The role of histomorphological studies in the production of commission forensic medical examinations in cases of stillbirth
- Authors: Berlay M.1,2
-
Affiliations:
- Regional Bureau of Forensic Medical Examination
- Stavropol State Medical University
- Section: Original study articles
- Submitted: 06.10.2024
- Accepted: 09.06.2025
- Published: 04.08.2025
- URL: https://for-medex.ru/jour/article/view/16196
- DOI: https://doi.org/10.17816/fm16196
- ID: 16196
Cite item
Abstract
Background: The methodology for conducting verification activities and investigating crimes related to poor-quality medical care in obstetrics by investigative bodies of the Russian Federation includes the appointment of commission forensic medical examinations. Carrying out a forensic histological examination of archival autopsy material and the placenta is an important stage of commission forensic medical examinations based on case materials in cases of intrauterine fetal death.
Aim: to study the features of conducting commission forensic medical examinations in cases of stillbirth and to clarify the need for forensic histological examination of archival autopsy material and the placenta from a modern scientific standpoint.
Materials and methods: an observational single-center retrospective selective cross-sectional study was conducted on the basis of the archive of the department of complex examinations of the State Healthcare Institution of the Stavropol Territory "Regional Bureau of Forensic Medical Examination". The study included commission forensic medical examinations in cases of intrauterine fetal death (n = 68) for the period from 01.01.2015 to 31.12.2022. Results: During the analyzed period, out of 68 (100%) commission forensic medical examinations in cases of stillbirth, 54 (79.4%) were appointed by investigators of the Investigative Committee, 11 (16.2%) - by investigators/inquiry officers/operational officers of the Ministry of Internal Affairs departments, 3 (4.4%) - by judges. In most cases, the appointment of examinations of this category was carried out within the framework of verification materials - 59 observations (86.7%). The cause of stillbirth was antenatal fetal death - 39 cases (57.4%), intranatal fetal death - 27 (39.73%), congenital developmental anomalies - 2 (2.9%). During the commission examinations of intrauterine fetal death in the State Budgetary Healthcare Institution of the Stavropol Territory "Regional Bureau of Forensic Medical Examination", in 66 cases (97.1%), forensic histological examination of autopsy material and placenta was carried out by histology experts.
Conclusion. The analysis showed that among the commission forensic medical examinations of the obstetric and gynecological profile, the share of examinations in cases of stillbirth was 39.1%. In order to improve the quality of examinations in this category, it is necessary to conduct a forensic histological study of autopsy material and placenta.
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About the authors
Margarita Berlay
Regional Bureau of Forensic Medical Examination; Stavropol State Medical University
Author for correspondence.
Email: berlay_mv@mail.ru
ORCID iD: 0000-0002-5809-8480
SPIN-code: 3676-6025
Cand. Sci.(Med.), Forensic Medical Expert, Assistant of Departament
Russian FederationReferences
- Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;6387(10018):587-603. doi: 10.1016/S0140-6736(15)00837-5
- Aminu M, Unkels R, Mdegela M, et al. Causes of and factors associated with stillbirth in low- and middle-income countries: a systematic literature review. BJOG. 2014;121(4):141–153. doi: 10.1111/1471-0528.12995
- Posmertnaya magnitno-rezonansnaya tomografiya i morfologicheskaya ocenka davnosti vnutriutrobnoj gibeli mertvorozhdennogo: metodicheskie rekomendacii / sost. Tumanova UN, Shhegolev AI. Seriya «Luchshie praktiki luchevoj i instrumental`noj diagnostiki». V. 108. Moscow: GBUZ «NPKCz DiT DZM». 2022. 36 р. (In Russ).
- Shhegolev AI, Tumanova UN, Shuvalova MP, et al. Vrozhdenny`e anomalii kak prichina mertvorozhdeniya. International Journal of Applied and Fundamental Research. 2015(10):263-267. (in Russ).
- Tumanova UN, Shuvalova MP, Shhegolev AI. Bolezni materi v geneze mertvorozhdeniya. International Journal of Applied and Fundamental Research. 2017(10):64–68. (in Russ).
- Shchegolev AI, Serov VN. Clinical significance of placental lesions. Obstetrics and Gynecology. 2019;(3):54-62. (in Russ). doi: 10.18565/aig.2019.3.54-62
- McClure E.M., Saleem S., Goudar S.S., et al. Stillbirth rates in low-middle income countries 2010–2013: a population-based, multi-country study from the Global Network. Reprod Health. 2015;12(2):S7. doi: 10.1186/1742- 4755-12-S2-S7
- Petrova TN. Features of investigation of crimes related to the low-quality of medical care at obstetrics. Consilium Medicum. 2017;19(6):9–31. (in Russ). doi: 10.26442/2075-1753_19.6.9-31
- Anisimov AA, Gilmetdinova ES, Nurmieva ER, et al. A double-edged weapon or commission forensic examination in civil trial on medical cases. Russ J Forensic Med. 2022;8(2):51–58. (in Russ). doi: https://doi.org/10.17816/fm675
- Barinov E.X., Romodanovskij P.O., Terent`eva L.V., et al. E`kspertnaya ocenka professional`ny`x oshibok i defektov okazaniya medicinskoj pomoshhi v akusherstve-ginekologii i neonatologii. Moscow: YurInfoZdrav, 2012. 214 р. (In Russ).
- Sokolova O.V. Patomorfologicheskoe issledovanie posleda pri proizvodstve sudebno-medicinskix e`kspertiz: Metodicheskie rekomendacii. Moscow: FGBU «Rossijskij centr sudebno-medicinskoj e`kspertizy`»; Izhevsk: OOO «Print», 2023. 59 р. (In Russ).
- Shhegolev AI, Tumanova UN, Shuvalova MP, et al. Gipoksiya kak prichina mertvorozhdaemosti v Rossijskoj Federacii. Zdorov`e, demografiya, e`kologiya finno-ugorskix narodov. 2014(3): 96-98. (in Russ).
- Pavlov KA, Dubova EA, Burduli GM, et al. Maceraciya ploda. Obstetrics and Gynecology. 2012(1):115–119.
- Shchegolev AI, Tumanova UN, Lyapin VM. Pathological estimation of the time of fetal death. Russian Journal of Archive of Pathology. 2017;79(6):60‑65. (In Russ). doi.org/10.17116/patol201779660-65
- Berlay MV. Antenatal`naya gibel` ploda v sudebno-medicinskom aspekte. V sbornike: Dekabr`skie chteniya po sudebnoj medicine v RUDN : aktual`ny`e voprosy` sudebnoj mediciny` i medicinskoj kriminalistiki. Materialy` VI Vserossijskoj nauchno-prakticheskoj konferencii s mezhdunarodny`m uchastiem. Moscow, 2023. P. 37-43. (In Russ).
- Genest DR. Estimating the time of death in stillborn foetuses: I. Histologic evaluation of fetal organs; an autopsy study of 150 stillborns. Obstet. Gynecol. 1992;80(4):575–584.
- Kim JH. Histologic Estimation of Intrauterine Retention Time after Fetal Death. Korean J Leg Med. 2013;37(4):191-197. doi: https://doi.org/10.7580/kjlm.2013.37.4.191
- Tumanova UN, Shhegolev AI. Porazheniya placenty` v geneze mertvorozhdeniya (obzor literatury`). International Journal of Applied and Fundamental Research. 2017(3):77–81. (In Russ).
- Cersonsky TEK, Saade GR, Silver RM, et al. Assessing Intrauterine Retention according to Microscopic Stillbirth Features: A Cluster Analysis Approach. Fetal Pediatr Pathol. 2023;42(6):860-869. doi: 10.1080/15513815.2023.2246571
- Klevno VА, Chumakova YuV, Dubrova SE, et al. Questions of forensic science and radiology on live births and stillbirths: Сases from expert practice. Russ J Forensic Med. 2021;7(2):101–107. doi.org/10.17816/fm364
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