Maturity should be understood as a certain degree of physical development of the infant. The need to establish maturity during a forensic medical examination of the corpse of a newborn baby is due to the fact that a child who has reached it (in the absence of deformities, developmental anomalies and diseases incompatible with life) is always viable, which is important for resolving a number of procedural issues by law enforcement officers.

“Maturity” is a morphological concept and characterizes the degree of intrauterine development of the fetus, which is delivered for examination, and the concept of “full term” refers to the stages of pregnancy, the signs of which remain in the mother’s body. Therefore, the forensic medical examination of the corpse of a newborn when resolving these two issues is limited only to determining its maturity. Determination of full-term pregnancy cannot be the subject of examination due to the lack of an object of study.

Signs of fetal maturity

Criteria for Fetal Maturity (1966)

elasticity of the skin with a well-developed subcutaneous fat layer;
the presence of vellus hair only in the area of the shoulder blades and shoulder girdle;
thick hair on the head 2-3 (more than 1) cm;
dilated pupils without membrane, transparent corneas;
elastic, resilient cartilages of the nose and ears;
protrusion of the nails on the fingers beyond their ends and reaching their ends on the toes;
testicles descended into the scrotum in boys,
Closing of the labia minora in girls by the labia majora, closure of the genital fissure.

Kasper-Günz fetal term indicators

Metrics of individual bones in full-term infants.

Criteria for fetal maturity (modern???)

The skin of a mature newborn is pale grayish in color, the subcutaneous fatty tissue is well developed. On the wings of the nose there are clogged sebaceous glands. The cartilage of the nose and ears is elastic. The length of the hair on the head is 2 cm. The down on the body and hands usually disappears, the fingernails extend beyond the ends of the fingers, and on the legs they reach the ends of the fingers. In boys, the testicles are located in the scrotum; in girls, the labia majora cover the labia minora. Subcutaneous fatty tissue is well developed. Mammary glands perform. An important sign of the maturity of a newborn, according to most authors, is the presence of ossification nuclei (in the sternum (Zhuravleva ossification point), calcaneus, talus, femur and humerus). Thus, in a mature newborn, in the lower epiphyses of the femurs, Beclard’s nuclei can be identified - islands of ossification with a diameter of about 0.5-0.6 cm.

Currently, signs that allow us to judge the maturity of a newborn are body length and weight, head size, shoulder width and other anthropometric data.

In some cases, to resolve the issue of maturity based on the detected parts of the fetus, the data of Kasper and Günz on the sizes of some bones of a mature newborn child can be used: diagonal length of the parietal bone - 7.6 cm; frontal height - 5.6 cm, width - 4.5 cm; collarbone length - 3.4 cm; shoulder blades - 3.2 cm; humerus - 7.5 cm; ulnar - 7 cm; radial - 6.6 cm; hips - 8.7 cm; tibia - 7.9 cm; fibula - 7.7 cm.

When conducting a forensic medical examination (examination) of the corpses of newborn babies, the question of their maturity, like other issues, is resolved on the basis of not one, but the entire set of signs, where one of the main ones is histological examination internal organs.

The weight of the fetus, the shape and size of the head, as well as the degree of maturity of the fetus are of great importance during childbirth. In most cases, the head is the presenting part, but it is very important that it also corresponds to the size of the pelvis.

Signs of fetal maturity

A conclusion about the maturity of the fetus is made by a pediatrician or obstetrician-gynecologist. In their absence, this should be done by a midwife.

The length of a full-term fetus is more than 47 cm (with normal development no more than 53 cm). The weight of the fetus should be more than 2500 g. The optimal weight is 3000-3600 g. With a weight of 4000 g or more, the child is considered large, with a weight of 5000 g or more - gigantic. The degree of maturity can be judged by bone density (according to fetal ultrasound, vaginal examination and examination of the newborn).

Mature newborn skin pale pink, with well-defined subcutaneous fatty tissue, many folds, good turgor and elasticity, residues of cheese-like lubricant, without the slightest signs of maceration. The length of the hair on the head is more than 2 cm, the vellus hairs are short, the nails extend beyond the fingertips. Ear and nasal cartilage are elastic. The chest is convex, in a healthy child the movements are active, the cry is loud, the tone is active, reflexes are well expressed, including searching and sucking. The child opens his eyes. The umbilical ring is located in the middle of the distance between the pubis and the xiphoid process; in boys, the testicles are lowered into the scrotum; in girls, the labia minora are covered by the labia majora.

