The baby is evaluated for the degree of maceration. This indicates how long the infant has been dead in utero. In this baby there are slight to mild external macerative changes, particularly evident on the lower back. The remainder of the examination is basically a head to foot assessment with special attention being paid to those features frequently seen in babies who are stillborn because of the presence of birth defects. The head is examined for the presence of anencephaly, apparent hydrocephalus, any abnormalities of shape or the presence of scalp defects or masses.
Note is made of the size and shape of the nose and whether the nostrils are patent.
The ears are examined for abnormal external architecture and, if they seem unusual, a drawing or description should be included. The region in front of the ear is examined for tags or pits. The chest is examined for symmetry, size and shape. Likewise the abdomen is examined for the presence of abdominal wall defect such as an omphalocele, gastrosschissis or umbilical hernia. The baby should be turned over so that the back is examined for evidence of abnormal curvature and for any sign of spina bifida.