Top

Published in:

01-11-2021 | Computed Tomography | Original Article

Pictorial review of the postmortem computed tomography in neonaticide cases

Authors: Mathilde Ducloyer, Arthur David, Bérengère Dautreme, Gilles Tournel, Florence Vincent, Renaud Clement, Lucile Tuchtan, Clémence Delteil, Guillaume Gorincour, Fabrice Dedouit

Published in: International Journal of Legal Medicine | Issue 6/2021

Abstract

Neonaticide is defined by the deliberate killing or homicide of a child within 24 h of its birth. In this context, three fundamental questions are generally asked of the forensic pathologist: what is the cause of death of the neonate? Was the child viable (i.e., what is the gestational age of the neonate)? Finally, was the neonate stillborn or liveborn?

Postmortem imaging can help answer these questions by conducting (1) a complete lesional analysis of the body and the placenta, (2) an estimation of the gestational age by measuring the lengths of the diaphyseal long bones, and (3) an analysis of the aeration of the lungs and intestines. Using the details of 18 cases, we illustrate aspects of neonaticide cases in postmortem computed tomography (PMCT), offering detailed examples of notable postmortem changes and abnormalities, especially in the analysis of the pulmonary parenchyma. This article presents a useful iconography for the radiologist confronted with this rare yet complex forensic situation.

Grabherr S, Egger C, Vilarino R et al (2017) Modern post-mortem imaging: an update on recent developments. Forensic Sci Res 2:52–64. https://doi.org/10.1080/20961790.2017.1330738CrossRefPubMedPubMedCentral

Redaktsiia, Thali M, Dirnhofer R, Vock P (2016) The virtopsy approach. 3D optical and radiological scanning and reconstruction in forensic medicine (CRC Press, Boca Raton, Fl: CRC Press. London NW. 2009). Sud-Meditsinskaya Ekspertiza 59:58. https://doi.org/10.17116/sudmed201659358-62

Baglivo M, Winklhofer S, Hatch GM et al (2013) The rise of forensic and post-mortem radiology—analysis of the literature between the year 2000 and 2011. J Forensic Radiol Imaging 1:3–9. https://doi.org/10.1016/j.jofri.2012.10.003CrossRef

Shelmerdine SC, Gerrard CY, Rao P et al (2019) Joint European Society of Paediatric Radiology (ESPR) and International Society for Forensic Radiology and Imaging (ISFRI) guidelines: paediatric postmortem computed tomography imaging protocol. Pediatr Radiol 49:694–701. https://doi.org/10.1007/s00247-018-04340-xCrossRefPubMedPubMedCentral

Sieswerda-Hoogendoorn T, Soerdjbalie-Maikoe V, de Bakker H, van Rijn RR (2014) Postmortem CT compared to autopsy in children; concordance in a forensic setting. Int J Legal Med 128:957–965. https://doi.org/10.1007/s00414-014-0964-6CrossRefPubMed

Krentz BV, Alamo L, Grimm J et al (2016) Performance of post-mortem CT compared to autopsy in children. Int J Legal Med 130:1089–1099. https://doi.org/10.1007/s00414-016-1370-zCrossRefPubMed

Gorincour G, Sarda-Quarello L, Laurent P-E et al (2015) The future of pediatric and perinatal postmortem imaging. Pediatr Radiol 45:509–516. https://doi.org/10.1007/s00247-014-3266-8CrossRefPubMed

OMS (1977) Organisation Mondiale de la Santé. Classification Internationale des maladies, révision 1975, Genève

Guddat SS, Gapert R, Tsokos M, Oesterhelweg L (2013) Proof of live birth using postmortem multislice computed tomography (pmMSCT) in cases of suspected neonaticide: advantages of diagnostic imaging compared to conventional autopsy. Forensic Sci Med Pathol 9:3–12. https://doi.org/10.1007/s12024-012-9361-yCrossRefPubMed

10.

Griest K (2010) Pediatric homicide: medical investigation. CRC Press, Boca Raton

11.

Beauthier J-P (2007) Traité de Médecine Legale, 2ème Edition. de Boeck

12.

