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


Duration of Intrauterine Demise


• "parboiled" reddened skin

< 8 hours


• skin slippage and peeling

> 8 hours


• extensive skin peeling

• red serous effusions in chest and abdomen due to hemoglobin staining

2-7 days


• 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



• Very edematous liveborn infants can have skin peeling.


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