A fetus that shows no signs of life and weighs 1000 g or more is classified as stillborn child.
Maceration (from Latin macerare — soften by soaking) includes all the changes which occur in a fetus retained in utero after death.
The risk of intrauterine demise increases toward term, approximately one third occurs at full term. A direct cause of death is found in only 50% of stillbirths. Full autopsy including examination of placenta, umbilical cord and membraned should be performed in all cases.
Sateges of maceration:
Estimating the time of death in stillborn fetus
Cause of death in macerated stillbirth
Autoptic signs of asphyxia are often found: small hemorrhages over the thymus, lungs and heart, congestion of internal organs. The lungs are airless. Light microscopy reveals amniotic fluid aspiration. Exact cause of death often remains unexplained but the mode of death (acute asphyxia of chronic fetal hypoxia) can be established in most cases unless severe maceration. Gross malformations or multiple congenital defects are occasionaly seen. On the other hand minor malformations and anomalies are unlikely to be the cause of death but sometimes may lead to diagnosis of chromosomal disorder (triploidy, trisomies). Negative findings (no congenital malformations or anomalies, normal growth and developement) are also helpful to both the parents and clinicans/genetics.
Minimal maceration of grade 0, skin slippage on
pressure. 40-week gestation stillbirth. The mode of death was
acute intrauterine asphyxia from unknown causes. The placenta
was stained by meconium.
Maceration, meconium staining, Macro, autopsy (73872)
Maceration, meconium staining, Macro, autopsy (73871)
Maceration, meconium staining, Macro, autopsy (73873)
Macerated stillbirth (stage I. maceration), true umbilical knot:
Umbilical knot, Macro, autopsy (73881)
Macerated 39-week stillbirth, stage II. maceration. Compression
of abnormal velamentous vessels by fetal presenting parts and
subsequent thrombosis was the cause of death.
Maceration, gr. 2, Macro, autopsy (73833)
Macerated term stillbirth, stage II. maceration, intrauterine
death at 39 week's gestation from acute intrauterine asphyxia
of unknown cause.
Maceration, mature child, Macro, autopsy (73837)
Maceration stage II.; head collapse with overlapping cranial bones:
Maceration, collaps of the calva, Macro, autopsy (73835)
Maceration, collaps of the calva, Macro, autopsy (73836)
Maceration, collaps of the calva, Macro, autopsy (73834)
Intrauterine fetal death at 31 week's gestation. Maceration
stage II. Stillbirth fetus with intrauterine growth retardation
of malnutrition type, birth weight 1000g. The cause of
stillbirth is chronic intrauterine hypoxia from large central
Placental infarctions, Macro, autopsy (73822)
Intrauterine death due to placental infarctions, Macro, autopsy (73820)
Intrauterine death due to placental infarctions, Macro, autopsy (73821)
Intrauterine death due to placental infarctions, Macro, autopsy (73818)
Intrauterine death due to placental infarctions, Macro, autopsy (73819)
Brain malformation (semilobar holoprosencephaly]
incompatible with survival in 32-week stillbirth. No signs
of maceration. Elective preterm delivery because of fatal
malformation. Malformation of brain is associated with
malformation of the central part of the face.
Holoprosencephaly, Macro, autopsy (73887)
Fetus, mumification, Macro, autopsy (73992)
Perinatal mortality is the sum of still births and deaths under 7 days per 1000 total births. Stillbirths are the major component of perinatal mortality, twice as common as early neonatal deaths. More than 300 stillbirths occur annually in the Czech republic. The number of stillbirths remains largely unchanged in recent years while the neonatal mortality has been declined significantly.
Definition of terms
Mortality rates in the Czech republic in 2007:
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