Expulsión fetal postmortem

Abstract

RESUMENUn evento extremadamente inusual en patología forense es la "expulsión postmortem de un feto" también denominado parto postmortem. El "parto postmortem" se define como la expulsión de un feto muerto tras el fallecimiento de una mujer embarazada cuando el útero materno muestra claros signos de putrefacción. Se considera que los gases generados en la fase enfisematosa de la putrefacción cadavérica dentro de la cavidad abdominal pueden prolapsar el útero y causar la expulsión total o parcial del feto.Presentamos el caso de una mujer embarazada de siete meses que desapareció y fue hallada muerta varios días más tarde en avanzado estado de putrefacción. Antes de practicar la autopsia se procedió a retirar la ropa interior y se encontró el feto fuera de la cavidad pél-vica. Al mismo tiempo se realiza una revisión histórica del tema.Palabras clave: expulsión fetal postmortem, parto postmortem, cesárea postmortem. Cuad Med Forense 2009; 15(55):77-81 ABSTRACTAn extremely unusual event in forensic pathology is the postmortem fetal extrusion or "coffin birth". It is defined as the expulsion of a dead fetus after the death of a pregnant woman when the maternal uterus shows signs of putrefaction. It is considered that the gases generated during the emphysematous phase of the cadaveric putrefaction may distend the uterus causing partial or total fetal extrusion.We present the case of a seven month pregnant woman who disappeared and was found dead some days later in a state of advanced putrefaction. The fetus was discovered inside the woman's underwear at the moment of undressing the body before autopsy. At the same time, an historical review of the issue is carried out.

Maternal–fetal death in medieval Pieve di Pava (central Italy, 10th–12th century AD)

“…The position of the fetus associated with the young female US 8432, found between her knees, is suggestive of a potential case of postmortem fetal extrusion. This phenomenon occurs when the nonviable fetus is spontaneously expelled after the death of a pregnant or parturient woman whose corpse shows clear signs of putrefaction (Lasso et al, 2009; Schulz et al, 2005) or during fire deaths (Vennemann et al, 2008). The expulsion of the fetus usually takes place 48–72 h after the death of the mother, when bacterial gas formation during the phases of autolysis and putrefaction causes significant abdominal swelling that, owing to intra‐abdominal pressure, can lead to a prolapse of the uterus and the partial or total expulsion of the fetus (Le Roy & Murphy, 2020; Schultz et al, 2005).…”

A possible case of dystocia due to foetal macrosomia at Shuanghuaishu site (3500–2900 BCE), Henan, China

“…In the extreme situation, extrusion of the foetus (coffin birth) occurs. As the mother's internal organs undergo autolysis, gases accumulate and the pressure may force the foetus partly or wholly through the perineal area, where it is found after death (Lasso, Santos, Rico, Pachar, & Lucena, 2009; Schulz, Püschel, & Tsokos, 2005). The phenomenon is documented forensically although the literature is small (Halcrow, Tayles, & Elliott, 2018).…”

“…The phenomenon is documented forensically although the literature is small (Halcrow, Tayles, & Elliott, 2018). Published cases tend to involve cadavers of women in their 6th through 10th month of pregnancy recovered after days or weeks of decay in settings such as a coffin in which an open space was present for the foetal remains to be extruded into (Lasso, Santos, Rico, Pachar, & Lucena, 2009; Panning, 1940; Schulz, Püschel, & Tsokos, 2005).…”

Possible case of partial postmortem fetal extrusion: Preliminary observations on the mummified remains of a turn‐of‐the‐19th‐century noblewoman in Finland

“…In this paper, we deliberate whether this finding represents a partial postmortem fetal extrusion. Postmortem fetal extrusion means a total (e.g., Lasso et al, 2009; Rascón Pérez et al, 2007) or partial (e.g., Augias et al, 2015; Schulz et al, 2005) protrusion of the dead fetus out of the body of a mother who died during the pregnancy. In these cases, the fetal remains are often premature and small (Augias et al, 2015; Viva et al, 2020).…”