Infant death

The following procedure is in addition to the procedures described under Autopsy procedure

History

  • Marital status of parents
  • Antenatal history of the pregnancy  
    • Birth history  
    • Post-natal complications of the infant and the mother must be looked into in detail

Preliminaries

  1. If Placenta is available, it must be examined for completeness and weight should be measured. if placenta and baby are brought separately, its cut end is examined and length of cord is measured.
  2. Measurements of baby
    • Weight
    • Crown rump length
    • Crown heel length
    • Head circumference
    • Chest circumference at level of nipple
    • Abdominal circumference at the level of umbilicus
  3. Presence or absence of clothing must be noted.

External Examination

  • Describe the site of caput succedaneum
  • Any congenital abnormality, incompatible with life must be noted. Injuries and abnormalities must be documented and photography must be done.   Maturity of the baby must be estimated.
  • Examination of Umbilical cord in detail (Length, ends, Watson Jelly).

Internal Examination

  • Skill should be applied to remove cerebral hemispheres to examine falx cerebri and tentorium cerebelli to exclude hemorrhage during birth.
  • Special care is to be applied to the thoracic organs: Degree of inflation of the lungs, must be examined for signs of respiration.
  • Cardiovascular and respiratory systems must be dissected en bloc.
  • Hydrostatic Flotation test ‘en bloc’ and ‘en detail’ should perform. However, the limitations of the flotation test must be appreciated.
  • Gastrointestinal system must be examined for presence or absence of food materials and samples must be retained for further analysis.
  • Examine (long bone, sternum and foot bone) centres of ossification (size and presence) for maturity.
  • All malformations must be described.
  • The umbilical cord and the placenta must be subject to morphological and histological examination if require.