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Forensic Medicine · Thanatology: maceration of the foetus
Sample itemA stillborn infant delivered several days after intrauterine death has peeling skin with red-brown fluid blisters, soft tissues and overlapping of the skull bones on a radiograph. What is this process?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Maceration, a sterile autolytic change in utero
A foetus that dies in utero with intact membranes lies in sterile liquor and undergoes aseptic autolysis. It shows skin slippage, red-brown discolouration, soft tissues and collapse of the skull with overlapping bones (Spalding's sign). Putrefaction needs access of air and bacteria, and mummification needs drying.
Option by option
A. Mummification of the foetus
Mummification gives a dry, shrunken, leathery foetus, which is not described here.
B. Putrefaction by gas-forming organisms
Putrefaction needs bacteria and air; the sterile liquor in intact membranes prevents it.
C. Maceration, a sterile autolytic change in utero (correct)
Correct. Aseptic softening and skin slippage of a retained dead foetus is maceration.
D. Adipocere formation
Adipocere needs fat to hydrolyse over weeks in moist surroundings.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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