“Was the Infant Born Alive?” A Review of Postmortem Techniques Used to Determine Live Birth In Cases of Suspected Neonaticide

Abstract

The question of whether an infant was born alive has received much attention in the forensic literature. The volume of literature reflects the degree of controversy surrounding the techniques employed and their varied interpretation and utility. The majority of the investigation has been focused on the question "Has the infant breathed?" to determine if an infant was born alive by utilizing techniques that assess aeration of the lungs. However , caution must be employed when interpreting these techniques due to the well-recognized limitations in their interpretation, particularly in the presence of gaseous decomposition and/or resuscitation efforts. Although in some instances there may be irrefutable evidence that the infant was born alive, there is no single finding that can reliably be utilized to answer the question "Was the infant born alive?" in every case. Hence, the approach to postmortem investigation continues to include a wide range of observations, dissections, special techniques, and ancillary tests to assist the pathologist to form a considered opinion. There are a number of more recently described techniques which show great promise in assisting to answer this question including advanced imaging and immunohistochemical studies of the umbilical cord. It remains, though, that in many cases it is not possible to definitively answer this question and stillbirth should be assumed due to the potential legal implications of determining that an infant was born alive.

Medicolegal Evaluation of an Abandoned Dead Neonate: A Case Report

“…It is argued that air can enter the lungs after the rupture of the amniotic membrane before the child is completely born. 2 Furthermore, resuscitation attempts at birth can also cause air entry into the lungs. There are fallacies of hydrostatic tests that have come negative in cases of live birth.…”

“…It is argued that air can enter the lungs after the rupture of the amniotic membrane before the child is completely born. 2 …”

“…There are fallacies of hydrostatic tests that have come negative in cases of live birth. 2 , 3 Laceration of the umbilical cord too isn't a concrete finding in a case of neonaticide. In the case of precipitate labor, when the delivery is without mother's knowledge as all the stages of labor merge into one, sudden delivery may snap the umbilical cord leaving behind the lacerated margin.…”

Pathological Findings of the Lung at Neonatal Autopsy in Dr. Hasan Sadikin General Hospital Bandung Period 2016-2019

“…Furthermore, a mosaic appearance has been found in some samples. [13][14][15] Some samples have shown a dark red color, solid texture, and a sharp margins. Its appearance is similar to that of the liver, showing an unrespired lung as a negative sign of breath.…”

Causes of death in newborn C57BL/6J mice

“…Identification of stillbirths has always been a challenge 40 and the lung floatation test is the subject of debate 38 as tissue decomposition can lead to confounding effects. Fortunately, in laboratory animal house facilities environmental conditions are highly standardized and the animals are inspected at least once every day.…”