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Pediatric Autopsy: Fetus, Newborn, and Child

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Handbook of Pediatric Autopsy Pathology

Abstract

Currently, pediatric autopsy is more accepted than adult autopsy because parents want more information about the death of their child and the implications for future pregnancies. These intricate, very valuable pathologic examinations can be performed from the embryonic stages through childhood. When combined with clinical information, this meticulous examination provides the necessary information to educate families concerning future pregnancies. The postmortem examination improves both treatment and the standard of care for the future. The normal anatomy of an adult and a child is similar; however, the prenatal/pediatric autopsy is significantly different. The variety and complexity of congenital anomalies found in perinatal and fetal autopsies are endless, and the prosector must be prepared to spend the necessary time demonstrating these anomalies. This detailed procedure can be altered to preserve any anomaly encountered, without deforming the body. The majority of the anomalies found in this population do not allow for survival to adulthood.

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Author information

Authors and Affiliations

  1. Laboratory Medicine, Pediatrics and Obstetrics and Gynecology Tampa General Hospital Morsani College of Medicine, University of South Florida, Tampa, Florida, USA

    Enid Gilbert-Barness AO, MD, MBBS, FRCPA (Professor of Pathology and Cell Biology)

  2. Department of Pediatrics-Cardiology, University of Florida, Valrico, Florida, USA

    Diane E. Spicer BS, PA(ASCP)

  3. Department of Pathology, Tampa General Hospital, Tampa, Florida, USA

    Thora S. Steffensen MD

Authors
  1. Enid Gilbert-Barness AO, MD, MBBS, FRCPA
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  2. Diane E. Spicer BS, PA(ASCP)
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  3. Thora S. Steffensen MD
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Appendices

Appendix 1: Clinical Information and Autopsy Checklist

figure afigure a

Appendix 2: Autopsy Protocol

figure bfigure b
figure wfigure w
figure xfigure x

Modified from Gilbert-Barness E, editor. Potter’s pathology of the fetus and infant, 2nd ed. Philadelphia: Mosby Year Book Inc.; 1997.

Appendix 3: List of Blocks

Organ

Block #

Site

Trachea

  

Larynx

  

Bronchi

  

Heart

  

Lung

  

Thyroid

  

Thymus

  

Submand gland

  

Tonsils/adenoids

  

Tongue

  

Liver

  

Pancreas

  

Esophagus

  

Stomach

  

Small bowel

  

Large bowel

  

Lymph node

  

Kidney

  

Bladder

  

Genitalia

  

Adrenals

  

Spleen

  

Diaphragm

  

Muscle

  

Nerve

  

Skin

  

Bones

  

Other

  

Appendix 4: List of Blocks—Neuropathology

Silt

Block #

Description

Cortex

  

Frontal

  

Parietal

  

Occipital

  

Temporal

  

Hippocampus

  

Central white matter

  

Basal ganglia

  

Hypothalamus

  

Thalamus

  

Choroid plexus

  

Midbrain

  

Pons

  

Medulla

  

Cerebellum

  

Spinal Cord

  

Cervical

  

Thoracic

  

Lumbar

  

Pituitary

  

Dura/Dural sinuses

  

Other

  

Appendix 5: Criteria Estimating Fertilization Age During Fetal Period

Age (weeks)

Fetal weight (g)

Foot length (mm)

Crown-rump length (mm)

Main external characteristics

Viable fetuses

26

1,000

55

250

Eyes partially open, eyelashes present

→28

1,300

59

270

Eyes open, good head of hair, skin slightly wrinkled

30

1,700

63

280

Toenails present, body filling out, testes descending

→32

2,100

68

300

Fingernails reach fingertips, skin pink and smooth

36

2,900

79

340

Body usually plump, lanugo hairs almost absent, and toenails reach toe tips

→38

3,400

83

360

Prominent chest, breasts protrude, testes in scrotum or palpable in inguinal canals, and fingernails extend beyond fingertips

  1. →, important landmarks

Appendix 6: Growth Characteristics of Placenta and Fetus

Gestation (weeks)

Placental weight (g)

Expected term weight (%)

Fetal weight (g)

Expected term weight (%)

24

195

41

680

21

26

220

47

880

27

28

280

58

1,070

33

30

290

60

1,330

41

32

320

68

1,690

52

34

370

77

2,090

62

36

420

87

2,500

77

38

450

43

2,960

91

41

480

100

3,250

100

42

495

103

3,410

105

  1. Data adapted from Wigglesworth JS, Singer DB. Textbook of fetal and perinatal pathology. 2nd ed. Boston: Blackwell Scientific Publications; 1991.

Appendix 7: Body Surface Area in Children

figure cfigure c

Adapted from Diem K. Documents Geigy: Scientific tables. 7th ed. New York: Geigy Pharmaceuticals; 1970; and modified from Dhom G, Piroth M. Das Wachstum der, Nebennierenrinde um Kindesalter. Verh Dtsch Ges Pathol. 1969;53:418–22.

Limits of hatched area indicate the 95th %

Appendix 8: Development and Growth of the External Dimensions of the Human Body

figure dfigure d

From: Scammon RE, Calkins LA. The development and growth of the external dimensions of the human body in the fetal period. Minneapolis: University of Minnesota Press; 1929, with permission

Appendix 9a, b: Development and Growth of the External Dimensions of the Human Body

figure efigure e

From: Scammon RE, Calkins LA. The development and growth of the external dimensions of the human body in the fetal period. Minneapolis: University of Minnesota Press; 1929, with permission

Appendix 10: Intrauterine Growth of Live-Born Caucasian Infants at Sea Level

figure ffigure f

From: Usher R, McLean F. Intrauterine growth of live-born Caucasian infants at sea level: standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr. 1969;74:901, with permission

Appendix 11: Intrauterine Growth of Live-Born Caucasian Infants at Sea Level

figure gfigure g

From: Usher R, McLean F. Intrauterine growth of live-born Caucasian infants at sea level: standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr. 1969;74:901, with permission

Appendix 12: Intrauterine Growth of Live-Born Caucasian Infants at Sea Level

figure hfigure h

From: Usher R, McLean F. Intrauterine growth of live-born Caucasian infants at sea level: standards obtained from ­measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr. 1969;74:901, with permission

Appendix 13: Intrauterine Growth of Live-Born Caucasian Infants at Sea Level

figure ifigure i

From: Usher R, McLean F. Intrauterine growth of live-born Caucasian infants at sea level: standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr. 1969; 74:901, with permission

