{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T18:03:32Z","timestamp":1789581812324,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Forensic Sciences"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Examination of the fetal brain represents a crucial step in the diagnostic assessment of fetal death in utero, particularly in cases of unexplained intrauterine fetal death (IUFD). Prolonged intrauterine retention, advanced autolysis, and the intrinsic structural immaturity of the fetal brain frequently compromise tissue integrity, limiting diagnostic evaluability. We describe a brain extraction technique preserving the dura mater combined with a modified alcohol\u2010formalin\u2010acetic acid fixation protocol aimed at improving morphological preservation and diagnostic yield. Between 2017 and 2019, 295 fetal autopsies were performed at the regional reference center for SIUD\u2014IRCCS Istituto Giannina Gaslini, Genoa, Italy. The method enables en bloc removal of the brain completely enveloped by the intact dura mater, which acts as a protective scaffold during handling and fixation. The brain is suspended in a modified Culling solution (40% buffered formalin at 10%, 40% ethanol at 95%, 20% glacial acetic acid) for approximately 20\u2009days prior to serial sectioning according to the Charcot's technique. This approach appears to reduce mechanical disruption even in severely macerated cases, ensures uniform tissue compaction, shortens fixation times compared with formalin alone, and preserves cortical, ventricular, and brainstem anatomical relationships. It also allows gross exclusion of major abnormalities, including extensive intraventricular and intraparenchymal hemorrhages, and enables systematic inspection and sampling of the dural venous sinuses. Histological and immunohistochemical analyses demonstrated satisfactory preservation quality comparable to conventional methods. This simple and reproducible technique enhances evaluability in fetal autopsies and supports more reliable etiological assessment in cases of IUFD.<\/jats:p>","DOI":"10.1111\/1556-4029.70474","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:31:09Z","timestamp":1789579869000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dura mater\u2010preserving technique for fetal brain extraction after intrauterine death with prolonged retention"],"prefix":"10.1111","author":[{"given":"Ezio","family":"Fulcheri","sequence":"first","affiliation":[{"name":"Pathology Unit IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Buffelli","sequence":"additional","affiliation":[{"name":"Pathology Unit IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Duzioni","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI) University of Genova  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Lupariello","sequence":"additional","affiliation":[{"name":"Legal Medicine Unit, Department of Public Health and Paediatrics University of Torino  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Pesce","sequence":"additional","affiliation":[{"name":"Central Laboratory of Analysis IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio Gaetano","family":"Vellone","sequence":"additional","affiliation":[{"name":"Pathology Unit IRCCS Istituto Giannina Gaslini  Genoa Italy"},{"name":"Department of Integrated Surgical and Diagnostic Sciences (DISC) University of Genova  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6616-0347","authenticated-orcid":false,"given":"Alessandro","family":"Bonsignore","sequence":"additional","affiliation":[{"name":"Section of Legal and Forensic Medicine, Department of Health Sciences (DISSAL) University of Genova  Genoa Italy"},{"name":"Medico Legal Unit IRCCS Istituto Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Guidelines on autopsy practice: fetal autopsy following antepartum or intrapartum death of non\u2010malformed fetuses","author":"Royal College of Pathologists","year":"2024"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm\u20102021\u20100403"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","DOI":"10.1385\/1592596738","volume-title":"Handbook of pediatric autopsy pathology","author":"Gilbert\u2010Barness E","year":"2005"},{"key":"e_1_2_13_5_1","volume-title":"Manuale delle autopsie perinatali [Manual of perinatal autopsies]","author":"Vald\u00e9s\u2010Dapena M","year":"1988"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","DOI":"10.1201\/b13395","volume-title":"The hospital autopsy","author":"Burton JL","year":"2010"},{"key":"e_1_2_13_7_1","volume-title":"Autopsy pathology","author":"Connolly AJ","year":"2015"},{"key":"e_1_2_13_8_1","volume-title":"Handbook of autopsy practice","author":"Ludwig J","year":"2022"},{"key":"e_1_2_13_9_1","volume-title":"Manuale di anatomia patologica e funzionale [manual of pathological and functional anatomy]","author":"Fulcheri E","year":"2022"},{"key":"e_1_2_13_10_1","unstructured":"Italian Republic.Law no. 31 of February 2 2006. Disciplina del riscontro diagnostico sulle vittime della sindrome della morte improvvisa del lattante (SIDS) e di morte inaspettata del feto [Regulations governing postmortem examination in victims of sudden infant death syndrome (SIDS) and unexpected fetal death]. Gazzetta Ufficiale della Repubblica Italiana2006Feb 8;(32)."},{"key":"e_1_2_13_11_1","unstructured":"Italian Ministry of Health.Decree of October 7 2014. Protocolli diagnostici nei casi della morte improvvisa infantile e della morte inaspettata del feto [Diagnostic protocols for cases of sudden infant death syndrome and unexpected fetal death]. Gazzetta Ufficiale Serie Generale2014Nov 22; (272)."},{"key":"e_1_2_13_12_1","volume-title":"Diseases of the fetus and newborn: pathology, imaging, genetics and management","author":"Reed GB","year":"1995"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000239833"},{"key":"e_1_2_13_14_1","volume-title":"Tecnica delle autopsie per riscontro diagnostico [Diagnostic Autopsy Techniques]","author":"Mottura G","year":"1986"},{"key":"e_1_2_13_15_1","volume-title":"Autopsie: guida tecnica illustrata [Autopsies: Illustrated Technical Guide]","author":"Varetto L","year":"2010"},{"key":"e_1_2_13_16_1","volume-title":"Compendio di Tecnica e Diagnostica delle Autopsie [Compendium of autopsy technique and diagnostics]","author":"Terribile Wiel Marin V","year":"2000"},{"key":"e_1_2_13_17_1","volume-title":"Anatomia Patologica: Le basi [pathological anatomy: the basics]","author":"Maresi E","year":"2008"},{"key":"e_1_2_13_18_1","doi-asserted-by":"crossref","DOI":"10.1007\/b138665","volume-title":"Postmortem technique handbook","author":"Sheaff MT","year":"2005"},{"key":"e_1_2_13_19_1","volume-title":"Gray's Anatomy","author":"Bannister LH","year":"1995"},{"key":"e_1_2_13_20_1","volume-title":"Federative international Programme for anatomical terminology","author":"FIPAT","year":"2019"},{"key":"e_1_2_13_21_1","unstructured":"PesceF FulcheriE.Tecniche di estrazione e di fissazione dell'encefalo fetale nelle ritenzioni protratte in utero post mortem [Techniques for Extraction and Fixation of the Fetal Brain in Prolonged Intrauterine Post\u2010Mortem Retention]. [dissertation]. Rome Italy: Universit\u00e0 Cattolica del Sacro Cuore2018."},{"key":"e_1_2_13_22_1","volume-title":"Cellular pathology technique","author":"Culling CFA","year":"1985"},{"key":"e_1_2_13_23_1","volume-title":"Tecniche di Anatomia Patologica [pathological anatomy techniques]","author":"Melis M","year":"1996"},{"key":"e_1_2_13_24_1","volume-title":"Bancroft's theory and practice of histological techniques","author":"Suvarna SK","year":"2018"},{"key":"e_1_2_13_25_1","volume-title":"Histological and histochemical methods","author":"Kiernan JA","year":"2015"},{"key":"e_1_2_13_26_1","volume-title":"Atlas of adult autopsy","author":"Suvarna SK","year":"2018"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/10935266211000036"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/1556\u20104029.70336"},{"key":"e_1_2_13_29_1","volume-title":"L'autopsia finalizzata al riscontro diagnostico. 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