GroßeOstendorf A-L, Rothschild MA, Müller AM, Banaschak S (2013) Is the lung floating test a valuable tool or obsolete? A prospective autopsy study. Int J Legal Med 127:447–451. https://doi.org/10.1007/s00414-012-0727-1CrossRef

13.

Mazuchowski EL, Franco DM, Berran PJ, Harcke HT (2016) The virtual hydrostatic test. Am J Forensic Med Pathol 1. https://doi.org/10.1097/PAF.0000000000000287

14.

Michiue T, Ishikawa T, Kawamoto O et al (2013) Postmortem CT investigation of air/gas distribution in the lungs and gastrointestinal tracts of newborn infants: a serial case study with regard to still- and live birth. Forensic Sci Int 226:74–80. https://doi.org/10.1016/j.forsciint.2012.12.011CrossRefPubMed

15.

Ducloyer M, Tuchtan L, Delteil C et al (2019) Lung density measurement in postmortem computed tomography: a new tool to assess immediate neonatal breath in suspected neonaticides. Int J Legal Med.https://doi.org/10.1007/s00414-019-02103-3

16.

Barber JL, Sebire NJ, Chitty LS et al (2015) Lung aeration on post-mortem magnetic resonance imaging is a useful marker of live birth versus stillbirth. Int J Legal Med 129:531–536. https://doi.org/10.1007/s00414-014-1125-7CrossRefPubMed

17.

Dettmeyer RB (2018) Forensic histopathology: fundamentals and perspectives, 2nd edn. Springer, Berlin Heidelberg, New YorkCrossRef

18.

Knight B, Saukko PJ (2004) Knight’s forensic pathology, 3rd ed. Arnold ; Distributed in the United States of America by Oxford University Press, London : New York

19.

Stocker JT, Dehner LP (2001) Pediatric pathology, 2nd edn. Lippincott Williams & Wilkins, Philadelphia

20.

Tsokos M (2007) Forensic pathology reviews, vol 2. Humana Press, Totowa

21.

Sieswerda-Hoogendoorn T, Soerdjbalie-Maikoe V, Maes A, van Rijn RR (2013) The value of post-mortem CT in neonaticide in case of severe decomposition: description of 12 cases. Forensic Sci Int 233:298–303. https://doi.org/10.1016/j.forsciint.2013.09.023CrossRefPubMed

22.

Levy AD, Harcke HT, Mallak CT (2010) Postmortem imaging: MDCT features of postmortem change and decomposition. Am J Forensic Med Pathol 31:12–17. https://doi.org/10.1097/PAF.0b013e3181c65e1aCrossRefPubMed

23.

Egger C, Vaucher P, Doenz F et al (2012) Development and validation of a postmortem Radiological Alteration Index: the RA-Index. Int J Legal Med 126:559–566. https://doi.org/10.1007/s00414-012-0686-6CrossRefPubMed

24.

Reichard R (2008) Birth injury of the cranium and central nervous system: birth injury of the cranium and CNS. Brain Pathol 18:565–570. https://doi.org/10.1111/j.1750-3639.2008.00205.xCrossRefPubMedPubMedCentral

25.

Lee SJ, Kim JK, Kim SJ (2018) The clinical characteristics and prognosis of subgaleal hemorrhage in newborn. Korean J Pediatr 61:387–391. https://doi.org/10.3345/kjp.2018.06800CrossRefPubMedPubMedCentral

26.

Ojumah N, Ramdhan RC, Wilson C et al2017) Neurological neonatal birth injuries: a literature review. Cureus.https://doi.org/10.7759/cureus.1938

27.

Hughes CA, Harley EH, Milmoe G et al (1999) Birth trauma in the head and neck. Arch Otolaryngol Neck Surg 125:193. https://doi.org/10.1001/archotol.125.2.193CrossRef

28.

Prabhu SP, Newton AW, Perez-Rossello JM, Kleinman PK (2013) Three-dimensional skull models as a problem-solving tool in suspected child abuse. Pediatr Radiol 43:575–581. https://doi.org/10.1007/s00247-012-2546-4CrossRefPubMed

29.

