Histomorphological analysis in panel forensic medical examinations in stillbirth cases

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

BACKGROUND: Panel forensic medical examinations are among the methods used by Russian investigative authorities for preliminary inquiries and criminal investigations into inadequate obstetric care. Forensic histological analysis of archival autopsy materials and placental tissue is a critical component of panel forensic medical examinations when investigating intrauterine fetal death.

AIM: The work aimed to analyze panel forensic medical examinations in stillbirth cases and determine the need for forensic histological examination of archival autopsy materials and placental tissue based on current scientific approaches.

METHODS: An observational, single-center, cross-sectional study was conducted using archival records from the Bureau of Forensic Medical Examination of Stavropol Territory. Inclusion criteria: cases of panel forensic medical examinations related to intrauterine fetal death (both antenatal and intranatal).

RESULTS: The study included panel forensic medical examinations of intrauterine fetal death cases (n = 68) from January 1, 2015, to December 31, 2022. In 79.4% of cases (n = 54), the examinations were initiated by investigators from the Investigative Committee; in 16.2% (n = 11), by investigators/officers from the Ministry of Internal Affairs; and in 4.4% (n = 3), by judges. In 86.7% of cases, the examinations were conducted as part of preliminary inquiries. The causes of stillbirth were antenatal fetal death in 57.4% (n = 39), intranatal fetal death in 39.7% (n = 27), and congenital abnormalities in 2.9% (n = 2). In 97.1% (n = 66) of panel examinations involving intrauterine fetal death, histologists performed forensic histological examination of autopsy material and the placenta.

CONCLUSION: The analysis showed that 39.1% of panel forensic medical examinations in obstetrics and gynecology were related to stillbirth. To improve the quality of expert examinations in this area, forensic histological examinations of autopsy material and the placenta are required. Improving the methodology for panel forensic medical examinations in stillbirth is a pressing issue that necessitates interdisciplinary collaboration among forensic medical experts, pathologists, obstetricians-gynecologists, and neonatologists.

Full Text

Restricted Access

About the authors

Margarita V. Berlay

The Russian National Research Medical University named after N.I. Pirogov

Author for correspondence.
Email: berlay_mv@mail.ru
ORCID iD: 0000-0002-5809-8480
SPIN-code: 3676-6025

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Evgeny M. Kildyushov

Stavropol State Medical University

Email: kem1967@bk.ru
ORCID iD: 0000-0001-7571-0312
SPIN-code: 6412-0687

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Stavropol

Ilya I. Fedko

Stavropol State Medical University

Email: fedkoi@mail.ru
ORCID iD: 0000-0002-7314-1221
SPIN-code: 8015-3062

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Stavropol

Horen A. Avanesyan

Stavropol State Medical University

Email: avanesyan-1983@inbox.ru
ORCID iD: 0000-0002-8039-7612

MD, Cand. Sci. (Medicine)

Russian Federation, Stavropol

Vera N. Borschevskaya

Stavropol State Medical University

Email: vera.borshhevskaya@bk.ru
ORCID iD: 0000-0002-9798-2607
SPIN-code: 7767-5112

MD, Cand. Sci. (Medicine)

Russian Federation, Stavropol

Elena A. Zolotukhina

Stavropol State Medical University

Email: zolotykhina.alena2015@yandex.ru
ORCID iD: 0009-0005-4969-9232
Russian Federation, Stavropol