Appendix 14: Hand Measurements by Age

figure jfigure j
figure vfigure v

Hand length (a), middle-finger length (b), and palm length (c)

From: Feingold M, Bossert HW. Normal values for selected physical parameters: an aid to syndrome delineation. Birth Defects Orig Artic Ser. 1974;10(suppl 13):1–16, with permission

Appendix 15: Hand Middle Finger and Palm Length

figure kfigure k

From: Feingold M, Bossert HW. Normal values for selected physical parameters: an aid to syndrome delineation. Birth Defects Orig Artic Ser. 1974;10(suppl 13):1–16, with permission

Appendix 16: Palpebral Fissure Length From 29 Week Gestation to 14 Years

figure lfigure l

From: Thomas IT, Gaitanzis VA, Frias JL. Palpebral fissure length from 29 week gestation to 14 year. J Pediatr. 1987;111:267; adapted from Jones KL, Hanson JW, Smith DW. Palpebral fissure size in newborn infants. J Pediatr. 1978;92:787, with permission

Appendix 17: Palpebral Fissure Length From 29 Week Gestation to 14 Years

figure mfigure m

From: Thomas IT, Gaitanzis VA, Frias JL. Palpebral fissure length from 29 week gestation to 14 year. J Pediatr. 1987;111:267, with permission

Appendix 18: Postnatal Growth in Infants Born After 30 Week Gestation

figure nfigure n

From: Gill A, Yu VYH, et al. Postnatal growth in infants born after 30 week gestation. Arch Dis Child. 1986;61:549, with permission

Appendix 19: Fetal Organ Weights as a Function of Body Weight

 

Total body weight (g)

 

500–999

1,000–1,499

1,500–1,999

2,000–2,499

2,500–2,999

3,000–3,499

3,500–3,999

4,000–4,499

>4,500

Heart

5.8

9.4

12.7

15.5

19

21.2

23.4

28

36

Lungs, combined

18.2

27.1

37.9

43.6

48.9

54.9

58

65.8

74

Liver

38.8

59.8

76.3

98.1

127.4

155.1

178.1

215.2

275.6

Spleen

1.7

3.4

4.9

7

9.1

10.4

12

13.6

16.7

Pancreas

1

1.4

2

2.3

3

3.5

4

4.6

6.2

Kidneys, combined

7.1

12.2

16.2

19.9

23

25.3

28.5

31

33.2

Adrenals, combined

3.1

3.9

5

6.3

8.2

9.8

10.7

12.5

15.1

Thymus

2.1

4.3

6.6

8.2

9.3

11

12.6

14.3

17.3

Thyroid gland

0.8

0.8

0.9

1.1

1.3

1.6

1.7

1.9

2.4

Brain

109

180

256

308

359

403

421

424

406

  1. Modified from Gilbert-Barness E, editor. Potter’s pathology of the fetus and infant. Philadelphia: Mosby Year Book Inc. 1997, with permission

Appendix 20: Means and Standard Deviations of Organ Weights and Measurements of Live-Born Infants

Gestation(weeks)

Bodyweight (g)

Crown-rump (cm)

Crown-heel (cm)

Toe–heel (cm)

Brain (g)

Thymus (g)

Heart (X)

Lungs (g)

Spleen (g)

Liver (g)

Kidneys (g)

Adrenals (g)

Pancreas (g)

