INFANTICIDE
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INFANTICIDE
Definition

Unlawful destruction of a newly born child below the
age of one year and is regarded as murder in law.
Punishable under sec 302 IPC
•
Foeticide
•
Neonaticide
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DUTIES OF A FORENSIC
PATHOLOGIST IN A CASE OF INFANTICIDE
1. Was the child still born or dead born?
2. Was the child born alive?
3. If born alive how long did the child survive?
4. What was the cause, manner of death?
5. Assist in identifying the mother if she is unknown
6. Assess the maturity of the child.
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WHO IS A STILL BORN CHILD?
One which was alive in utero, until the process of

delivery began

Died during delivery

Did not show any signs of life after complete expulsion
from mother.
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STILL BORN CHILD
One which issued forth from the mother after 28th week

of pregnancy and did not at any time after completely
expelled breathe or show any other signs of life
( WHO)
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.
STILL BORN CHILD

Prematurity

Anoxia

Birth trauma

Intracranial haemorrhage

Excessive moulding

Placental abnormalities
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WHO IS A DEAD BORN CHILD?

One which died in utero before birth process began

Show one of the following signs after it is completely born

Maceration

Mummification.

Putrefaction
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MACERATION

Aseptic autolysis

Death in utero surrounded by liquor
amnii(3-4 days)

Skin is red or purple can be easily
peeled off

Soft, flaccid, flattened

Emits sweetish, disagreeable smell

Skull sutures separate,

SPALDING SIGN
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Spalding’s sign

Loss of alignment and overriding of cranial bones

Due to shrinkage of cerebrum after death

Within few days
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U.S.G.APPEARANCE OF SPALDINGS SIGN
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Signs of live birth

In civil cases, any sign of life after complete birth
of the child is accepted as proof of livebirth

The law presumes that every newborn child found
dead was born dead until the contrary is proved.

Criminal cases: signs of live birth by P.M.
examination
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EVIDENCE OF LIVE BIRTH

Cry
 Feeling
 Hearing
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heart beat
 Muscular
movements
 Pulsating
cord
 Vagitus
uterinus
 Vagitus
vaginalis
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SIGNS OF RESPIRATION
Shape of
Chest
Position of
diaphragm
Arched or
drum shaped
Descends to
6th or 7th rib
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Changes in
Lungs
Sp gravity
Volume
Consistence
colour
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HYDROSTATIC TEST

Based on the specific gravity of lungs

Un respired 1040-1050, respired 940

Determination of buoyancy of lungs

Ratio of specific gravity of lungs to that of water
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HYDROSTATIC TEST step1

Lungs removed with
larynx, bronchi, trachea
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HYDROSTATIC TEST step1

This is placed in water, if
it floats test is positive.
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HYDROSTATIC TEST step 2

Lungs is cut into 15-20
fragments if they float
test is positive.
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HYDROSTATIC TEST step 3

Pieces are squeezed under
water look for air bubbles,
then expel residual air
by placing the lung pieces
between wooden block and
apply pressure...

This is placed in water, if it
floats test is positive.
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HISTOLOGY OF UNRESPIRED LUNG
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
Gland like structure of
lung

Alveoli collapsed

Thick walled ductules
lined by cuboidal or
columnar epithelial cells
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HISTOLOGY OF RESPIRED LUNG
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
Alveoli and bronchii
expanded

Lined by flat epithelium
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ALVEOLAR DUCT MEMBRANE









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Frozen section
Using fat stain
Deficiency of surface
tension lowering agent
Injury to cellular lining of
alveoli
Lack of fibrinolysin
Absent in babies wt
<1200gm
I.U Asphyxia, prematurity,
D.M,C.S,E.B
Baby live born
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FALLACIES OF HYDROSTATIC TEST
EXPANDED LUNGS MAY SINK FROM
Acute pulmonary oedema, pneumonia
Atelectasis, air not entering alveoli due
to feeble respiration
Obstruction by alveolar duct membrane
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FALLACIES OF HYDROSTATIC TEST
UN EXPANDED LUNGS MAY FLOAT FROM
1.Putrefaction
2. Artificial inflation
3. Alcoholic fixation
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HYDROSTATIC TEST NOT NECESSARY IF.
Foetus is less than 180 days of IU life
Foetus is a monster, congenital anomalies
Macerated
Umbilical cord separated, milk in stomach
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SIGNS OF STRUGGLE TO BREATHE
1.
Pseudo clots
2.
Cyanosed expanded lungs
3.
Tardieu's spots
4.
Distention of large bowel with Meconium
5.
Oedema of lungs
6.
Presence of alveolar duct membrane
7.
Phagocytosis of meconium
8.
Bronchopneumonia
9.
Contusion of lungs
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OTHER SIGNS OF LIVE BIRTH
1.Saliva in stomach
2. Air in stomach
( Breslau's second life test)
3. Changes in middle ear
( Wredin’s test)
4. Changes in kidney and bladder
5. Neonatal line in enamel of unerrupted teeth
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IF BORN ALIVE HOW LONG
DID THE CHILD SURVIVE?
Changes in the skin
Changes in umbilical cord
Presence of caput succedaneum
Changes in circulation, blood
Meconium discharge( within 24-48 hrs )
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SKIN CHANGES

