i1543-2165-137-8-1083-b03","series-title":"Obstet Gynecol","first-page":"185","article-title":"Second-trimester abortion by dilatation and evacuation: an analysis of 11,747 cases","volume":"62","author":"Peterson\n              WF,","year":"1983","unstructured":"Peterson\n              WF, \n            \n              Berry\n              FN, \n            \n              Grace\n              MR, \n            \n              Gulbranson\n              CL. \n          \n          Second-trimester abortion by dilatation and evacuation: an analysis of 11,747 cases. Obstet Gynecol. 1983;62(2):185\u2013190."},{"issue":"2","key":"i1543-2165-137-8-1083-b04","series-title":"Pediatr Dev Pathol","first-page":"131","article-title":"Correlation of prenatal ultrasound diagnosis and pathologic findings in fetal anomalies","volume":"2","author":"Sun\n              CC,","year":"1999","unstructured":"Sun\n              CC, \n            \n              Grumbach\n              K, \n            \n              DeCosta\n              DT, \n            \n              Meyers\n              CM, \n            \n              Dungan\n              JS. \n          \n          Correlation of prenatal ultrasound diagnosis and pathologic findings in fetal anomalies. Pediatr Dev Pathol. 1999;2(2):131\u2013142."},{"issue":"9","key":"i1543-2165-137-8-1083-b05","series-title":"Prenat Diagn","first-page":"800","article-title":"Evaluation of 2407 fetuses in a Turkish population","volume":"27","author":"Ceylaner\n              G,","year":"2007","unstructured":"Ceylaner\n              G, \n            \n              Ceylaner\n              S, \n            \n              Gunyeli\n              I, \n            \n              Ekici\n              E, \n            \n              Celasun\n              B, \n            \n              Danisman\n              N. \n          \n          Evaluation of 2407 fetuses in a Turkish population. Prenat Diagn. 2007;27(9):800\u2013807."},{"issue":"4","key":"i1543-2165-137-8-1083-b06","series-title":"Acta Obstet Gynecol Scand","first-page":"284","article-title":"Diagnostic evaluation of intrauterine fetal deaths in Stockholm 1998\u201399","volume":"81","author":"Petersson\n              K,","year":"2002","unstructured":"Petersson\n              K, \n            \n              Bremme\n              K, \n            \n              Bottinga\n              R, \n            et al\n          . Diagnostic evaluation of intrauterine fetal deaths in Stockholm 1998\u201399. Acta Obstet Gynecol Scand. 2002;81(4):284\u2013292."},{"issue":"6","key":"i1543-2165-137-8-1083-b07","series-title":"Aust NZJ Obstet Gynaecol","first-page":"445","article-title":"The role of autopsy following pregnancy termination for fetal abnormality","volume":"47","author":"Dickinson\n              JE,","year":"2007","unstructured":"Dickinson\n              JE, \n            \n              Prime\n              DK, \n            \n              Charles\n              AK. \n          \n          The role of autopsy following pregnancy termination for fetal abnormality. 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Pathol Res Pract. 2007;203(7):525\u2013531."},{"issue":"1","key":"i1543-2165-137-8-1083-b09","series-title":"J Ultrasound Med","first-page":"69","article-title":"Correlation of prenatal sonographic diagnosis and morphologic findings of fetal autopsy in fetuses with trisomy 21","volume":"26","author":"Szigeti\n              Z,","year":"2007","unstructured":"Szigeti\n              Z, \n            \n              Csaba\n              A, \n            \n              Pete\n              B, \n            \n              Hajdu\n              J, \n            \n              Papp\n              Z, \n            \n              Papp\n              C. \n          \n          Correlation of prenatal sonographic diagnosis and morphologic findings of fetal autopsy in fetuses with trisomy 21 [quiz inJ Ultrasound Med. 2007;26(1):69\u201370.] J Ultrasound Med. 2007;26(1):61\u201368."},{"issue":"1","key":"i1543-2165-137-8-1083-b10","series-title":"J Perinat Med","first-page":"59","article-title":"Correlation between ultrasound and autopsy findings after 2nd trimester terminations of pregnancy","volume":"36","author":"Antonsson\n              P,","year":"2008","unstructured":"Antonsson\n              P, \n            \n              Sundberg\n              A, \n            \n              Kublickas\n              M, \n            et al\n          . Correlation between ultrasound and autopsy findings after 2nd trimester terminations of pregnancy. J Perinat Med. 2008;36(1):59\u201369."},{"issue":"4","key":"i1543-2165-137-8-1083-b11","series-title":"Am J Clin Pathol","first-page":"415","article-title":"Pathologic examination of fetal specimens from dilation and evacuation procedures","volume":"103","author":"Klatt\n              EC.","year":"1995","unstructured":"Klatt\n              EC. \n          \n          Pathologic examination of fetal specimens from dilation and evacuation procedures. Am J Clin Pathol. 1995;103(4):415\u2013418."},{"issue":"17","key":"i1543-2165-137-8-1083-b12","series-title":"New Engl J Med","first-page":"1000","article-title":"The value of the autopsy in three medical eras","volume":"308","author":"Goldman\n              L,","year":"1983","unstructured":"Goldman\n              L, \n            \n              Sayson\n              R, \n            \n              Robbins\n              S, \n            \n              Cohn\n              LH, \n            \n              Bettmann\n              M, \n            \n              Weisberg\n              M. \n          \n          The value of the autopsy in three medical eras. New Engl J Med. 1983;308(17):1000\u20131005."},{"issue":"12","key":"i1543-2165-137-8-1083-b13","series-title":"Arch Pediatr Adolesc Med","first-page":"1190","article-title":"What new information pediatric autopsies can provide: a retrospective evaluation of 100 consecutive autopsies using family-centered criteria","volume":"161","author":"Feinstein\n              JA,","year":"2007","unstructured":"Feinstein\n              JA, \n            \n              Ernst\n              LM, \n            \n              Ganesh\n              J, \n            \n              Feudtner\n              C. \n          \n          What new information pediatric autopsies can provide: a retrospective evaluation of 100 consecutive autopsies using family-centered criteria. 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