20

381  ±  104

18.3  ±  2.2

25.6  ±  2.2

3.6  ±  0.7

49  ±  15

0.8  ±  2.3

2.8  ±  1.0

11.5  ±  2.9

0.7  ±  0.3

22.4  ±  8.0

3.7  ±  1.3

1.8  ±  1.0

0.5  ±  0.5

21

426  ±  66

19.1  ±  1.2

26.7  ±  1.7

3.8  ±  0.1

57  ±  8

1  ±  0.3

3.2  ±  0.4

12.9  ±  2.8

0.7  ±  0.2

24.1  ±  4.2

4.2  ±  0.7

2  ±  0.5

0.5

22

473  ±  63

20  ±  1.3

27.8  ±  1.6

4  ±  0.4

65  ±  13

1.2  ±  0.3

3.5  ±  0.6

14.4  ±  4.3

0.8  ±  0.4

25.4  ±  5.2

4.7  ±  1.5

2  ±  0.6

0.6  ±  0.3

23

524  ±  116

20.8  ±  1.9

28.9  ±  3.0

4.2  ±  0.5

74  ±  11

1.4  ±  0.7

3.9  ±  1.3

15.9  ±  4.9

0.8  ±  0.4

26.6  ±  8.0

5.3  ±  1.8

2.1  ±  0.8

0.7  ±  0.4

24

584  ±  92

21.6  ±  1.4

30  ±  1.7

4.4  ±  0.3

83  ±  15

1.5  ±  0.7

4.2  ±  1.0

17.4  ±  5.9

0.9  ±  0.5

28  ±  7.1

6  ±  1.8

2.2  ±  0.8

0.8  ±  0.5

25

655  ±  106

22.5  ±  1.6

31.1  ±  2.0

4.6  ±  0.4

94  ±  25

1.8  ±  1.2

4.7  ±  1.2

19  ±  5.3

1.1  ±  1.6

29.7  ±  9.8

6.8  ±  1.9

2.2  ±  1.4

0.9  ±  0.3

26

739  ±  181

23.3  ±  1.9

32.2  ±  2.4

4.8  ±  0.7

105  ±  21

2  ±  1.1

5.2  ±  1.3

20,6  ±  6.3

1.3  ±  0.7

32.1  ±  10.9

7.6  ±  2.5

2.4  ±  1.1

1  ±  0.5

27

836  ±  197

24.2  ±  2.5

33.4  ±  3.5

5  ±  0.5

118  ±  21

2.3  ±  1.2

5.8  ±  1.9

22.1  ±  9.7

1.7  ±  1.0

35.1  ±  13.3

8.6  ±  3.0

2.5  ±  1.1

1.2  ±  0.5

28

949  ±  190

25  ±  1.7

34.5  ±  2.3

5.2  ±  0.6

132  ±  29

2.6  ±  1.5

6.5  ±  1.9

23.7  ±  10.0

2.1  ±  0.8

38.9  ±  12.6

9.7  ±  12.0

2.7  ±  1.2

1.4  ±  0.5

29

1,077  ±  449

25.9  ±  2.8

35.6  ±  4.4

5.4  ±  0.8

147  ±  49

3  ±  1.9

7.2  ±  2.7

25.3  ±  12.6

2.6  ±  0.9

43.5  ±  15.8

10.9  ±  4.4

3  ±  1.2

1.5  ±  1.0

30

1,219  ±  431

26.7  ±  3.3

36.7  ±  4.2

5.7  ±  0.7

163  ±  38

3.5  ±  2.6

8.1  ±  2.6

26.9  ±  20.3

3.3  ±  2.0

49.1  ±  18.8

12.3  ±  8.5

3.3  ±  2.7

1.7  ±  1.0

31

1,375  ±  281

27.6  ±  3.8

37.8  ±  3.1

5.9  ±  0.7

180  ±  34

4  ±  3.4

9  ±  2.8

28.5  ±  13.2

4  ±  1.2

55.4  ±  17.3

13.7  ±  5.2

3.7  ±  1.3

1.8  ±  0.6

32

1,543  ±  519

28.4  ±  9.5

38.9  ±  5.7

6.1  ±  1.1

198  ±  48

4.7  ±  3.6

10.1  ±  4.4

30.2  ±  19.0

4.7  ±  5.4

62.5  ±  30.0

15.2  ±  7.4

4.1  ±  1.7

2  ±  0.8

33

1,720  ±  580

29.3  ±  3.3

40  ±  3.5

6.3  ±  0.7

217  ±  49

5.4  ±  3.2

11.2  ±  4.0

31.8  ±  13.5

5.5  ±  3.5

70.3  ±  25.4

16.8  ±  7.7

4.6  ±  1.5

2.1  ±  0.8

34

1,905  ±  625

30.1  ±  4.3

41.1  ±  4.0

6.5  ±  0.6

237  ±  53

6.1  ±  3.8

12.4  ±  2.8

33.5  ±  16.5

6.4  ±  3.0

78.7  ±  30.2

18.5  ±  9.3

5.1  ±  2.2

2.3  ±  1.1

35

2,093  ±  309

30.9  ±  2.0

42.3  ±  2.9

6.7  ±  0.4

257  ±  45

6.9  ±  4.5

13.7  ±  3.6

35.2  ±  20.5

7.2  ±  5.2

87.4  ±  30.6

20.1  ±  10.9

5.6  ±  2.8

2.5  ±  0.6

36

2,280  ±  615

31.8  ±  3.9

43.4  ±  5.9

6.9  ±  1.1

278  ±  96

7.7  ±  5.0

15  ±  5.1

36.9  ±  17.5

8.1  ±  3.1

96.3  ±  33.7

21.7  ±  6.8

6.1  ±  3.1

2.6  ±  0.7

37

2,462  ±  821

32.6  ±  5.0

44.5  ±  7.0

7.1  ±  1.2

298  ±  70

8.4  ±  5.6

16.4  ±  5.7

38.7  ±  22.9

8.8  ±  6.4

105.1  ±  33.7

23.3  ±  9.9

6.6  ±  3.3

2.8  ±  0.9

38

2,6  ±  534

33.5  ±  3.2

45.6  ±  5.1

7.3  ±  0.8

318  ±  106

9  ±  2.8

17.7  ±  5.4

40.6  ±  17.1

9.5  ±  3.5

113.5  ±  34.7

24.8  ±  7.2

7.1  ±  2.9

3  ±  1.1

39

2,789  ±  520

34.3  ±  1.9

46.7  ±  4.4

7.5  ±  0.5

337  ±  91

9.4  ±  2.5

19.1  ±  2.8

42.6  ±  14.9

10.1  ±  3.5

121.3  ±  39.2

26.1  ±  4.9

7.4  ±  2.5

3.3  ±  0.5

40

2,922  ±  450

35.2  ±  2.8

47.8  ±  4.2

7.7  ±  0.8

356  ±  79

9.5  ±  5.0

20.4  ±  5.6

44.6  ±  22.7

10.4  ±  3.3

127.9  ±  35.8

27.3  ±  11.5

7.7  ±  3.0

3.6  ±  1.3

41

3,025  ±  600

36  ±  3.1

48.9  ±  5.4

7.9  ±  0.8

372  ±  65

9.1  ±  4.8

21.7  ±  10.9

46.8  ±  26.2

10.5  ±  4.5

133.1  ±  55.7

28.1  ±  12.7

7.8  ±  2.8

3.9  ±  1.5

42

3,091  ±  617

36.9  ±  2.4

50  ±  3.8

8.1  ±  1.1

387  ±  61

8.1  ±  3.8

22.9  ±  6.2

49.1  ±  14.6

10.3  ±  3.6

136.4  ±  38.9

28.7  ±  9.7

7.8  ±  3.2

4.3  ±  1.9

  1. Modified data from Women & Infants Hospital Providence, RI. From Jones KI, Harrison JW, Smith DW. Palpebral fissure size in newborn infants. J Pediatr. 1978;92:787, with permission

Appendix 21: Means and Standard Deviations of Organ Weights and Measurements of Stillborn Infants

Gestation(weeks)

Bodyweight (g)

Crown-rump (cm)

Crown-heel (cm)

Toe–heel (cm)

Brain (g)

Thymus (g)

Heart (g)

Lungs (g)

Spleen (g)

Liver (g)

Kidneys (g)

Adrenals (g)

Pancreas (g)

