Document Detail


Estimating the time of death in stillborn fetuses: I. Histologic evaluation of fetal organs; an autopsy study of 150 stillborns.
MedLine Citation:
PMID:  1383898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether the autopsy histology of fetal tissues can determine the time of death of stillborn fetuses. METHODS: Hematoxylin and eosin slides from autopsies of 150 stillborn fetuses with well-timed deaths were evaluated retrospectively. Fetuses were divided into a learning set (100 fetuses) and a test set (50 fetuses). RESULTS: From assessment of the 100 fetuses in the learning set, 23 histologic features were identified with possible temporal associations with fetal death. When those histologic features were randomly and blindly assessed in the 50 test fetuses, ten features performed well as diagnostic tests (sensitivity, specificity, and positive predictive values at or above 0.875), correctly classifying 43 of 50 fetuses (86%) with respect to the time of death. The ten histologic features and their predicted death-to-delivery intervals were: loss of nuclear basophilia in individual cells in renal cortical tubules (4 hours), liver (24 hours), inner half of the myocardium (24 hours), outer half of the myocardium (48 hours), bronchial epithelium (96 hours), and tracheal cartilage (1 week); and loss of nuclear basophilia of all cells in the liver (96 hours), gastrointestinal tract (1 week), adrenal (1 week), and kidney (4 weeks). The development of these histologic changes appeared to be accelerated by fetal hydrops and a delivery-to-autopsy interval exceeding 24 hours and decelerated by fetal gestational age under 25 weeks. CONCLUSION: Histologic changes identifiable in hematoxylin and eosin-stained fetal tissue may be useful for estimating the time of death in many stillborn fetuses.
Authors:
D R Genest; M A Williams; M F Greene
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  80     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-10-26     Completed Date:  1992-10-26     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  575-84     Citation Subset:  AIM; IM    
Affiliation:
Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.
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MeSH Terms
Descriptor/Qualifier:
Autopsy
Cell Nucleus / pathology
Eosine Yellowish-(YS)
Female
Fetal Death / pathology*
Gestational Age
Hematoxylin
Humans
Male
Observer Variation
Predictive Value of Tests
Retrospective Studies
Sensitivity and Specificity
Staining and Labeling
Time Factors
Chemical
Reg. No./Substance:
17372-87-1/Eosine Yellowish-(YS); 517-28-2/Hematoxylin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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