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Histologic Estimation of Intrauterine Retention Time after Fetal Death

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The intrauterine retention time (IURT) after fetal death can be estimated from the loss of nuclear basophilia. We therefore attempted to derive an autolysis equation to estimate IURT in experimental rat fetuses and human fetal autopsy slides. The degree of loss of nuclear basophilia in various tissues was assessed by hematoxylin and eosin (H & E) staining. Fetal rat tissues showed different rates of autolysis, allowing for the construction of an experimental autolysis curve. We also reviewed the H &E stained slides obtained from 27 human fetal autopsy cases with well-documented death intervals. The degree of autolysis in various tissues was evaluated using percentile scores (PS). Using the findings from H&E staining, we derived the equation Ln (PS/[100-PS]) = 2.62716-0.02377 × IURT. However, this equation or autolysis scores showed some limitations. Owing to the inconsistency of PS, this equation is reliably applicable only within 24 hours of intrauterine fetal death. In the fetal autopsy review, fetal hydrops, local effusion, and sepsis also contributed to accelerated autolysis.

Abstract

The intrauterine retention time (IURT) after fetal death can be estimated from the loss of nuclear basophilia. We therefore attempted to derive an autolysis equation to estimate IURT in experimental rat fetuses and human fetal autopsy slides. The degree of loss of nuclear basophilia in various tissues was assessed by hematoxylin and eosin (H & E) staining. Fetal rat tissues showed different rates of autolysis, allowing for the construction of an experimental autolysis curve. We also reviewed the H &E stained slides obtained from 27 human fetal autopsy cases with well-documented death intervals. The degree of autolysis in various tissues was evaluated using percentile scores (PS). Using the findings from H&E staining, we derived the equation Ln (PS/[100-PS]) = 2.62716-0.02377 × IURT. However, this equation or autolysis scores showed some limitations. Owing to the inconsistency of PS, this equation is reliably applicable only within 24 hours of intrauterine fetal death. In the fetal autopsy review, fetal hydrops, local effusion, and sepsis also contributed to accelerated autolysis.

참고문헌 (5)

  1. Shanklin DR, "Fetal maceration. 2. An analysis of 53 human stillborn infants", Am J Obstet Gynecol, 88, pp.224~229 (1964)
  2. Babala J, "Practical significance and various new aspects arising from the pathological-anatomical analysis of intrauterine dead fetuses", Bratisl Lek Listy, 54, pp.210~215 (1970)
  3. Genest DR, "Estimating the time of death in stillborn fetuses: I. Histologic evaluation of fetal organs; an autopsy study of 150 stillborns", Obstet Gynecol, 80, pp.575~584 (1992)
  4. Langman J, "Medical embryology", pp.351~ (1981)
  5. Dillman RC, "Sequential sterile autolysis in the ovine fetus: microscopic changes", Am J Vet Res, 40, pp.321~325 (1979)

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