20

313  ±  139

18.0  ±  2.0

24.9  ±  2.3

3.3  ±  0.6

41  ±  24

0.4  ±  0.3

2.4  ±  1.0

7.1  ±  3.0

0.3  ±  1.0

17  ±  9

2.7  ±  2.9

1.3  ±  0.6

0.5  ±  0.1

21

353  ±  125

18.9  ±  4.8

26.2  ±  3.6

3.5  ±  0.6

48  ±  18

0.5  ±  0.3

2.6  ±  0.9

7.9  ±  3.8

0.4  ±  0.6

IS  ±  7

3.1  ±  1.3

1.4  ±  0.7

0.5  ±  0.4

22

398  ±  117

19.8  ±  9.6

27.4  ±  2.5

3.8  ±  0.4

55  ±  15

0.6  ±  0.4

2.8  ±  0.9

8.7  ±  3.1

0.5  ±  0.4

19  ±  10

3.5  ±  0.8

1.4  ±  0.6

0.6  ±  0.5

23

450  ±  118

20.6  ±  2.3

28.7  ±  3.3

4  ±  0.5

64  ±  18

0.8  ±  0.5

3  ±  1.4

9.5  ±  5.7

0.7  ±  0.5

21  ±  7

4.1  ±  1.7

1.5  ±  0.8

0.7  ±  0.3

24

510  ±  179

21.5  ±  3.1

29.9  ±  4.3

4.2  ±  0.8

74  ±  25

0.9  ±  0.7

3.3  ±  1.8

10.5  ±  5.6

0.9  ±  0.7

22  ±  8

4.6  ±  2.4

1.5  ±  0.8

0.7  ±  0.3

25

581  ±  178

22.3  ±  4.0

31.1  ±  6.5

4.4  ±  0.8

85  ±  31

1.1  ±  0.8

3.7  ±  1.3

11.6  ±  4.9

1.2  ±  0.4

24  ±  35

5.3  ±  2.4

1.6  ±  0.8

0.8  ±  0.7

26

663  ±  227

23.2  ±  4.1

32.4  ±  5.3

4.7  ±  0.9

98  ±  37

1.4  ±  1.4

4.2  ±  2.2

12.9  ±  8.7

1.5  ±  1.1

26  ±  16

6.1  ±  3.6

1.7  ±  0.9

0.8  ±  0.7

27

758  ±  227

24.1  ±  2.9

33.6  ±  3.2

4.9  ±  1.4

112  ±  37

1.7  ±  1.1

4.8  ±  3.6

14.4  ±  9.7

1.9  ±  1.0

29  ±  24

7  ±  3.1

1.9  ±  1.5

0.9  ±  0.3

28

864  ±  247

24.9  ±  2.2

34.9  ±  5.6

5.1  ±  1.2

127  ±  39

2  ±  2.1

5.4  ±  2.6

16.1  ±  7.0

2.3  ±  1.1

32  ±  32

7.9  ±  2.5

2.1  ±  1.6

1  ±  0.3

29

984  ±  511

25.8  ±  4.1

36.1  ±  5.9

5.3  ±  1.2

143  ±  57

2.4  ±  2.6

6.2  ±  2.4

18  ±  13.6

2.7  ±  2.0

36  ±  23

9  ±  4.5

2.4  ±  1.2

1.1  ±  1.2

30

1,115  ±  329

26.6  ±  2.4

37.3  ±  3.6

5.6  ±  0.7

160  ±  72

2.8  ±  4.1

7  ±  2.8

20.1  ±  8.6

3.1  ±  1.5

40  ±  22

10.1  ±  6.0

2.7  ±  1.3

1.2  ±  0.2

31

1,259  ±  588

27.5  ±  3.0

38.6  ±  2.7

5.8  ±  0.7

178  ±  32

3.2  ±  1.9

8  ±  3.1

22.5  ±  10.1

3.6  ±  4.0

46  ±  38

11.3  ±  4.1

3  ±  1.8

1.4  ±  1.4

32

1,413  ±  623

28.4  ±  2.8

39.8  ±  5.4

6  ±  0.6

196  ±  92

3.7  ±  2.2

9.1  ±  4.1

25  ±  10.7

4.2  ±  2.4

52  ±  32

12.6  ±  8.0

3.5  ±  1.8

1.6  ±  0.6

33

1,578  ±  254

29.2  ±  3.5

41.1  ±  3.1

6.2  ±  0.4

216  ±  51

4.3  ±  1.5

10.2  ±  2.0

27.8  ±  5.8

4.7  ±  2.3

58  ±  17

13.9  ±  3.5

3.9  ±  1.4

1.8  ±  0.8

34

1,750  ±  494

30.1  ±  3.5

42.3  ±  4.3

6.5  ±  0.8

236  ±  42

4.8  ±  5.6

11.4  ±  3.2

30.7  ±  15.2

5.3  ±  2.5

66  ±  22

15.3  ±  5.1

4.4  ±  1.3

2  ±  0.5

35

1,930  ±  865

30.9  ±  3.9

43.5  ±  5.8

6.7  ±  0.9

256  ±  70

5.4  ±  3.4

12.6  ±  5.3

33.7  ±  14.3

5.9  ±  6.8

74  ±  46

16.7  ±  7.1

4.9  ±  1.9

2.3  ±  0.7

36

2,114  ±  616

31.8  ±  4.0

44.8  ±  7.2

6.9  ±  0.8

277  ±  94

6.1  ±  4.1

13.9  ±  5.8

36.7  ±  16.8

6.5  ±  2.9

82  ±  36

18.1  ±  6.3

5.4  ±  2.4

2.6  ±  2.6

37

2,300  ±  647

32.7  ±  5.1

46  ±  7.9

7.2  ±  0.9

297  ±  69

6.7  ±  3.9

15.1  ±  9.9

39.8  ±  11.1

7.2  ±  6.3

91  ±  57

19.4  ±  9.7

5.8  ±  6.2

2.9  ±  3.1

38

2,485  ±  579

33.5  ±  2.6

47.3  ±  3.9

7.4  ±  0.8

317  ±  83

7.4  ±  6.1

16.4  ±  4.4

42.9  ±  15.7

7.8  ±  5.9

100  ±  44

20.8  ±  6.0

6.3  ±  2.1

3.2  ±  1.6

39

2,667  ±  596

34.4  ±  3.7

48.5  ±  4.9

7.6  ±  0.5

337  ±  132

8.1  ±  4.7

17.5  ±  3.9

45.8  ±  15.2

8.5  ±  4.5

109  ±  53

22  ±  5.8

6.7  ±  5.3

3.5  ±  1.9

40

2,842  ±  482

35.2  ±  6.4

49.7  ±  3.2

7.8  ±  0.7

355  ±  57

8.9  ±  4.3

18.6  ±  12.9

48.6  ±  19.4

9.2  ±  4.1

118  ±  49

23.1  ±  8.6

7  ±  2.9

3.9  ±  1.7

41

3,006  ±  761

36.1  ±  3.7

51  ±  5.4

8.1  ±  0.8

373  ±  141

9.6  ±  5.6

19.5  ±  4.9

51.1  ±  17.0

9.9  ±  4.5

126  ±  53

24.1  ±  10.5

7.1  ±  3.0

4.2

42

3,156  ±  678

36.9  ±  2.0

52.2  ±  3.0

8.3  ±  0.5

389  ±  36

10.4  ±  5.0

20.3  ±  4.5

53.2  ±  10.1

10.6  ±  3.7

135  ±  54

24.9  ±  8.1

7.2  ±  2.9

4.5  ±  2.3

  1. Modified data from Women & Infants Hospital, Providence. Rl. From Jones KL. Harrison JW, Smith DW. Palpebral fissure size in newborn infants. J Pediatr. 1978;92:787, with permission

