Dating of the intrauterine fetal demise dating sex perm
The gap between 24 hours and 2 weeks can be filled using histologic features if they are adequately searched for. found that the distribution of a single feature on routine histologic slides allowed for interval estimates.That feature was loss of nuclear basophilia (loss of hematoxylin staining of nucleoproteins of cells) of a particular organ: Loss of at least 1% of nuclear staining - We have not routinely included estimates of time interval between death and delivery in our summaries.Given the relevance of severity of maceration to timing of fetal death, it is a little surprising that no careful assessment of the absolute relationship (rather than just the sequence) between macerative changes and interval since death was attempted until recently.Prior to then we could only vaguely correlate severity of maceration and interval since death.That scale of severity of maceration is as follows: None Slight -- skin slippage, rare bullae, little (e.g.scrotum only or single spots of skin loss elsewhere) or no denudation Mild -- focal denudation of multiple regions without other changes Moderate-- generalized skin maceration/ denudation but without significant compressive changes Advanced -- compression and/or mummification and/or internal liquefaction Examples of each of these are shown in the figures.
The causes of a large percentage of stillbirths is unknown, even in cases where extensive testing and autopsy have been performed.
From those assessments they were able to provide far more specific information about the absolute timing of external macerative changes, internal histologic changes and placental changes.
Related to external characteristics they found that changes occurred somewhat more rapidly than previously assumed.
In the Wi SSP series, the distribution of degree of maceration in the first 1040 stillborns is: (with the rest "indeterminate").
Note that intrapartum deaths (babies with no macerative changes) are quite infrequent, accounting for only about a sixth of all stillborns.