Proof of live birth using postmortem multislice computed tomography (pmMSCT) in cases of suspected neonaticide: advantages of diagnostic imaging compared to conventional autopsy

• Published in: Forensic science, medicine, and pathology Vol. 9; no. 1; pp. 3 - 12
• Main Authors: Guddat, Saskia S., Gapert, René, Tsokos, Michael, Oesterhelweg, Lars
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-03-2013; Springer
• Subjects: Air; Autopsy; Cause of Death; Criminology and Criminal Justice; CT imaging; Deglutition; Diagnostic imaging; Female; Forensic Medicine; Forensic Medicine - methods; Gastrointestinal system; Gastrointestinal Tract - diagnostic imaging; Humans; Infant Mortality; Infant, Newborn; Infanticide; Live Birth; Liver; Liver - blood supply; Lung - diagnostic imaging; Male; Medicine; Medicine & Public Health; Multidetector Computed Tomography; Original Article; Pathology; Postmortem Changes; Predictive Value of Tests; Respiration; Whole Body Imaging; Pulmonary and gastrointestinal aeration; Forensic death investigation; Flotation test; Virtual autopsy; Biological imaging
• ISSN: 1547-769X; 1556-2891
• DOI: 10.1007/s12024-012-9361-y

Proof of live birth is of major importance in suspected neonaticide cases. Although not without controversy the lung flotation test is the main method used to asses this in different jurisdictions worldwide. The present study examines the usefulness of postmortem multislice computed tomography (pmMSCT) in the detection of live birth signs. Body scans were conducted on four infants, one was stillborn, another died a day after birth and the other two were classified as neonaticides. The appearance of the lungs, gastrointestinal tract and vascular system of the liver was compared in these cases. Clear differences were discernable between the lungs of the stillborn and the 1 day old infant. The aerated lungs and air in the stomach and duodenum were clearly visible in the latter case while the stillborn infant lacked these signs. The two neonaticide cases demonstrated similarly aerated lung tissue to the 1 day old infant. The hepatic vessels did not show any putrefactive gas changes in any of the cases. The extent of aeration of the peripheral alveoli was easily observable on the pmMSCT, thus making it a useful tool in the possible differentiation between artificially and naturally aerated lungs. During the four autopsies the classic flotation tests were performed and similar positive aeration of the lungs in the two neonaticides was shown. The stillborn’s tests, on the other hand were negative for aeration. The results of this study clearly demonstrate the advantages of using pmMSCT before commencing a conventional autopsy in cases of suspected neonaticide.