Obstetrics and gynecology: lecture notes A. A. Ilyin

Lecture No. 4. Signs of fetal maturity, size of the head and body of a mature fetus

The length (height) of a mature, full-term newborn varies from 46 to 52 cm or more, averaging 50 cm. Fluctuations in the body weight of a newborn can be very significant, but the lower limit for a full-term fetus is the weight of 2500–2600 g. The average body weight of a mature, full-term newborn 3400–3500 g. In addition to the body weight and length of the fruit, its maturity is judged by other characteristics. A mature, full-term newborn has a well-developed subcutaneous fat layer; skin pink, elastic; the vellus cover is not expressed, the length of the hair on the head reaches 2 cm; ear and nasal cartilages are elastic; nails are dense, protruding beyond the edges of the fingers. The umbilical ring is located midway between the pubis and the xiphoid process. In boys, the testicles are lowered into the scrotum. In girls, the labia minora are covered by the labia majora. The baby's cry is loud. Muscle tone and movements of sufficient force. The sucking reflex is well expressed.

The head of a mature fetus has a number of features. It is the largest and densest part of it, as a result of which it experiences the greatest difficulties when passing through the birth canal. After the birth of the head, the birth canal is usually well prepared for the advancement of the fetal trunk and limbs. The facial part of the skull is relatively small, and its bones are firmly connected. The main feature of the cranial part of the head is that its bones are connected by fibrous membranes - sutures. In the area where the sutures join there are fontanelles - wide areas connective tissue. The lack of a strong connection between the skull bones is of great importance during childbirth. A large head can change its shape and volume, as sutures and fontanelles allow the bones of the skull to overlap each other. Thanks to this plasticity, the head adapts to the mother's birth canal. The most important sutures connecting the bones of the fetal skull are the following: the sagittal suture, passing between the two parietal bones; frontal suture - between the two frontal bones; coronal suture - between the frontal and parietal bones; lambdoid (occipital) suture – between the occipital and parietal bones. Among the fontanelles on the fetal head, the large and small fontanelles are of practical importance. The large (anterior) fontanel has diamond shape and is located at the junction of the sagittal, frontal and coronal sutures. The small (posterior) fontanelle has triangular shape and is a small recess in which the sagittal and lambdoid seams converge.

Head a full-term mature fetus has the following dimensions:

1) straight size (from the bridge of the nose to the occipital protuberance) – 12 cm, head circumference along the straight size – 34 cm;

2) large oblique size (from the chin to the occipital protuberance) – 13–13.5 cm; head circumference – 38–42 cm;

3) small oblique size (from the suboccipital fossa to the anterior angle of the large fontanelle) – 9.5 cm, head circumference – 32 cm;

4) average oblique size (from the suboccipital fossa to the border of the scalp of the forehead) – 10 cm; head circumference – 33 cm;

5) vertical, or vertical, size (from the top of the crown to the sublingual region) - 9.5–10 cm, head circumference - 32 cm;

6) large transverse size (the greatest distance between the parietal tubercles) – 9.5 cm;

7) small transverse size (distance between the most distant points of the coronal suture) – 8 cm.

Dimensions torso the fruits are as follows:

1) shoulder size (shoulder girdle diameter) – 12 cm, shoulder girdle circumference – 35 cm;

2) transverse size of the buttocks – 9 cm, circumference – 28 cm.

author A. A. Ilyin

From the book Obstetrics and Gynecology: Lecture Notes author A. A. Ilyin

From the book Propaedeutics of Childhood Illnesses by O. V. Osipova

author A.I. Ivanov

From the book Obstetrics and Gynecology author A.I. Ivanov

From the book Polyclinic Pediatrics: lecture notes author Notes, cheat sheets, textbooks "EXMO"

From the book Propaedeutics of Childhood Illnesses: Lecture Notes by O. V. Osipova

From the book Encyclopedia of Clinical Obstetrics author Marina Gennadievna Drangoy

From the book Children's Diseases. Complete guide author author unknown

From the book Planning a Child: Everything Young Parents Need to Know author Nina Bashkirova

From the book Harmonious Childbirth – Healthy Children author Svetlana Vasilievna Baranova

From the book Pregnancy: week by week. Consultations with an obstetrician-gynecologist author Alexandra Stanislavovna Volkova

Today we will list and briefly describe the signs of a full-term newborn. In addition, we will dwell on the issues of postmaturity or prematurity. How is it possible to determine this from a child and how do children differ? What does this mean for a newborn?