Appendix 22: Percentiles of Weights from Age 1–12 Month

Age (months)

1st

5th

10th

25th

50th

75th

90th

95th

99th

kg

 

Males

1

2.34

2.97

3.26

3.68

4.14

4.55

4.88

5.17

5.42

2

3.78

4.33

4.58

5.00

5.48

5.81

6.17

6.29

6.75

3

4.68

5.21

5.42

5.80

6.30

6.73

7.10

7.27

7.89

4

5.39

5.85

6.01

6.45

6.96

7.44

7.83

8.06

8.77

5

5.82

6.30

6.58

7.00

7.50

8.02

8.44

8.77

9.51

6

6.20

6.72

7.00

7.45

7.95

8.51

8.98

9.27

10.12

7

6.59

7.09

7.40

7.89

8.34

8.95

9.48

9.76

10.61

8

7.03

7.46

7.74

8.25

8.71

9.36

9.91

10.19

11.04

9

7.31

7.80

8.09

8.59

9.09

9.74

10.24

10.64

11.43

10

7.53

8.11

8.39

8.92

9.42

10.07

10.60

11.04

11.83

11

7.77

8.37

8.66

9.21

9.72

10.39

10.92

11.44

12.23

12

8.02

8.59

8.91

9.48

10.01

10.70

11.23

11.82

12.58

 

Females

1

2.30

2.91

3.10

3.53

3.87

4.14

4.52

4.86

5.41

2

3.66

3.96

4.15

4.63

4.95

5.30

5.73

5.89

6.42

3

4.33

4.63

4.81

5.30

5.71

6.15

6.59

6.86

7.28

4

4.82

5.17

5.39

5.86

6.34

6.84

7.25

7.56

7.98

5

5.20

5.62

5.87

6.36

6.87

7.40

7.89

8.16

8.67

6

5.56

5.96

6.28

6.77

7.31

7.90

8.46

8.63

9.26

7

5.86

6.35

6.72

7.11

7.72

8.32

8.87

9.12

9.77

8

6.15

6.69

7.01

7.48

8.10

8.71

9.27

9.52

10.24

9

6.44

6.99

7.25

7.82

8.47

9.08

9.59

9.91

10.64

10

6.72

7.26

7.57

8.15

8.79

9.43

9.95

10.22

11.02

11

6.98

7.54

7.86

8.44

9.12

9.76

10.27

10.58

11.42

12

7.22

7.81

8.11

8.71

9.42

10.07

10.60

10.91

11.80

  1. Modified from Roche AF, Guo S, Moor WM. Weight recumbent length from 1 to 12 mo of age: reference data for 1 mo increments. Am J Clin Nutr. 1989;49:599–607, with permission

Appendix 23: Percentiles of Body Length from 1 to 12 Month of Age

Age

1st

5th

10th

25th

50th

75th

90th

95th

99th

 

Males

1

47.99

50.85

51.90

53.20

54.68

56.14

57.29

58.38

60.35

2

52.78

55.44

56.02

57.04

57.51

59.98

61.05

62.02

63.61

3

55.83

58.20

58.77

59.83

61.29

62.83

64.05

64.66

66.51

4

58.10

60.33

61.13

62.29

63.64

65.22

66.60

67.16

68.95

5

60.46

62.44

63.21

64.22

65.72

67.37

68.67

69.40

71.10

6

62.35

64.08

65.06

66.07

67.53

69.19

70.44

71.30

73.05

7

63.91

65.76

66.61

67.74

69.23

70.83

72.18

73.01

74.85

8

65.25

67.22

68.10

69.37

70.86

72.30

73.82

74.70

76.57

9

66.41

68.49

69.39

70.82

72.25

73.80

75.38

76.24

78.18

10

67.41

69.76

70.70

72.14

73.64

75.19

76.85

77.63

79.69

11

68.25

70.95

71.94

73.36

74.98

76.53

78.32

78.95

81.13

12

69.05

72.14

73.18

74.61

76.22

77.88

79.60

80.49

82.49

 

Females

1

47.95

49.81

50.72

52.25

53.76

55.06

56.14

56.37

57.70

2

51.23

53.63

54.26

55.89

57.06

58.46

59.49

60.08

61.39

3

53.88

56.24

57.03

58.56

59.70

61.20

62.43

63.13

64.07

4

56.17

58.42

59.35

60.72

61.85

63.42

64.68

65.58

66.39

5

58.21

60.35

61.20

62.71

63.89

65.47

66.73

67.70

68.47

6

60.08

62.10

62.89

64.53

65.61

67.31

68.58

69.69

70.47

7

61.82

63.80

64.40

66.08

67.36

69.03

70.27

71.48

72.29

8

63.44

65.41

65.93

67.59

68.95

70.49

71.83

73.11

73.98

9

64.98

66.90

67.44

69.00

70.47

71.91

73.37

74.59

75.56

10

66.36

68.22

68.77

70.28

71.84

73.36

74.82

75.98

77.05

11

67.54

69.43

70.00

71.49

73.15

74.66

76.21

77.32

78.47

12

68.77

70.61

71.22

72.76

74.42

75.95

77.49

78.57

79.81

  1. Modified from Roche AF, Guo S, Moore WM. Weight and recumbent length from 1 to 12 mo of age: reference data for 1 mo increments. Am J Clin Nutr. 1989;49:599–607, with permission

Appendix 24: Organ Weights in Children

Age

Bodylength (cm)

Brain (g)

Heart (g)

Rightlung (g)

Leftlung (g)

Spleen (g)

Liver (g)

Rightkidney (g)

Leftkidney (g)’

Combinedadrenals (g)

Thymus (g)

Pancreas (g)

Birth-3 days

49

335

17

21

18

8

78

13

14

–

–

–

3–7 days

49

358

18

24

22

9

96

14

14

–

–

–

1–3 weeks

52

382

19

29

26

10

123

15

15

—

—

—

3–5 weeks

52

413

20

31

27

12

127

16

16

4.9

5.5–8.5

5.7

5–7 weeks

53

422

21

32

28

13

133

19

18

—

—

—

7–9 weeks

55

489

23

32

29

13

136

19

18

4.9

5.0–10.0

7.2

2–3 months

56

516

23

35

30

14

140

20

l9)