Martin A, Paddock M, Johns CS et al (2020) Avoiding skull radiographs in infants with suspected inflicted injury who also undergo head CT: “a no-brainer?” Eur Radiol 30:1480–1487. https://doi.org/10.1007/s00330-019-06579-wCrossRefPubMed

30.

Idriz S, Patel JH, AmeliRenani S et al (2015) CT of normal developmental and variant anatomy of the pediatric skull: distinguishing trauma from normality. Radiographics 35:1585–1601. https://doi.org/10.1148/rg.2015140177CrossRefPubMed

31.

Dupuis O, Silveira R, Dupont C et al (2005) Comparison of “instrument-associated” and “spontaneous” obstetric depressed skull fractures in a cohort of 68 neonates. Am J Obstet Gynecol 192:165–170. https://doi.org/10.1016/j.ajog.2004.06.035CrossRefPubMed

32.

Nadas S, Reinberg O (1992) Obstetric fractures. Eur J Pediatr Surg 2:165–168. https://doi.org/10.1055/s-2008-1063431CrossRefPubMed

33.

Km J HS (2014) [Neonatal skull fracture]. In: Ugeskr. Laeger. https://pubmed.ncbi.nlm.nih.gov/25347566/?from_term=skull+fracture+newborn&from_pos=4. Accessed 15 Mar 2020

34.

Wobus RE (1925) A pathognomonic sign of intrauterine death. Am J Obstet Gynecol 10:457. https://doi.org/10.1016/S0002-9378(25)90889-7CrossRef

35.

Silva MET, Oliveira DA, Roza TH et al (2015) Study on the influence of the fetus head molding on the biomechanical behavior of the pelvic floor muscles, during vaginal delivery. J Biomech 48:1600–1605. https://doi.org/10.1016/j.jbiomech.2015.02.032CrossRefPubMed

36.

Ami O, Maran JC, Gabor P et al (2019) Three-dimensional magnetic resonance imaging of fetal head molding and brain shape changes during the second stage of labor. PLoS ONE 14:e0215721. https://doi.org/10.1371/journal.pone.0215721CrossRefPubMedPubMedCentral

37.

Arthurs OJ, Barber JL, Taylor AM, Sebire NJ (2015) Normal perinatal and paediatric postmortem magnetic resonance imaging appearances. Pediatr Radiol 45:527–535. https://doi.org/10.1007/s00247-014-3166-yCrossRefPubMedPubMedCentral

38.

Smith AB, Lattin GE, Berran P, Harcke HT (2012) Common and expected postmortem CT observations involving the brain: mimics of antemortem pathology. Am J Neuroradiol 33:1387–1391. https://doi.org/10.3174/ajnr.A2966CrossRefPubMedPubMedCentral

39.

Sieswerda-Hoogendoorn T, Beenen LFM, van Rijn RR (2015) Normal cranial postmortem CT findings in children. Forensic Sci Int 246:43–49. https://doi.org/10.1016/j.forsciint.2014.10.036CrossRefPubMed

40.

Prayer D, Kasprian G, Krampl E et al (2006) MRI of normal fetal brain development. Eur J Radiol 57:199–216. https://doi.org/10.1016/j.ejrad.2005.11.020CrossRefPubMed

41.

Garel C, Elmaleh M, Chantrel E et al (2003) Fetal MRI: normal gestational landmarks for cerebral biometry, gyration and myelination. Childs Nerv Syst 19:422–425. https://doi.org/10.1007/s00381-003-0767-4CrossRefPubMed

42.

Mohan S, Rogan EA, Batty R et al (2013) CT of the neonatal head. Clin Radiol 68:1155–1166. https://doi.org/10.1016/j.crad.2013.06.011CrossRefPubMed

43.

Whitby E, Griffiths P, Rutter S et al (2004) Frequency and natural history of subdural haemorrhages in babies and relation to obstetric factors. Lancet 363:846–851. https://doi.org/10.1016/S0140-6736(04)15730-9CrossRefPubMed

44.

Kumpulainen V, Lehtola SJ, Tuulari JJ et al (2020) Prevalence and risk factors of incidental findings in brain MRIs of healthy neonates—the FinnBrain Birth Cohort Study. Front Neurol 10.https://doi.org/10.3389/fneur.2019.01347

45.

