Minimally Invasive Tissue Sampling in Preterm Deaths: A Validation Study

• Main Authors: Rahell Hailu MD, Tigist Desta MD, Yonas Bekuretsion MD, Messele Bezabih MD, Addisu Alemu MD, Tiruzer Bekele MD, Bewketu Abebe MD, Mesfin Asefa MD, Zemene Tigabu MD, Yonas Girma MD, Beza Eshetu MD, Mahlet Abayneh MD, Amha Mekasha MD, Assaye Kassie Nigussie MD, Elizabeth M McClure PHD, Robert L Goldenberg MD, Lulu M Muhe MD, PHD
• Format: Article
• Language: English
• Published: SAGE Publishing 2020-08-01
• Series: Global Pediatric Health
• Online Access: https://doi.org/10.1177/2333794X20953263

Uncertainty about the causes of neonatal deaths impedes achieving global health targets to reduce mortality. Complete diagnostic autopsy (CDA) is the gold standard to determine cause of death. However, it is often difficult to perform in high-burden, low-income settings. Validations of more feasible methods to determine cause of death are needed. This prospective, multi-center study in Ethiopia assessed the validity of the minimally invasive tissue sampling (MITS) approach to contribute to causes of death in preterm neonates compared to CDA. The MITS and CDA of 105 cases were reviewed. The MITS sampling success for lungs and liver was 100% and 84%, respectively. The kidney and brain had sampling successes of 58% each. MITS showed good agreement with CDA for the diagnosis of hyaline membrane disease (kappa = 0.78), and moderate to substantial agreement for pneumonia and pulmonary hemorrhage (kappa = 0.59 and 0.68, respectively). Even though CDA is the gold standard in identifying the cause of death, we believe that the MITS method can be a useful alternative method in supporting determination of cause of death in low-resource settings.