Background: The aims of this study were to evaluate the trend and
clinical utility of the autopsy in Bahrami Children's Hospital in
Tehran, Iran. Methods: In this retrospective descriptive-analytic
survey during a six years course from 1998 to 2003, autopsies in the
hospital were studied. The clinical and autopsy diagnoses were compared
and categorized as follows: 1. Change (Clinical and Autopsy diagnoses
discordant), 2. Add (Significant unexpected findings noted on the
autopsy, although the clinical diagnosis was not altered), 3. Confirm
(Clinical and Autopsy diagnoses concordant), 4. Autopsy inconclusive
Findings: Eighty four autopsies were studied. Out of 350 neonatal
deaths, autopsy was performed in 74 neonates (21%) and of 249 under 5
year deaths (except neonates) autopsy was performed in only 10 cases
(4%). The autopsy rate declined during these years. In 61 cases (73%)
the autopsy diagnoses confirmed the clinical diagnosis, in 10 cases
(12%) it changed the clinical diagnoses, in 11 cases (13%) it
significantly added to the clinical diagnoses and in 2 cases (2%) it
was inconclusive.Conclusions: This study reveals a decline in neonatal
and infant autopsy during a six year period. This study also
demonstrates that neonatal and infant autopsy continues to provide
clinically useful data in 25% of cases and remains a valuable tool in
pediatric medicine