Abstract

The germinal matrix neuroepithelium and the choroidal fissure of the fetal choroid plexus commonly possess microvessels that are often poorly developed. There may be a reduction of type IV collagen that surrounds these fragile microvessels. During the first and second trimester of neural development, these microvessels are friable and can undergo intraventricular hemorrhage under a number of circumstances. Early subtle changes in the integrity of germinal matrix epithelium are not easily visualized by ultrasound. The current investigation employing scanning electron microscopy clearly defines subtle hemorrhagic events and tearing of the germinal matrix neuroepithelium in the brains of human fetuses. A 23-week-old fetus survived for 11 days but died from other causes. The choroid plexus of this fetus was compared with the choroid plexus and germinal matrix epithelium of a 22-week-old fetus that was the product of an elective termination due to severe anhydramnios of unknown origin and a 19-week-old male fetus from an elective termination. All tissues were autopsy material not requiring institutional review board approval.

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