Although contemporary prenatal testing has improved the recognition of fetal anomalies, autopsy remains a valuable tool by providing diagnosis or clarification of some prenatal findings in 16% of cases . Furthermore, it has been shown that autopsy provides important information decisive for genetic counseling in over 50% of cases .
In the past several decades, the number of terminations of pregnancies has increased secondary to the development of prenatal diagnosis . During the same period, fetal and neonatal autopsy rates have decreased worldwide . This resulted in a loss of major information that could have been used to counsel clinicians and parents regarding future pregnancies . This reduction is mainly due to parental refusal of the autopsies; the reasons for their objection are (among others): religious considerations, fear of disfiguration of the dead fetus, and delay in funeral plans [6, 7]. This has brought about the development of less invasive techniques for the analysis of dead fetuses. Postmortem fetal magnetic resonance imaging (PMFMRI) has been shown to be significantly more acceptable for parents and many healthcare professionals ; therefore, the demand for such (less invasive) imaging examinations has increased.
Besides PMFMRI, other postmortem imaging modalities have been increasingly used or been developed, including conventional radiographs, ultrasonography (US), and computed tomography (CT). Each of these techniques has its own advantages and limitations. Still, to date, no or little established standardized guidelines have been defined for perinatal and pediatric postmortem imaging. Across European countries, there is no unique approach to determine which subpopulation of postmortem fetuses should be imaged and with what modality . This will need to be defined in the near future.
PMFMRI has an overall high negative predictive value and can be used as a first intention/screening tool. A discussion between experienced perinatal radiologists, fetal pathologists, and geneticists could then select which cases would require full or selective autopsy . This will be particularly important for central nervous system (CNS) anomalies .
For some authors, gestational age and body weight influence the diagnostic accuracy of PMFMRI. Jawad et al.  used the cut-off of 500 g. In their series, they demonstrated that PMFMRI provides diagnostic images in 90% of fetuses with a body weight > 535 g, opposed to less than 50% of fetuses with a body weight < 122 g. Therefore, they concluded that 500 g should be the limit for PMFMRI at 1.5 T. Their experience is not completely confirmed by ours. We do perform second trimester PMFMRI and we almost always have diagnostic images for fetuses with low body weight (our smallest fetus weighed 140 g at 15 weeks gestation) . Furthermore, the prenatal diagnosis of malformations becomes more accurate in small fetuses and termination of second trimester pregnancies tends to increase. It will, therefore, be important to further develop sequences adapted to small fetuses.
In order to optimize the contribution of PMFMRI, additional information from non-invasive examinations are required, including detailed external examination, skeletal radiographs, placental analysis, and genetic testing .
The aims of the present overview are to summarize the present (and hypothesize the future) utility of PMFMRI based on the presently available literature and on our own experience, as we perform it routinely in daily clinical practice.