, meaning “the act of seeing with one’s own eyes,” is a centuries-old technique and a cornerstone of medical diagnostics. Autopsies can help inform treatments, sharpen diagnoses, and correct misdiagnoses. Without them, death often remains a dense, impenetrable mystery. Nowhere is this more true than when the individual in question is a child—and even more so if that child never gets the chance to leave the womb.
But an autopsy is invasive, involving cutting open the body to inspect the organs inside. In the case of children, the idea can horrify parents, even if the cause of death is unknown. “More and more parents are finding that socially unacceptable, or feeling that they don’t want to put their baby through that,” says Owen Arthurs, a professor of radiology at Great Ormond Street Hospital, a children’s hospital in London.
“Even though we don’t always find a cause of death, what we got from parents’ feedback is that finding nothing is actually really helpful for them psychologically, because a lot of them think it’s their fault or something they did wrong,” says Susan Shelmerdine, a consultant academic pediatric radiologist with the team. “Just knowing it wasn’t something they did has actually been shown to be beneficial.
Still, a typical CT or MRI scan doesn’t create detailed enough images to fully capture what may have happened inside the body of a very small baby. To rectify this, the team has pioneered the use of a newer imaging technique with very young children, called microfocus computed tomography, or micro-CT. It captures 3D objects in higher resolution, meaning the team can inspect small babies with
of accuracy as with an invasive autopsy. If needed, a small-incision laparoscopic autopsy—keyhole surgery where the pathologist looks inside the body using a camera mounted on the end of a thin tube—can be used as well.
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