An approximate time for intrauterine fetal demise of a stillborn infant can be reached from clinical and postmortem findings.
Maternal Examination Prior to Delivery
Fetal movements:
(1) most women can accurately recognize fetal movements
(2) cessation of movements is usually followed by fetal death within 24 hours.
Fetal heart monitoring:
(1) false positive assessment can occur if maternal pulse taken
Examination of Fetus
Grade of Maceration
Features
Duration of Intrauterine Demise
0
• "parboiled" reddened skin
< 8 hours
I
• skin slippage and peeling
> 8 hours
II
• extensive skin peeling
• red serous effusions in chest and abdomen due to hemoglobin staining
2-7 days
III
• liver yellow-brown
• turbid effusion
• may be mummified
>= 8 days
Additional datings:
(1) bullae in epidermis (leading to peeling): appear at about 24 hours
(2) hemoglobin staining of internal viscera (loss of normal color): 24-48 hours
(3) separation of dura from calvarium bone: 5+ days
Limitations:
• Very edematous liveborn infants can have skin peeling.
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Specialty: Clinical Laboratory, Pedatrics
ICD-10: ,
