The Diagnosis of the Age of the Fetus by the Use of Roentgenograms

Abstract

The determination of the age of the fetus is of considerable practical importance. On the age of the fetus and on its development are based the chief factors that are to be considered before giving prognosis as to the possibility of saving the life of the prematurely born infant. The method of treatment, and especially that of feeding, depends primarily on the age of such infant. In medicolegal cases the question of the age of the fetus may occasionally be of paramount importance, and when only portions of the fetus are available for examination, the roentgenographic method offers the best means for arriving at a diagnosis of the age of such fetus.Time of Conception.\p=m-\Theage of the fetus is the time which has elapsed from conception; that is, from the time of the fertilization of the ovum from which the fetus developed. The time of conception cannot be accurately determined. Conception does not follow immediately after insemination, and its relation to menstruation is so uncertain that an error of one month is possible in attempts to calculate the age of the fetus from the time of menstruation. A number of observers,

Quantitative anatomy of the primary ossification center in the fetal pubis bone

“…Caffey and Madell [ 4 ] presented the entire pubis to ossify from only one ossification center which was subsequently fused with the iliac and ischial ossification centers. Contrariwise, Hess [ 15 ] identified four types of pubic ossification. In type A, the ossification center was confined to the superior pubic ramus, and the process of ossification did not progress medially toward the connection with the inferior pubic ramus.…”

Origin and prenatal growth of behavior.

“…It is possible that this Aristotelian doctrine is basic to the rules of the church in regard to prenatal baptism which is considered historically by Witkowski (349, pp. [133][134][135][136][137][138][139][140][141][142][143][144][145][146][147][148][149][150][151][152].…”

“…The use of the X-ray in the study of the fetus has given a new clue to the determination of fetal age by the study of the ossification of the fetal skeleton, although it is by no means an absolute clue. Hess has brought together much of the literature on this subject and suggests approesimate norms of ossification at certain periods (145).…”

The onset and early development of behavior.

“…in crown-rump, length. Sometimes, however, premature infants are born and successfully reared who have passed less than 180 days in the mother's body; but 180 or 181 days is usually taken as the average lower limit below which viability cannot be maintained (Hess, 1922). Claims have been made that much younger fetuses have been raised, but as, for example, in the case of Rodman's fetus which was alleged to have been but 4 months old, there is much doubt of the accuracy of the age estimation (Rodman, 1815;Baker, 1825).…”

“…The use of the X-ray in the study of the fetus has given a new clue to the determination of fetal age by the study of the ossification of the fetal skeleton, although it is by no means an absolute clue. Hess (1918) has brought together much of the literature on this subject and suggests approximate norms of ossification at certain periods. (See also Mall, 1906, andAdair, 1918.)…”