ABSTRACT
Making the determination of live birth versus stillbirth in a discarded newborn infant based on gross and microscopic autopsy findings can be a challenging task for the forensic pathologist. The traditional criteria for live birth determination are frequently challenged in court, and indisputable evidence of live birth remains elusive. The histologic finding of pulmonary interstitial emphysema has not been considered as a useful determinant of live birth. The authors report two cases of discarded newborn infants in which the finding of pulmonary interstitial emphysema was used as an indicator of live birth.
Subject(s)
Fetal Death/diagnosis , Forensic Medicine/methods , Pulmonary Emphysema/pathology , Adult , Female , Humans , Infant, Newborn , PregnancyABSTRACT
CONTEXT: The practice of infants cosleeping with adults has long been the subject of controversy. Autopsy findings in cases of sudden infant death syndrome (SIDS) are usually indistinguishable from those found with unintentional or intentional suffocation, and the determination of the cause of death in cases of sudden unexpected death in infancy is often based on investigative findings and the exclusion of natural or traumatic causes. OBJECTIVE: To further elucidate the risk of cosleeping. METHODS: We reviewed 58 cases of sudden unexpected infant deaths. Cases were excluded if there was any significant medical history or evidence of trauma or abuse. RESULTS: Twenty-seven of the infants were cosleeping. Eleven of these cases had been previously diagnosed as SIDS, and in 7 cases parental intoxication was documented. CONCLUSION: Our findings support recent studies that suggest that cosleeping or placing an infant in an adult bed is a potentially dangerous practice. The frequency of cosleeping among cases diagnosed as SIDS in our study suggests that some of these deaths may actually be caused by mechanical asphyxia due to unintentional suffocation by the cosleeping adult and/or compressible bedding materials.