4.9

10.0

8.0

4 months

59

540

27

37

33

16

160

22

21

4.8

9.5

10.0

5 months

61

644

27

38

35

16

188

25

25

5.0

12.5

11.0

6 months

62

660

31

42

39

17

200

26

25

4.9

10.0

11.0

7 months

65

691

34

49

41

19

227

30

30

5.5

11.0

11.0

8 months

65

714

37

32

45

20

254

31

30

5.4

9.0

12.0

9 months

67

750

37

53

47

20

260

31

30

5.4

9.5

15.0

10 months

69

809

39

54

51

22

274

32

31

5.7

20–38

13.5

11 months

70

852

40

59

53

25

277

34

33

6.1

20–38

15.0

12 months

73

925

44

64

57

26

288

36

35

6.2

20–38

14.5

14 months

74

944

45

66

60

26

304

36

35

—

20–38

—

16 months

77

1,010

48

72

64

28

331

39

39

—

20–38

—

18 months

78

1,042

52

72

65

30

345

10

43

—

20–38

—

20 months

79

1,050

56

83

74

30

370

43

44

—

20–38

—

22 months

82

1,059

56

80

75

33

380

44

44

—

20–38

—

24 months

84

1,064

56

88

76

33

394

47

46

—

20–38

—

3 years

88

1,141

59

89

77

37

418

48

49

—

25

—

4 years

99

1,191

73

90

85

39

516

58

56

—

25

—

3  years

106

1,237

85

107

104

47

596

65

64

—

25

—

6 years

109

1,243

94

121

122

58

642

68

67

—

25

—

7 years

113

1,263

100

130

123

66

680

69

70

—

25

—

8 years

119

1,273

110

150

140

69

736

74

75

—

25

—

9 years

125

1,275

115

174

152

73

756

82

83

—

25

—

10 years

130

1.290

116

177

166

85

852

92

95

—

25

—

11 years

135

1,320

122

201

190

87

909

94

95

—

25

—

12 years

139

1,351

124

—

—

93

936

95

96

—

25

—

  1. Data adapted from Sunderman FW, Boerner F. Normal values in clinical medicine. Philadelphia: W. B. Saunder Company; 1949; Schulz DM, Giordano DA, Schulz DH. Weights of organs of fetuses and infants. Arch Pathol. 1969;74:244–350, with permission

Appendix 25: Weights of All Four Parathyroid Glands Combined (mg)

Age

Males

Females

<1 days

6.6

5.3

1 day–3 months

6.2

8.8

3 months–1 year

25.4

18.3

1–5 years

34.9

23.0

6–10 years

51.4

63.3

11–20 years

98.1

100.9

>21 years

117.6  ±  4.0

131.3  +  5.8

Appendix 26: Protocol for Gross Examination of the Brain

figure ofigure o

Appendix 27: Brain Weight as a Function of Age in Children and Adolescents

Age

Females

Males

Body height (cm)

Brain weight (g)

Body height (cm)

Brain weight (g)

0 month

49

372

51

448

1 month

54

516

54

523

2 months

57

560

58

609

4 months

60

645

62

718

7 months

66

755

68

871

9 months

71

935

72

999

13 months

75

961

79

1,141

16 months

78

1,117

83

1,176

19 months

82

1,121

83

1,109

22 months

87

1,063

83

1,088

2 years

87

1,176

90

1,249

3 years

98

1,213

99

1,317

4 years

99

1,243

107

1,419

5 years

109

1,284

114

1,480

6 years

118

1,286

117

1,437

7 years

123

1,328

128

1,424

8 years

130

1.400

133

1,457

9 years

132

1,360

138

1.489

10 years

135

1,550

135

1,501

11 years

145

1,380

148

1,397

12 years

157

1,356

154

1,483

13 years

163

1,453

159

1,564

14 years

164

1,322

166

1,484

15 years

166

1,378

168

1,483

16 years

164

1,383

175

1,547

17 years

166

1,380

174

1,528

18 years

166

1,359

176

1,491

  1. Data adapted from Voigt J, Pakkenberg H. Brain weight of Danish children. Acta Anat. 1983;116:290–301

Appendix 28: Gestational Development of the Cerebral Hemispheres

Gestational age

No. examined

Sulci and fissures

Gyri

10–15

(n  =  6)

Interhemispheric fissure, hippocampal sulcus, Sylvianfissure, transverse cerebral fissure, callosal sulcus

 

16–19

(n  =  13)

Parietooccipital fissure, olfactory sulcus, circularsulcus, cingulate sulcus, calcarine fissure

Gyrus rectus, insula, cingulate gyrus

20–23

(n  =  41)

Rolandic sulcus, collateral sulcus, superior temporal sulcus

Parahippocampal gyrus, superior temporal gyrus

24–27

(n  =  46)

Prerolandic sulcus, middle temporal sulcus, Postrolandic sulcus, interparietal sulcus, superior frontal sulcus, lateral occipital sulcus

Prerolandic gyrus, middle temporal gyrus,postrolandic gyrus, superior and inferior parietallobules, superior and middle frontal gyri, superiorand inferior occipital gyri, cuneus and lingualgyrus, fusiform gyrus

28–31

(n  =  36)

Inferior temporal sulcus, inferior frontal sulcus

Inferior temporal gyrus, triangular gyrus, medialand lateral orbital gyri, callosomarginal gyrus,transverse temporal gyrus, angular and­supramarginal gyri, external occipitotemporal gyrus

32–35

(n  =  29)

Marginal sulcus, secondary superior, middle and inferior frontal, superior and middle temporal, superior and inferior parietal, prerolandic and postrolandic, superior and inferior occipital sulci and gyri, insular gyri

Paracentral gyrus

36–39

(n  =  31)

Secondary transverse and inferior temporal and cingulate sulci and gyri, tertiary superior, middle, and inferior frontal and superior parietal sulci and gyri

Anterior and posterior orbital gyri

40–44

(n  =  29)

Secondary, orbital, callosomarginal, and insular sulciand gyri, tertiary inferior temporal and superior andinferior occipital gyri and sulci

 
  1. From: Gilles FH, Leviton A, Dooling EC. The developing human brain—growth and epidemiologic neuropathology. Boston: John Wright; 1988, with permission

