Clinical trial NCT02148055: Comparative Evaluation of IRM and Autopsy in the Evaluation of Intra Uterine Fetal Death
Official title: Comparative Evaluation of IRM and Autopsy in the Evaluation of Intra Uterine Fetal Death.
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: NA
Conditions: Spontaneous Intra Uterine Fetal Death
Keywords: spontaneous intrauterine death
fetal MRI
autopsy
Lead sponsor: University Hospital, Rouen
Sponsor class: OTHER
First posted: 2014-05-28
Enrollment: 2
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: DIAGNOSTIC

Brief summary: Fetal intra uterine death is a rare event (incidence 2/1000 births) , unexpected and psychologically painful for the couple and the healthcare team. In this difficult context, it is essential to understand the etiology of death to guide the management of subsequent pregnancies. Among the investigations, foetopathologic examination is essential, but the examination of the brain is not possible in more than half of the cases due to the cerebral maceration due to the incompressible delay between death and expulsion.

The use of MRI as a diagnostic tool fetal post- mortem " virtual autopsy " performed before expulsion of the fetus is interesting because it would permit to obtain a macroscopic examination of the fetal brain, archivable, and a gain concerning the diagnosis. Thus, a normal MRI will exclude cerebral anatomical abnormality , stroke or bleeding . If MRI abnormalities are found , it will not only guide the foetopathologic review, but mainly to guide the etiology . On the other hand , it is a non-invasive tool and acceptability by the couple would be better than autopsy which is often refused by the couple in this difficult psychological context.

In this study , MRI will be given in addition to conventional autopsy in the painful waiting time between the time of diagnosis of death and expulsion without delaying care . If this study is validated , MRI may be systematically proposed in this indication or alternative to autopsy when it will be refused by the parents.


Eligibility criteria: Inclusion Criteria:

* Patient for which he was diagnosed with intra uterine death confirmed by ultrasound
* Mono fetal pregnancy,
* Term: 24 to 42 weeks' gestation
* Age\> 18 years
* Patient having readen the letter of information and signed the consent.

Exclusion Criteria:

* Contraindication to MRI (heart valve, pacemaker, neurosurgical clips, claustrophobia, intraocular metallic foreign bodies)
* Maternal complications: bleeding during, eclampsia, placental hematoma retro, imminent work
* Twin pregnancy
* Patient under guardianship or trusteeship
* Patient not speaking and writing French

Primary outcomes:
measure: Recognition of anatomic cerebral structures evaluated by a common grid.
timeFrame: Before H 24 for MR. Bedore day 5 for autopsy.
Secondary outcomes:
measure: Recognition and mesurement of anatomic thoracic and abdominal structures by a common grid.
timeFrame: Before H24 for MR. Before day 5 for autopsy.
measure: Recognition and mesurement of the placenta and umbilical cord.
timeFrame: Before H24 for IRM. Before day 5 for autopsy.
measure: Comparaison of quality criteria of both exams.
timeFrame: Before H24 for MRI. Before day 5 for autopsy.
Other outcomes:
Locations:
city: Rouen
country: France
facility: CHU Hopitaux de Rouen
Study officials:
References: