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Pregnancy-Related Death, Death in Newborns, and Sudden Infant Death Syndrome

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Forensic Histopathology

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Abstract

Both pregnancy-related fatalities and death in newborns can often only be explained with the help of histopathological investigations. On the one hand, ectopic pregnancies resulting in fatal bleeding are seen very seldom, while on the other, infections (endometritis, sepsis, shock) and, extremely rarely, amniotic fluid embolism can occur postpartum. Histopathological findings consistent with a “soap abortion” are seen in countries where abortion is banned. In the case of death in newborns, the placenta, amnion, and umbilical cord always require histological investigation (villous dysmaturity, infarcts, inflammatory disorders such as chorioamnionitis and funisitis). In newborns, pulmonary atelectasis needs to be detected in order to confirm a suspected stillbirth. Microscopic analysis of the endometrium is able to detect recent pregnancy (identification of the Arias-Stella reaction). Sudden infant death syndrome (SIDS) requires numerous histopathological examinations to exclude a natural cause of death. In particular, viral pneumonia and viral myocarditis need to be ruled out. In the case of suspected SIDS, regular salivary gland investigations can lead to the detection of cytomegalovirus-induced sialadenitis, while hepatocyte vacuolation is suggestive of a lipid metabolism disorder [e.g., medium-chain acyl-CoA dehydrogenase (MCAD) deficiency].

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    Reinhard B. Dettmeyer

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Dettmeyer, R.B. (2018). Pregnancy-Related Death, Death in Newborns, and Sudden Infant Death Syndrome. In: Forensic Histopathology. Springer, Cham. https://doi.org/10.1007/978-3-319-77997-3_17

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