Use of casts in the necropsy diagnosis of fetal congenital heart disease.

OBJECTIVE To evaluate a casting technique in the interpretation of fetal cardiac anatomy. DESIGN In 32 fetuses, the echocardiographic and cast features were compared and correlated. PATIENTS Three normal fetal heart specimens from spontaneous abortuses and 32 specimens from spontaneous or induced abortions with congenital heart malformation. RESULTS There was close correlation between the echocardiographic and anatomical features in 32 abnormal fetuses studied. In some, additional features of diagnosis could be displayed on the cast and the relative sizes of the cardiac structures could be appreciated and defined. CONCLUSIONS With increasing echocardiographic detection of congenital heart disease in early prenatal life, an increasing number of fetal heart specimens of small size are dissected for pathological confirmation. The use of silicone rubber casts to reproduce the internal anatomy proved a useful addition to dissection, providing a three dimensional model of the cardiac defect.