For this reason, it is necessary to know not only the signs of full term and maturity of the newborn, but also to be able to correctly diagnose and be aware of possible problems. If we consider the child as an object of birth, then this must be done based on the size of the head, since this is the most voluminous part of the fetal body, which experiences the greatest difficulties during movement along the birth canal. Now we propose to talk in more detail about the signs of a full-term newborn.

Full term baby

What is fetal maturity? This is a certain state of the child, which characterizes the readiness of the internal organs to ensure the life of the baby outside the womb. After birth, the child must be examined by a neonatologist.

The doctor needs to assess three parameters:

determination of full-term birth of a newborn baby, the signs of which we will consider in this section;
assess the degree of physical development;
morphological and functional maturity.

Which baby is considered full-term? These signs include:

birth time - from thirty-eight to forty-two weeks;
body weight must be more than two and a half kilograms;
body length - from forty-six centimeters or more.

It is very important to note that there are a number of other signs that a newborn is full-term. We are talking about morphological and functional maturity. We will talk about this in detail further. To summarize everything that has been said in this section, we can highlight the main signs of a full-term newborn:

gestational age;
body mass;
body length.

External signs

Let's start with the main signs that are visible to the naked eye. The first item on this list should be a loud and demanding voice. Secondly, the skin should be pink and velvety. Be sure to pay attention to the fact that the newborn’s skin should be clean and the fat layer should be even. Third, the presence of an open large fontanel. However, according to statistics, in fifteen percent of cases the small one is also open. Fourth external sign- this is the formation of the auricle, all arches should be clearly expressed. The fifth sign is that the navel is located in the center of the abdomen, nail plates should completely cover the nail phalanges. The sixth sign is that girls have a closed genital opening, and boys have testicles descended into the scrotum.

Functional signs

In this section we list the functional signs of a full-term newborn. These include the following:

the baby’s limbs should be bent at the joints;
movements are chaotic and quite active;
Children are characterized by increased muscle tone;
body temperature is stable, deviations within the normal range of up to six tenths degrees Celsius are possible;
the newborn's breathing is also stable - from forty to sixty breaths per minute;
the heartbeat can be heard well, rhythmically (the norm is from one hundred twenty to one hundred and forty beats per minute);
in a full-term baby, all reflexes are symmetrical, it is possible to cause specific ones.

Specific reflexes of newborns:

sucking;
search;
prehensile;
proboscis and others.

Prematurity

Now let's turn to the issue of criteria for prematurity, postmaturity of the baby. A premature baby is born before the end of intrauterine development, that is, before the thirty-seventh week of pregnancy. Such babies have a small body weight, weighing less than two and a half kilograms, and their height does not reach forty-five centimeters. Newborns have problems with thermoregulation and insufficient response to external stimuli. It is important to note statistical information: such children are born in approximately 10% of cases.

It is worth knowing that there is a term “extreme prematurity” if the baby is born before twenty-two weeks. This condition is the line between a miscarriage and a premature baby. Body weight in this case is a decisive factor: if it reaches half a kilogram, then it is a premature baby, and just one gram less is a miscarriage.

Prematurity is usually classified according to the body weight of the newborn.

Problems of prematurity can lie in both the mother or father and the baby. They are briefly listed in the table below.

Manifestation of prematurity

The signs of full term, prematurity and postmaturity of a newborn that we consider in the article are reflected in the behavior and development of the baby. We invite you to talk about how prematurity in newborns manifests itself. We will now present the general clinical picture. Firstly, the newborn has body disproportion (a very large head). In addition, the sutures of the skull are open, so the bones are pliable. Secondly, the ears are soft. Third, the child is in the frog position, as muscle hypotonia is noted. The fourth sign is that boys’ testicles have not yet descended into the scrotum, and girls’ labia majora have not yet fully developed. Fifth, specific reflexes are extremely weakly expressed. Sixth - shallow and weak breathing (up to 54), low blood pressure (approximately 55-65). Seventh - frequent urination and regurgitation.

