Skeletal maturation of the human fetus assessed radiographically on the basis of ossification sequences in the hand and foot



In studies of postnatal human development the skeletal maturation of the hand has been found to be a better indicator of general physical maturation than attained body height. For assessment of prenatal human development the Crown-rump length (CRL) has so far been the most commonly used measure.

The object of the present study is to examine the possibility of also using the skeletal maturation of the hand as a maturity indicator in fetal development.

The study is based upon a radiographic and histochemical investigation of 169 human fetuses. On the basis of counting silver-impregnated diaphyses on radiographs of the hand and foot a maturity indicator (CNO = Composite Number of Ossified bones in hand and foot) was established. Owing to the marked regularity of the recorded ossification pattern, the CNO parameter can be used for evaluating fetal maturation during the early half of the prenatal period.

To supplement the assessment of skeletal maturation during the later stages of development, a classification based on the shape of some bones was included in the study.

In many cases fetuses of the same size (CRL) exhibited different stages of skeletal maturation (CNO).

In accordance with findings from assessment of postnatal development, a more accurate evaluation of fetal development is obtained by combining the size parameter CRL with an assessment of fetal skeletal maturation, CNO.