Proisy M, Loget P, Bouvet R et al (2015) Non-specific post-mortem modifications on whole-body post-mortem computed tomography in sudden unexpected death in infancy. J Forensic Radiol Imaging 3:16–23. https://doi.org/10.1016/j.jofri.2015.02.001CrossRef

46.

Tindall VR, Scott JS (1965) Placental calcification a study of 3,025 singleton and multiple pregnancies. BJOG Int J Obstet Gynaecol 72:356–373. https://doi.org/10.1111/j.1471-0528.1965.tb01470.xCrossRef

47.

Jeacock MK, Scott J, Plester JA (1963) Calcium content of the human placenta. Am J Obstet Gynecol 87:34–40. https://doi.org/10.1016/S0002-9378(16)35139-0CrossRefPubMed

48.

Wei SH, Helmy M, Cohen AJ (2009) CT evaluation of placental abruption in pregnant trauma patients. Emerg Radiol 16:365–373. https://doi.org/10.1007/s10140-009-0804-zCrossRefPubMedPubMedCentral

49.

Fadl SA, Linnau KF, Dighe MK (2019) Placental abruption and hemorrhage—review of imaging appearance. Emerg Radiol 26:87–97. https://doi.org/10.1007/s10140-018-1638-3CrossRefPubMed

50.

Fadl S, Moshiri M, Fligner CL et al (2017) Placental imaging: normal appearance with review of pathologic findings. Radiographics 37:979–998. https://doi.org/10.1148/rg.2017160155CrossRefPubMed

51.

MacDonald H (2002) Perinatal care at the threshold of viability. Pediatrics 110:1024–1027. https://doi.org/10.1542/peds.110.5.1024CrossRefPubMed

52.

Villar J, Ismail LC, Victora CG et al (2014) International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet 384:857–868. https://doi.org/10.1016/S0140-6736(14)60932-6CrossRefPubMed

53.

Créquat J, Duyme M, Brodaty G (2000) Biometry 2000. Fetal growth charts by the French College of fetal ultrasonography and the Inserm U 155. Gynecol Obstet Fertil 28:435–445PubMed

54.

Collège français d’échographie fœtale (CFEF) (2017) Compte rendu du séminaire de travail du Collège français d’échographie fœtal (CFEF) sur les référentiels et standards de biométrie fœtale. Juin 2017. Gynécol Obstét Fertil Sénologie 45:545–551. https://doi.org/10.1016/j.gofs.2017.08.012CrossRef

55.

Scheuer L, Black SM (2000) Developmental juvenile osteology. Academic Press, San Diego

56.

Fazekas IG, Kósa F (1978) Forensic fetal osteology. Akadémiai Kiadó, Budapest

57.

Adalian P, Piercecchi-Marti MD, Bourliere-Najean B et al (2001) Postmortem assessment of fetal diaphyseal femoral length: validation of a radiographic methodology. J Forensic Sci 46:215–219CrossRef

58.

Piercecchi-Marti M-D, Adalian P, Bourliere-Najean B et al (2002) Validation of a radiographic method to establish new fetal growth standards: radio-anatomical correlation. J Forensic Sci 47:328–331CrossRef

59.

Adalian P, Piercecchi-Marti M-D, Bourlière-Najean B et al (2002) Nouvelle formule de détermination de l’âge d’un fœtus. C R Biol 325:261–269. https://doi.org/10.1016/S1631-0691(02)01426-9CrossRefPubMed

60.

Carneiro C, Curate F, Cunha E (2016) A method for estimating gestational age of fetal remains based on long bone lengths. Int J Legal Med 130:1333–1341. https://doi.org/10.1007/s00414-016-1393-5CrossRefPubMed

61.

Schaefer M, Scheuer L, Black SM (2009) Juvenile osteology: a laboratory and field manual. Elsevier/Academic Press, Amsterdam, Burlington

62.

Graham CB (1972) Assessment of bone maturation–methods and pitfalls. Radiol Clin North Am 10:185–202PubMed

63.