Postmaturity

What features does a post-term newborn baby have? Signs of postmaturity in the mother should be diagnosed by a doctor using CTG and ultrasound examination. These symptoms include:

absence of labor;
reduction in abdominal circumference;
quite large fruit;
compaction of the child’s skull;
meconium in amniotic fluid;
reduced glucose concentration in amniotic fluid;
A urine test shows low estriol levels.

It is worth noting that there are two types of post-term pregnancy:

In case of true postmaturity, the baby is in serious danger, because hypoxia develops.

What are the causes of postmaturity and how do they affect the baby?

How does a post-term pregnancy affect the child? The baby has the following signs:

thin body;
dry and wrinkled skin;
peeling of the skin;
lack of fetal lubrication;
long nails and hair;
open eyes;
increased activity.

Please note that the skin of post-term newborns acquires a yellowish tint. To prevent post-term pregnancy, it is very important to undergo a CTG procedure three times a week (after 40 weeks). Your baby's heartbeat and movements will help determine exactly how your baby is feeling.

Causes this phenomenon unknown, but doctors distinguish two large groups:

Please note that there is also a psychological factor. If future mom If she is afraid of childbirth and is not psychologically ready for it, then the pregnancy may be delayed. In this case, you need the support of loved ones or consultation with a psychologist.

Differences between a full-term and premature baby

A full-term baby has a number of characteristics. He is ready for life outside the womb, has certain reflexes, the skin is able to maintain a certain temperature regime, heart rate is stable, breathing and activity are normal. A premature baby is the exact opposite: he is not ready for life outside the womb, he is unable to maintain temperature, his heart rate and breathing are unstable, his blood pressure is low, and newborn reflexes are poorly developed.

It should be noted that full-term and fetal maturity are ambiguous concepts.

Term indicates the length of time the fetus remains in the mother's body.

Maturity characterizes the degree of development of the fetus.
Maturity is usually understood as a set of signs (level of physical development, development of the skin of soft tissues, musculoskeletal system), i.e., the degree of fetal development at which independent life of the child in the external environment is possible.
Among the signs of maturity of newborns, leading importance is given to:

Sufficient development of the subcutaneous fat layer;

The length of the hair on the head is at least 2 cm;

The cartilage of the ears and nose is dense;

The nail plates on the fingers extend beyond the ends of the fingers, on the feet they reach the ends of the fingers;

Condition of the external genitalia and other signs.

Accelerated growth and physical development fetus may determine the recognition of a newborn child as viable in cases where, by intrauterine age (less than 8 lunar months), viability in the forensic medical sense has not yet been achieved, which significantly changes the legal assessment of the fact of infanticide and responsibility for it.
The above should be taken into account by the investigator when assessing the expert’s conclusions.

Whether a baby is full-term or preterm is determined by whether the baby was born at term or prematurely.

The normal duration of pregnancy is 280 days, or 10 lunar months (a lunar month is 28 days). Deviations from this period are possible; in such cases, the baby will be considered premature or post-term.

The birth of a baby to term is characterized by a combination of a number of signs. Its body length is 50 cm, head circumference is 32 cm, the distance between the shoulders is 12 cm, between the trochanters of the thighs is 9.5 cm, weight is 3 kg.

The skin of a full-term baby is pink, elastic, and covered with delicate down in the shoulder area. Fingernails extend beyond the ends of the fingers, while toenails extend to the ends. The cartilage of the nose and ears is dense and elastic. The mammary glands in boys and girls are slightly swollen. In boys, the testicles are located in the scrotum; in girls, the labia majora cover the labia minora. Transverse section of the distal epiphysis femur in the central part of the section, the so-called ossification nucleus is clearly visible in the form of a dark red focus with a maximum diameter of 0.5 cm, located against the background of white cartilaginous tissue.

A premature baby's body length, other dimensions and weight will be smaller the more premature he is. The skin is pale, flabby, wrinkled, and covered with fluff everywhere. The face has an old-looking appearance, the cartilages of the nose and ears lack elasticity. Fingernails and toenails do not reach the ends of the fingers. In boys, the scrotum is empty due to the location of the testicles in abdominal cavity. In girls, the labia majora do not cover the labia minora.

A full-term baby is usually mature.