Bright red skin with vernix
caseosa ( 1-2days)

Dark, brick red, yellow

Exfoliation of skin of
abdomen(1-3days)

Normal colour by 7days
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CHANGES IN THE UMBILICAL CORD
Cut end showing two artery & one vein,
with clots
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CHANGES IN THE UMBILICAL CORD
Cut end showing inflammatory
ring at base
36 To 48 hrs after birth
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CHANGES IN THE UMBILICAL CORD
Cut end showing dry shrivelled
& mummified appearance
Second to third day after birth
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CHANGES IN THE UMBILICAL CORD
Cord falls off
leaving slightly suppurating ulcer
Five to Sixth day after birth
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CAPUT SUCCEDANEUM
Swelling containing serum in the presenting part of
with ecchymosis,occur after rupture of membrane
Pits on pressure,
Disappear by 24-72 hrs after birth.
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DIFFERENTIAL DIAGNOSIS
OF SCALP SWELLINGS IN A CHILD
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CEPHAL HAEMATOMA







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Collection of blood
between pericranium
and flat bone of skull
Rupture of emissary vein
Forceps, normal labour
Never present at birth
Develops 12-24 hrs
Swelling limited by
suture lines
Resolves in 6-8weeks
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CIRCULATORY CHANGES AT BIRTH
BEFORE BIRTH
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AFTER BIRTH
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CHANGES IN CIRCULATION
SL NO
STRUCTURE
CLOSURE
1
Umbilical artery
3rd day
2
Umbilical vein and
Ductus Venosus
4th or 5th day
3
Ductus Arteriosis
7th or 10th day
4
Foramen Ovale
2nd or 3 rd month
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CAUSES OF DEATH
Natural
Accidental (During & after birth)
Criminal
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( Act of omission
or commission)
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NATURAL CAUSES OF DEATH

Immaturity

Debility

Congenital diseases

Haemorrhages

Malformations

Spasm of larynx

Disease of placenta

Erythroblasosis foetalis
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ACCIDENTAL CAUSES
DURING BIRTH
 Prolonged
 Prolapse
 Knots
labour
of cord
separation of
placenta
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 Suffocation
or twists of cord
 Premature
 Death
AFTER BIRTH
 Precipitate
labour
of mother
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PRECIPITATE LABOUR

Combined duration of first and second stage less than two
hours

Common in multiparae,roomy pelvis,

Influence of drugs, hysterical fits

Hyperactive uterine contraction & diminished tissue
resistance

Maternal and foetal risk

Examine foetus for injuries, mud, sand

Examine placenta, cord
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CRIMINAL CAUSES- ACT OF OMISSION

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SUFFOCATION
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ACT OF OMISSION, STARVATION
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ACT OF OMISSION, STARVATION
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AN ACT OF COMMSSION- DROWNING
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AN ACT OF COMMSSION- SUFFOCATION
Circum oral pallor
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AN ACT OF COMMSSION- HEAD INJURY
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ASSESS MATURITYOF - VIABILITY

Ability of a neonate to lead a separate existence
outside the mother

Usually attained by 180-210 days
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APPEARANCE OF A FULL TERM MATURE INFANT
NO
LAND MARKS TO LOOK FOR
MEASUREMENT
1
Crown heel length
48-52 cm
2
Head circumference
30-35cm
3
Weight
2500-3300 gm
4
Scalp hair
2-3cm length
5
Mid point
Umbilicus
6
Both testis
In scrotum
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Ossification centre for
femur,tibia,cuboid, sternum ( last
piece)
Appeared
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BI SECTED STERNUM
SHOWING OSSIFICATION CENTRES
6 th month
6 th month
7 th month
7 th month
9th month
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AUTOPSY ON INFANTS & STILL BORNS
EXTERNAL EXAMINATION

Clothes and wrappings

Appearance of the body

Maturity data

Malformations and birth injuries

Umbilical cord
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AUTOPSY ON INFANTS & STILL BORNS
INTERNALEXAMINATION

Head/ Mouth/Neck

Thorax

Abdomen, other viscera

Genitals

Limbs and sternum
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CONCEALMENT OF BIRTH I.P.C 318

Secret burial or disposal
of body

Irrespective of child dies
before or after birth

Punishment , 2 yrs
imprisonment with or
without fine
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ABANDONING OF INFANT I.P.C 317

Parent or guardian of a
child below 12 yr or any
one entrusted with the care
of such child leaves it in any
place with the intention of
abandonment

7 yrs imprisonment
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