Appendix 29: Regional Development of the Cerebral Hemispheres

Lobe

Fissures and sula

Gestational age (weeks)

Gyri

Gestational age (weeks)

Frontal

Interhemispheric fissure

10

Gyrus rectus

16

Transverse cerebral fissure

10

Insula

18

Hippocampal sulcus

10

Cingulate gyrus

18

Callosal sulcus

14

Prerolandic gyrus

24

Sylvian fissure

14

Superior frontal gyrus

25

Olfactory sulcus

16

Middle frontal gyrus

27

Circular sulcus

18

Triangular gyrus

28

Cingulate sulcus

18

Medial and lateral orbital gyri

28

Rolandic sulcus

20

Callosomarginal gyrus

28

Prerolandic sulcus

24

Anterior and posterior orbital gyri

36

Superior frontal sulcus

25

  

Inferior frontal sulcus

28

  

Parietal

Interhemispheric fissure

10

Cingulate gyrus

18

Transverse cerebral fissure

10

Postrolandic gyrus

25

Sylvian fissure

11

Superior parietal lobule

26

Parietooccipital fissure

16

Inferior parietal lobule

26

Rolandic sulcus

20

Angular gyrus

28

Postrolandic sulcus

25

Supramarginal gyrus

28

Interparietal sulcus

26

Paracentral gyri

35

Temporal

Sylvian fissure

14

Superior temporal gyrus

23

Superior temporal sulcus

23

Parahippocampal gyrus

23

Collateral sulcus

23

Middle temporal gyrus

26

Middle temporal sulcus

26

Fusiform gyrus

27

Inferior temporal sulcus

30

Inferior temporal gyrus

30

  

External occipitotemporal gyrus

30

  

Transverse temporal gyrus

31

Occipital

Interhemispheric fissure

10

Superior occipital gyri

27

Calcarine fissure

16

Inferior occipital gyri

27

Parietooccipital sulcus

16

Cuneus

27

Collateral sulcus

23

Lingual gyrus

27

Lateral occipital sulcus

27

External occipitotemporal gyrus

30

  1. From: Gilles FH, Leviton A. Pooling EC. The developing human brain—growth and epidemiologic neuropathology. Boston: John Wright; 1983, with permission

Appendix 30: Gyral Pattern of the Fetal Brain

figure pfigure p

cc corpus callosum, cing cingulate sulcus, circ circular sulcus, coll collateral sulcus, cm centimeter, FS superior frontal sulcus, g rect gyrus rectus, interpar or ip interpariental gyrus, olf olfactory sulcus (dotted lines indicate sulci underneath the olfactory bulbs, parahip parahippocampal gyrus, p-o parietoccipital fissure, Post Rol postrolandic sulcus, Pre Rol ­prerolandix sulcus, Rol rolandic (central) sulcus, Sylv Sylvian, Tm middle temporal sulcus

From: Gilles FH, Leviton A, Pooling EC. The developing human brain—growth and epidemiologic neuropathology. Boston: John Wright; 1983, with permission

Appendix 31: Gyral Pattern of the Perinatal Brain

figure qfigure q

ang angular gyrus, ant/post anterior and posterior orbital gyri, cm centimeter, F1 superior frontal gyrus, med/lat orb medial and lateral orbital gyri, O1 superior occipital gyrus, O2 inferior occipital, supra marg supra marginal, T1 superior temporal gyrus, T2 middle temporal gyrus, T3 inferior temporal gyrus, triang triangular gyrus, TT transverse temporal gyrus

From: Gilles FH, Leviton A. Pooling EC. The developing human brain—growth and epidemiologic neuropathology. Boston: John Wright; 1983, with permission

Appendix 32: Surfaces of Cerebral Hemispheres for Use in Indicating Lesions

figure rfigure r

(a) Right lateral; (b) left lateral; (c) right medial; and (d) left medial From: the Perinatal Autopsy Protocol of ­Magee-Women’s Hospital, and Hannah Kinney. M.D. Children’s Hospital. Boston: Massachusetts

Appendix 33: Gestational Age and Mean Organ Weights and Measurements with 1 Standard Deviation (SD)

Gestationage (weeks)

Bodyweight (urn)

SD (n)

Crown-rump (cm)

SD

n

Crown–heel (cm)

SD

n

Toe–heel (cm)

SD (n)

Brain (gm)

SD

(n)

Thymus (gm)

SD

(n)

12

21

±6.4 (8)

7.6

±0.6

(10)

9.3

±1.0

(9)

1.0

±0.1 (11)

3.5

±1.5

(6)

0.01

 

(3)

13

31

±10 (21)

8.7

±0.8

(21)

11.4

±1.0

(16)

1.2

±0.1 (27)

4.6

±1.7

(II)

0.03

±0.01

(9)

14

49

±16 (18)

9.8

±1.1

(18)

13.5

±1.5

(17)

1.5

±0.1 (18)

7.8

±4.1

(12)

0.05

±0.03

(13)

15

75

±22 (49)

10.9

±1.0

(43)

15.4

±1.4

(40)

1.8

±0.2 (50)

12.6

±3.4

(31)

0.09

±0.05

(37)

16

108

±25 (36)

12.0

±1.1

(37)

17.3

±1.5

(36)

2.1

±0.2 (41)

17.5

±3.7

(23)

0.14

±0.08

(27)

17

149

±32 (50)

13.2

±1.1

(48)

19.2

±1.6

(47)

2.4

±0.2 (53)

22.6

±4.7

(34)

0.18

±0.06

(41)

18

195

±44 (44)

14.3

±1.2

(47)

21.0

±1.6

(44)

2.7

±0.2 (50)

29.9

±7.5

(40)

0.27

±0.10

(39)

19

248

±46 (52)

15.4

±1.2

(51)

22.7

±1.4

(44)

3.0

±0.1 (57)

35.2

±6.6

(43)

0.39

±0.12

(41)

20

307

±47 (66)

16.5

±1.2

(65)

24.4

±1.8

(64)

3.3

±0.3 (67)

45.5

±7.2

(54)

0.53

±0.18

(56)

21

370

±60 (38)

17.7

±1.4

(36)

26.0

±2.1

(35)

3.6

±0.3 (38)

53.3

±8.8

(33)

0.70

±0.26

(34)

22

438

±74 (50)

18.8

±1.6

(50)

27.5

±2.1

(50)

3.9

±0.3 (50)

63.5

±10.5

(45)

0.91

±0.34

(45)

