Original ArticlesAssessing gestational age from histology of fetal skin: an autopsy study of 379 fetuses
Section snippets
Materials and methods
We studied 379 human fetuses at 12–30 weeks’ gestational age. Of these, 250 constituted a reference to establish histologic criteria (Table 1). Gestational age derived from the last menstrual period (LMP) coincided with early ultrasound measurements and developmental indices (especially foot length) at postmortem examination. The causes of abortion or fetal death included intradecidual hemorrhage with abruptio placentae, premature rupture of membranes with chorioamnionitis, and pregnancy
Results
Our evaluation used criteria that were easily recognized and were not sensitive to tilting of the specimens or putrefaction. Embryos up to 9 weeks’ gestation (after the LMP) are covered by a single layer of epidermal cells. From 9 to 13 weeks, two-layered skin is seen with a second, superficial layer called periderm. From 13 weeks on, an intermediate layer is added and fetal skin is stratified, but still does not show appendages. Starting at 14 weeks, the skin of the abdomen shows budding of
Discussion
Development of body shape and organ architecture in human fetuses has been completed largely by 12 weeks’ gestation. However, four organs show major changes in developmental patterns throughout further stages of fetal development. The migration and differentiation of neurons in the brain follow precise timing, but definition of distinctive stages is very difficult from routine examination. The development of the lungs, with branching of the bronchial tree, and development of the kidneys, with
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