Sergey M. Karpov

Stavropol State Medical University

Email: karpov25@rambler.ru
ORCID iD: 0000-0003-1472-6024
SPIN-code: 3890-9809

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Stavropol

References

  1. Lawn JE, Blencowe H, Waiswa P, et al. Stillbirths: Rates, Risk Factors, and Acceleration Towards 2030. The Lancet. 2016;387(10018):587–603. doi: 10.1016/S0140-6736(15)00837-5 EDN: WPMRHB
  2. 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: An International Journal of Obstetrics & Gynaecology. 2014;121(s4):141–153. doi: 10.1111/1471-0528.12995
  3. Tumanova UN, Shchegolev AI. Postmortem Magnetic Resonance Imaging and Morphological Assessment of the Duration of Intrauterine Death of a Stillborn Child: Methodological Recommendations. Moscow: Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies; 2022. (In Russ.) EDN: PXCJQZ
  4. Shchegolev AI, Serov VN. Clinical Significance of Placental Lesions. Obstetrics and Gynecology. 2019;(3):54–62. doi: 10.18565/aig.2019.3.54-62 EDN: SKHUGA
  5. McClure EM, Saleem S, Goudar SS, et al. Stillbirth Rates In Low-Middle Income Countries 2010 - 2013: A Population-Based, Multi-Country Study From the Global Network. Reproductive Health. 2015;12(2):1–8. doi: 10.1186/1742-4755-12-S2-S7 EDN: QDDKDX
  6. Kachina NN, Kildyushov EM. Forensic Examination (Research) of Corpses of Fetuses and Newborns: A Tutorial for Students. Moscow: Svetlitsa; 2009. (In Russ.) ISBN: 978-5-902438-16-8
  7. Anisimov AA, Gilmetdinova ES, Nurmieva ER, et al. A Double-Edged Weapon or Commission Forensic Examination in Civil Trial on Medical Cases. Russian Journal of Forensic Medicine. 2022;8(2):51–58. doi: 10.17816/fm675 EDN: VOJGWE
  8. Sokolova OV. Pathomorphological Examination of the Placenta in Forensic Medical Examinations: Methodological Recommendations. Moscow: Federal Center for Forensic Medical Expertise; 2023. (In Russ.) ISBN: 978-5-9631-1070-6 EDN: OMTEBF
  9. Shchegolev AI, Tumanova UN, Chausov AA, Shuvalova MP. Stillbirths in the Russian Federation in 2020 (COVID-19 Pandemic Year). Obstetrics and Gynecology. 2022;(11):131–140. doi: 10.18565/aig.2022.11.131-140 EDN: VOYQQF
  10. Shchegolev AI, Tumanova UN, Lyapin VM. Pathological Estimation of the Time of Fetal Death. Russian Journal of Archive of Patology. 2017;79(6):60–65. doi: 10.17116/patol201779660-65 EDN: ZXFDWB
  11. Kildyushov EM, Kopylov AV, Berlay MV. Expert evaluation of stillbirth in forensic medical practice. Forensic Medical Expertise. 2025;68(2):55–60. doi: 10.17116/sudmed20256802155 EDN: BIEICR
  12. Genest DR, Williams MA, Greene MF. Estimating the Time of Death in stillborn fetuses: I. Histologic Evaluation of Fetal Organs; an Autopsy Study of 150 Stillborns. Obstet Gynecol. 1992;80(4):575–584.
  13. Kim JH. Histologic Estimation of Intrauterine Retention Time after Fetal Death. Korean J Leg Med. 2013;37(4):191–197.
  14. Shchegolev AI, Mishnev OD, Tumanova UN, et al. Neonatal sepsis as a cause of perinatal mortality in the Russian Federation. International Journal of Applied and Fundamental Research. 2016(5):589–594. doi: 10.17513/mjpfi.9456 EDN: VVTIUZ
  15. Carter SWD, Neubronner S, Su LL, et al. Chorioamnionitis: An Update on Diagnostic Evaluation. Biomedicines. 2023;11(11):2922. doi: 10.3390/biomedicines11112922 EDN: RCHGOE
  16. Bączkowska M, Zgliczyńska M, Faryna J, et al. Molecular Changes on Maternal–Fetal Interface in Placental Abruption—A Systematic Review. Int J Mol Sci. 2021;22(12):6612. doi: 10.3390/ijms22126612 EDN: MICZGW
  17. Jung E, Romero R, Yeo L, et al. The fetal inflammatory response syndrome: the origins of a concept, pathophysiology, diagnosis, and obstetrical implications. Semin Fetal Neonatal Med. 2020;25(4):101146. doi: 10.1016/j.siny.2020.101146 EDN: KUIQXS
  18. Cersonsky TEK, Saade GR, Silver RM, et al. Assessing Intrauterine Retention according to Microscopic Stillbirth Features: A Cluster Analysis Approach. Fetal and Pediatric Pathology. 2023;42(6):860–869. doi: 10.1080/15513815.2023.2246571 EDN: MLCMQX
  19. Klevno VA, Chumakova YV, Dubrova SE, et al. Questions of Forensic Science and Radiology on Live Births and Stillbirths: Cases From Expert Practice. Russian Journal of Forensic Medicine. 2021;7(2):101–107. doi: 10.17816/fm364 EDN: AIEERO

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Antenatal death of the fetus at 30 weeks of gestation. The duration of intrauterine death is 7–10 days: a — histological preparation of the kidney (stained with hematoxylin and eosin, magnification ×40): pronounced tissue autolysis, the nuclei of the cells of the proximal and distal tubules are not outlined, the capillary loops of the glomeruli are collapsed; b — histological preparation of the liver (stained with hematoxylin and eosin, magnification ×40): pronounced autolysis of the parenchyma, the beam structure of the lobules is not visible, hepatocytes are in a granular-lumpy mass, their nuclei are not outlined.

Download (574KB)
Indexing metadata
3. Fig. 2. Antenatal death of the fetus at 37–38 weeks of gestation. Histological preparation of the placenta (stained with hematoxylin and eosin): a — magnification ×100, basal deciduitis (black arrow), retroplacental hematoma due to placental abruption (white arrow); b — magnification ×400, segmented leukocytes are visible among the cellular infiltrate (white arrows).

Download (396KB)
Indexing metadata

Copyright (c) 2025 Eco-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 81753 выдано 09.09.2021 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 – 59181 выдано 03.09.2014 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies