Forensic Autopsy; The death of an infant is a tragic event for a family and for medical practitioners. Within develop countries, the stillbirth rate is estimate to be 4.2 to 6.8 per 1000 live births, whereas in the developing world, this rate is 20 to 32 per 1000 live births. Infant (1–12 months) mortality rates (IMRs) widely vary among counties.
In China, the estimate average IMR level in 2010 for 31 provinces was 1.23% for males and 1.07% for females; so whereas the IMR in the United States was 0.68% in 2007 and 0.596% in 2013, respectively. Autopsy improves definitive diagnosis; so informs genetic counseling; also assists in medical malpractice evaluation and resolving medical disputes. It is additionally useful in criminal investigation.
Forensic autopsy in fetuses
However, data base on forensic autopsy in fetuses, neonates and infants in China remains rarely report. Complete autopsy and histopathologic examination serve important roles in forensic investigation of fetal, neonatal, and infant death, as well as providing valuable insights for clinical obstetrics and pediatrics. In a “verbal autopsy,” a poor outcome is review by obstetricians; also pediatricians to help them identify contributors to the death.
However, completion of a true post mortem examination generally provides; so further information helpful for definitive diagnosis. Autopsy of noncriminal deaths is optional in China and mainly perform by a forensic practitioner. The autopsy rates for fetuses and infants are very low in China. The National Health and Family Planning Commission of PR China requires; so that hospitals belonging to the III and II grades must attain autopsy rates of at least 15% and 10%, respectively.
However, these percentages are not achieve in many hospitals; so mainly because of parental refusal, lack of awareness of the importance of autopsy; also neglect of medical workers, helpless pathologists, and so on. From 1998 to 2008, the autopsy rates in China’s different representative hospitals were 0.04% to 2.04%, and some hospitals did not perform a single autopsy for years.
Medical litigation claims
In TMFC, the mean annual autopsy number was only 10.8, though there has been a rising tendency since 2010. In this study, the purposes of these autopsies were mainly for the following reasons: investigation of unexpected fetal or infant deaths for the purpose of medical litigation claims; identification of the cause of unexpected fetal death as guidance for subsequent pregnancies; and criminal investigations.
In conclusion, this study was the 1st retrospective analysis of fetal, neonatal, and infant death as refer to and asses by forensic autopsy in TFMC and central China. These cases show a predominance of male gender, and most were associate with potential medical litigation.
Placental and/or umbilical cord pathology, asphyxia due to AFA and/or MAS, and pneumonia were the leading causes of fetal, neonatal, and infant death, respectively. Our data can inform clinical practitioners about the underlying causes of some of the most distressing cases in their practices, as well as potentially help families and practitioners to have appropriate expectations about the reality that this period of life is statistically the most dangerous of all.