INFANTICIDE Dr. Siju ; - PowerPoint Presentation

1. INFANTICIDEDr. Siju; Associate Professor, Dept. of Forensic Medicine and ToxicologySKHMC, Kulasekharam.

2. Definitions:Infanticide: Killing of an infant at any time from birth up to the age of 12 months. Foeticide: Killing of a foetus at any time before birth. (Foetus – from 8 weeks up to delivery)Neonaticide: Killing of a neonate. ( Neonate – Up to 28 days after delivery)

3. MOTIVES FOR INFANTICIDE:IllegitimacyUnmarried girls and widows becoming pregnant Married women living apart from her husband become pregnantPoverty of parentsReligious superstitions

4. Still Birth: Still born child is one which born after 28 weeks of pregnancy, which did not breathe or show any other signs of life, at any time, after it is completely born. The child was alive in the uterus and died during the process of delivery.Causes: Intra uterine asphyxia.Placental abnormalitiesToxaemias of pregnancyErythroblastosis foetalisIntracranial haemorrhage due to excessive moulding.Congenital defects.

5. DEAD BORN CHILD: Dead born baby is one which is already dead in the uterus before birth process began.Signs:Rigor mortis.MacerationMummificationPutrefaction

6. Rigor mortis: It appears if the baby dead in utero a few ours before birth.Maceration: It is the process of aseptic autolysis. Usually occurs when the child remains in the uterus for 3-4 days. Sings:Skin slippageBody soft, flaccid, flattens out when placed on the tableSkin purplish and shows large vesicles after 24 hrs.Abdomen distendedUmbilical card will be red and soft.Joints are loose and flexibleBrain greyish and pulpy. Spalding’s sign

7. Spalding’s sign:This sign is seen in intra-uterine death. Due to the shrinkage of brain, the alignment of skull bones will be lost and there will be overriding. Robert’s sign: Appearance of gas shadow in the chambers of heart and aorta on X-ray by 12 hrs.

8. Mummification: It occurs when the foetus remains in the uterus for many days after its death and the liquor amnii is scanty and no air is entering into the uterus due to impact membranes. The foetus becomes dried up and shrivelled. It occurs 2 weeks of intrauterine death.Putrefaction: If the membranes are ruptured and the dead foetus remains inside the uterus, the signs of putrefaction may appear on the foetus like bluish discolouration, marbling etc.

9. Viability of the child:Viability means the ability of the child to have a separate existence after it is separated from its mothers womb. The period of viability is 210 days of gestation for all legal procedures.

10. PRECIPITATE LABOUR: Labour terminating in a very short time than that taken on the average, either in a primipara or multipara is called precipitate labour. In this delivery occurs suddenly and rapidly without the knowledge of the mother. All the three stages of labour are merged into one. The foetus is normal or premature. It is possible in multiparae with large roomy pelvis, but is extremely rare in primiparae. A woman may be delivered unconsciously during fits or periods of coma, hysteria, hypnosis, under the influence of narcotic drugs, anaesthetics, and even deep drunkenness.

11. The child may die from (1) suffocation by falling into a lavatory pan,(2) head injury and fracture of the skull with subdural haemorrhage often bilateral, by a fall on a hard floor. If the woman was standing, and (3) haemorrhage from the torn end of the cord. If the birth occurs in the toilet bowl or into a bucket containing liquid, the infant will inhale the liquid andblood, and meconium and vaginal mucus are found in the air-passages.

12. Medico-legal Importance: (1) The mother or her relatives may be accused of killing the infant, while the death may be due to injury, haemorrhage or asphyxia from precipitate labour. (2) In a case of murder, death of the child may be attributed to precipitate labour.

13. BATTERED BABY SYNDROME OR NON ACCIDENTAL INJURY OF CHILDHOOD:A battered child is one who has received repetitive physical injuries as a result of non accidental violence, produced by a parent or guardian. In addition to physical injury, there may be non-accidental deprivation of nutrition, care and affection.Classical features: The classical features of syndrome are obvious discrepancy between thenature of the injuries and explanation offered by the parents, and delay between the injury, and medicalattention which cannot be explained. The constant feature is repetition of injuries at different dates, often progressing from minor to more severe.

14. Features: (1) Age: Usually less than three years old, though it may occur at any age. (2) Sex: Slightly more in males (55 to 63%). (3) Position in family: One child of a family, commonly the eldest or the youngest and often unwanted, such as the result of pregnancy before marriage, failure of contraception or an illegitimate child. (4) Socio-economic factors: Parents tend to be young between 20 to 30 years, and belong to lower social class and lower education. The family is usually isolated. There is often a history of family disharmony, long-standing emotional problems or financial problems. Many of the fathers have criminal records, or unemployed or socially unstable. Many mothers have multiple social and psychiatric problems with a chaotic and violent home background.

15. SUDDEN INFANT DEATH SYNDROMESudden infant death syndrome (SIDS) , or cot death or crib death is defined as the sudden and unexpected death of seemingly healthy infant, whose death remains unexplained even after thorough case investigation, death scene examination, review of clinical history and complete autopsy. Features: (1) Incidence: 0.6 per thousand live births. (2) Age: 2 weeks to 2 years, but most deaths take placebetween one and 7 months, with a peak at 2 to 4 months. (3) Sex: There is slight increase in males. (4) Twins: There is increased risk (threefold) amongst members of a twin pair. Most twins are premature and of low birth weight. (5) Geographical distribution: The occurrence is worldwide. (6) Time of death: Death always occurs during sleep at all times of night with a moderate increase in the early morning hours. (7) Prematurity has a higher risk. (8) Socio-economic standard of the family is usually low. (9) Cigarette smoking and drug abuse by pregnant women increase the risk.