Estimating the time of death in stillborn fetuses

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Estimating the Time of death in stillborn fetuses

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

• Bullae in epidermis (leading to peeling): appear at about 24 hours
• Hemoglobin staining of internal viscera (loss of normal color): 24-48 hours
• Separation of dura from calvarium bone: 5+ days

REFERENCES

1. Bain AD. The perinatal autopsy, pages 820-834. IN: Cockburn F, Drillien CM (editors). Neonatal Medicine. Blackwell Scientific Publications. 1974.
2. Langley FA. The perinatal postmortem examination. J Clin Pathol. 1971; 24: 159-169.
3. Wigglesworth JS. Perinatal Pathology, Second Edition. WB Saunders. 1996. Chapter 6: The macerated stillborn fetus. pages 78-86.