Brogdon BG (1998) The scope of forensic radiology. Clin Lab Med 18:203–240. https://doi.org/10.1016/S0272-2712(18)30169-0CrossRefPubMed

64.

Gentili P, Trasimeni A, Giorlandino C (1984) Fetal ossification centers as predictors of gestational age in normal and abnormal pregnancies. J Ultrasound Med 3:193–197. https://doi.org/10.7863/jum.1984.3.5.193CrossRefPubMed

65.

Adair FL, Scammon RE (1921) A study of the ossification centers of the wrist, knee and ankle at birth, with particular reference to the physical development and maturity of the newborn. Am J Obstet Gynecol 2:35–60. https://doi.org/10.1016/S0002-9378(21)90258-8CrossRef

66.

Naderi S, Bolandgray A, Ardekani MS, Rahimian H (1975) Evaluation of knee joint ossification centers for the assessment of fetal maturity in a developing country. Eur J Obstet Gynecol Reprod Biol 5:167–170. https://doi.org/10.1016/0028-2243(75)90001-5CrossRef

67.

Thali MJ (2011) Brogdon’s forensic radiology. CRC Press, Boca Raton

68.

Durigon M (2007) Pratique médico-légale. Masson, Issy-les-Moulineaux

69.

Mercer BM, Sklar S, Shariatmadar A et al (1987) Fetal foot length as a predictor of gestational age. Am J Obstet Gynecol 156:350–355. https://doi.org/10.1016/0002-9378(87)90282-1CrossRefPubMed

70.

Adamsbaum C, Rey-Salmon C (2013) Maltraitance chez l’enfant. Médecine sciences publications-Lavoisier, Paris

71.

Resnick PJ (1970) Murder of the newborn: a psychiatric review of neonaticide. Am J Psychiatry 126:1414–1420. https://doi.org/10.1176/ajp.126.10.1414CrossRefPubMed

72.

Vellut N, Cook JM, Tursz A (2012) Analysis of the relationship between neonaticide and denial of pregnancy using data from judicial files. Child Abuse Negl 36:553–563. https://doi.org/10.1016/j.chiabu.2012.05.003CrossRefPubMed

73.

Stenton S, Cohen MC (2020) Assessment of neonaticide in the setting of concealed and denied pregnancies. Forensic Sci Med Pathol. https://doi.org/10.1007/s12024-019-00212-4CrossRefPubMed

74.

Porter T, Gavin H (2010) Infanticide and neonaticide: a review of 40 years of research literature on incidence and causes. Trauma Violence Abuse 11:99–112. https://doi.org/10.1177/1524838010371950CrossRefPubMed

75.

Currarino G (2000) Occipital osteodiastasis: presentation of four cases and review of the literature. Pediatr Radiol 30:823–829. https://doi.org/10.1007/s002470000337CrossRefPubMed

76.

Panda A (2014) Skeletal dysplasias: a radiographic approach and review of common non-lethal skeletal dysplasias. World J Radiol 6:808. https://doi.org/10.4329/wjr.v6.i10.808CrossRefPubMedPubMedCentral

Title: Pictorial review of the postmortem computed tomography in neonaticide cases
Authors: Mathilde Ducloyer
Arthur David
Bérengère Dautreme
Gilles Tournel
Florence Vincent
Renaud Clement
Lucile Tuchtan
Clémence Delteil
Guillaume Gorincour
Fabrice Dedouit
Publication date: 01-11-2021
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Published in: International Journal of Legal Medicine / Issue 6/2021
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI: https://doi.org/10.1007/s00414-021-02677-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pictorial review of the postmortem computed tomography in neonaticide cases

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2021

Advances in forensic diagnosis of electric shock death in the absence of typical electrical marks

Development and validation of novel 8-dye short tandem repeat multiplex system for forensic applications

Key genetic and forensic attributes of Uttarakhand population of India

GFAP positivity in neurons following traumatic brain injuries

Intra-bone nuclear DNA variability and STR typing success in Second World War first ribs

Forensic age estimation based on magnetic resonance imaging of the proximal humeral epiphysis in Chinese living individuals