23

510

±77 (39)

19.9

±1.3

(40)

29.0

±1.8

(40)

4.2

±0.2 (40)

74.9

±13.5

(34)

1.14

±0.43

(36)

24

586

±74 (29)

21.0

±1.4

(30)

30.4

±1.4

(30)

4.4

±0.2 (30)

81.7

±14.8

(28)

1.41

±0.48

(22)

25

665

±104 (24)

22.1

±1.1

(22)

31.8

±1.8

(24)

4.6

±0.2 (24)

93.6

±12.2

(23)

1.70

±0.54

(17)

26

747

±110 (13)

23.3

±1.1

(13)

33.1

±1.6

(13)

4.8

±0.2 (13)

103.4

±12.9

(12)

2.04

±0.39

(10)

Gestationage (weeks)

Heart (gm)

SD (n)

Lungs (gm)

SD

(n)

Spleen (gm)

SD

(n)

Liver (gm)

SD

(n)

Kidneys (gm)

SD

(n)

Adrenals (gm)

SD

n

12

0.15

±0.02 (5)

0.5

±0.3

(7)

0.01

 

(3)

1.0

±0.4 (7)

0.16

±0.04

(6)

0.10

±0.04

(6)

13

0.2

−0.1 (11)

1.1

±0.4

(12)

0.01

±0.01

(10)

1.4

±0.5 (14)

0.21

±0.08

(13)

0.15

±0.04

(I1)

11

0.3

±0.1 (15)

1.8

±0.7

(16)

0.03

±0.02

(16)

2.3

±1.1 (15)

0.35

±0.11

(16)

0.22

±0.11

(15)

15

0.5

±0.2 (38)

2.6

±0.9

(37)

0.06

±0.04

(38)

3.3

±1.2 (37)

0.61

±0.20

(37)

0.33

±0.11

(38)

16

0.8

±0.2 (31)

3.5

±1.3

(33)

0.09

±0.05

(30)

5.0

±1.4 (30)

0.97

±0.33

(32)

0.48

±0.19

(33)

17

1.1

±0.4 (39)

4.6

±1.5

(40)

0.14

±0.07

(45)

7.1

±1.9 (39)

1.33

±0.46

(45)

0.65

±0.22

(44)

IN

1.5

±0.4 (43)

5.8

±2.2

(40)

0.19

±0.10

(44)

9.5

±2.5 (38)

1.75

±0.51

(40)

0.83

±0.31

(43)

19

1.9

±0.5 (48)

7.1

±2.0

(45)

0.27

±0.11

(46)

12.1

±3.2 (47)

2.28

±0.56

(46)

1.03

±0.34

(47)

20

2.3

±0.6 (61)

8.6

±2.6

(55)

0.36

±0.17

(59)

14.9

±3.8 (56)

2.89

±0.63

(56)

1.23

±0.38

(61)

21

2.8

±0.6 (37)

10.2

±3.0

(38)

0.47

±0.20

(34)

17.8

±4.1 (37)

3.46

±0.96

(38)

1.43

±0.45

(37)

22

3.3

±0.8 (44)

11.9

±3.5

(43)

0.60

±0.18

(46)

20.7

±4.3 (46)

4.20

±1.33

(44)

1.64

±0.48

(45)

23

3.8

±0.9 (39)

13.8

±3.8

(31)

0.73

±0.27

(34)

23.6

±6.8 (36)

5.01

±1.16

(32)

1.83

±0.50

(36)

24

4.4

±0.9 (29)

15.8

±5.3

(26)

0.89

±0.31

(27)

26.4

±5.9 (24)

5.66

±1.47

(28)

2.02

±0.57

(25)

25

5.0

±1.0 (22)

18.0

±5.3

(18)

1.05

±0.25

(18)

29.1

±4.7 (18)

6.52

±1.25

(22)

2.19

±0.54

(21)

26

5.6

±1.1 (11)

20.2

±5.4

(10)

1.24

±0.36

(9)

31.6

±6.3 (11)

7.50

±1.60

Ml

2.35

±0.63

(10)

From: Hansen K, Sung J, Huang BS, Pinar H, Singer DB, Oyer CE. Reference values for second trimester fetal and neonatal organ weights and measurements. Pediatr Dev Pathol. 2003;6:160–7, with permission

Appendix 34: Reference Values for Transverse Cerebellar Diameter Throughout Gestation

figure sfigure s

+, TCD (mm); •, +2 SD (mm); ♦, −2 SD (mm)

From: Pinar H, Burke SH, Huang CW. Singer DB. Sung CJ. Reference values for Transverse cerebellar diameter ­throughout gestation. Pediatr Dev Pathol. 2002;5:489–94, with permission

Appendix 35: Reference Values for Second Trimester Fetal and Neonatal Organ Weights and Measurements

figure tfigure t

Mean weights of heart (a), lungs (b), spleen (c), liver (d), kidneys (e), and adrenals (f) of second trimester fetuses and neonates with 90th and 10th percentile ranges

From: Hansen K, Sung J, Huang BS, Pinar H, Singer DB. Oyer CE. Reference values for second trimester fetal and ­neonatal organ weights and measurements. Pediatr Dev Pathol. 2003;6:160–7, with permission

Appendix 36: Reference Values for Second Trimester Fetal and Neonatal Organ Weights and Measurements

figure ufigure u

Mean weights of whole body (a), crown-rump length (b), crown-heel length (c), toe-heel length (d), brain (e), and thymus (f) of second and third trimester fetuses and neonates

From: Hansen K, Sung J, Huang BS, Pinar H, Singer DB. Oyer CE. Reference values for second trimester fetal and ­neonatal organ weights and measurements. Pediatr Dev Pathol. 2003;6:160–7, with permission

Appendix 37: Reference Values for Second Trimester Fetal and Neonatal Organ Weights and Measurements

figure zfigure z

Mean weights of heart (a), lungs (b), spleen (c), liver (d), kidneys (e), and adrenals (f) of second and third trimester fetuses and neonates

From: Hansen K, Sung J, Huang BS, Pinar H, Singer DB. Oyer CE. Reference values for second trimester fetal and neonatal organ weights and measurements. Pediatr Dev Pathol. 2003;6:160–7, with permission

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Gilbert-Barness, E., Spicer, D.E., Steffensen, T.S. (2014). Pediatric Autopsy: Fetus, Newborn, and Child. In: Handbook of Pediatric Autopsy Pathology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6711-3_2

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