DEFINITION OF PATHOMORPHOLOGICAL CRITERIA FOR LIVE BIRTH
Introduction: despite the achievements of modern perinatology, today there are a number of unresolved issues, one of them is the definition of live birth of a child.
In the Republic of Kazakhstan, since 2008, the implementation of the criteria for live birth and stillbirth, recommended by WHO, has begun. Thus, according to the WHO recommendation, a live birth is considered when the product of conception after 22 weeks of pregnancy is completely separated [extracted] from the mother's body and in the presence of at least one sign of life in a newborn child in the form of attempts to breathe independently, heartbeat, movements, pulsation of the umbilical cord, etc. But together, in everyday practice, doctors of practical health care face the problem of determining live birth or stillbirth, which leads to many questions and disagreements.
Aim: to analyze the literature on the topic of determining the pathomorphological criteria of live birth.
Search Strategy: The sources were searched in the following databases: Pubmed, Scopus, Ebscohost, Medline, The Sosgape Library, SpringerLink, Web of Knowledge [Thomson Reuters], Paragraph Medicine, ScienceDirect. The search depth was 20 years: from 2000 to 2020. The inclusion criteria were: articles in English on the forensic medical examination of live births. The exclusion criteria were: articles describing individual cases and series of cases; articles published earlier than 2000; materials that do not have an evidence base, summaries of reports, abstracts and newspaper articles. We included 45 articles on this topic that were available in full text and went through a critical evaluation process. The search depth is 20 years, but several sources (1965, 1969, 1984, 1992, 1993 years) were also included in this analysis because they contained conceptual (basic) information.
Results: Analysis of the literature showed that over the past 20 years, no single method has emerged that has convincingly proven the fact of live birth. The combination of different methods, the comparison of the results of several research methods will allow us to get closer to the truth, to determine / exclude live birth.
Conclusions: The issue of determining the live birth rate is an urgent problem that requires further study.
Bekturgan T. Karin1, https://orcid.org/0000-0002-8080-787X
Aizada M. Marat1, https://orcid.org/0000-0002-3935-3351
Tamara K. Chuvakova1, https://orcid.org/0000-0001-5411-8061
Bagila K. Nurmagambetova1, https://orcid.org/0000-0003-3210-3760
Zaituna G. Khamidullina1, https://orcid.org/0000-0002-5324-8486
Kulyash К. Jaxalykova1, https://orcid.org/0000-0001-5540-3331
Gulzhanat N. Aimagambetova2, https://orcid.org/0000-0002-2868-4497
Aigerim A. Yeltaeva1, https://orcid.org/0000-0002-2930-8901
Umit U. Usmanova3, https://orcid.org/0009-0000-1459-9809
1 NJSC "Astana Medical University", Astana, Republic of Kazakhstan;
2 Nazarbayev University, Department of Surgery, School of Medicine, Astana, Republic of Kazakhstan;
3 SME on the REM "City Multidisciplinary Hospital No. 2", Astana, Republic of Kazakhstan.
1. Ардашкин А.П., Недугов Г.В. Судебно-медицинская экспертиза трупов плодов и новорожденных (экспертно-правовая характеристика, гистологическая диагностика). Самара: Офорт. 2006. 145 с.
2. Витер В.И., Вавилов А.Ю., Бабушкина К.А., Хасанянова С.В. Судебно-медицинская экспертиза трупов плодов и новорожденных: Учебное пособие. 2016. С. 12-14.
3. Клевно В.А., Чумакова Ю.В., Дуброва С.Э., Муранова Н.С., Попова О.М. Живорожденность и мертворожденность: вопросы судебной медицины и рентгенологии. Случаи из экспертной практики // Судебная медицина. 2021. Т.7. № 2. С. 101-107.
4. Коробеев А. И., Ширшов А. А. Критерии живорождения при определении жизни как объекта уголовно-правовой охраны // Lex russica. 2020. Т. 73. № 5. С. 64—72. DOI: 10.17803/1729-5920.2020.162.5.064-072.
5. Крюков В.Н., Буромской И.В. Практикум по судебной медицине. Издание 3. Судебно-медицинское исследование трупов плодов и новорожденных: Учебное пособие. Москва: ООО Фирма «Светотон ЛТД». 2007. 38 с.
6. Кунгурова В.В. Морфология плаценты в свете решения вопроса живорожденности и мертворожден-ности в судебно-медицинской практике // Проблемы экспертизы в медицине 2008. Т. 7. №3. С. 3–41.
7. Мальков П.Г., Франк Г.А., Пальцев М.А. Стандартные технологические процедуры при проведении патологоанатомических исследований: Клинические рекомендации. М.: Практическая медицина. 2017. 137 с.
8. Мачинский П.А., Тишков С.В. Судебно-медицинское исследование трупов плодов и новорожденных в учебном процессе. Сообщение 4. Понятия «живорожденность» и «мертворожденность» // В помощь практическому врачу. 2015. С. 52-55.
9. Международная классификация болезней 10-го пересмотра (МКБ-10). http://mkb-10.com. (Дата обращения 27.01.2022)
10. Мустафина-Бредихина Д.М. Правовые основы оформления живорождения, жизнеспособность и право на жизнь. Часть 1 // Неонатология: новости, мнения, обсуждение. 2020. Т. 8. № 2. С. 54–57. DOI: 10.33029/2308-2402-2020-8-2-54-57. (Дата обращения 27.11.2021)
11. Мустафина-Бредихина Д.М. Правовые основы оформления живорождения, жизнеспособность и право на жизнь. Часть 2 // Неонатология: новости, мнения, обсуждение. 2020. Т. 8. № 3. С. 50–53. https://doi.org/10.33029/2308-2402-2020-8-3-50-53. (Дата обращения 27.11.2021)
12. Насыров Р.А., Мельникова В.Ф., Красногорская О.Л., Попова Е.Д., Наркевич Т.А., Сидорова Н.А., Панеях М.Б., Федотова Е.П. Принципы проведения патоморфологических исследований в случаях перинатальной смерти // Педиатр. 2018. Т. 9. № 3. С. 85–105. DOI: 10.17816/PED9385-105.
13. Ремнева О.В., Чернова А.Е., Нестеров Ю.Н., Буркова Т.В. Интранатальная гибель плода в срочных родах: клинико-патоморфологические сопоставления // Бюллетень медицинской науки. 2017. Т. 7. № 3. С. 47-52.
14. Пальцев М.А., Кактурский Л.В., Зайратьянц О.В. Патологическая анатомия: Национальное руководство. М.: ГЭОТАР-Медиа. 2011. 1264 с.
15. Пиголкин Ю.И., Дубровин И.А. Судебная медицина: Учебник. М.: ООО «Издательство «Медицинское информационное агентство». 2015. С. 49–52.
16. Струков А.И., Серов В.В. Патологическая анатомия: Учебник. М.: Литтерра. 2010. 880 с.
17. Тагаев Н.Н. Судебная медицина. Учебное пособие. Харьков: «Факт», 2003. 1253 с.
18. Фишер Ф.Т., Шверер М., Лохнер С., Максиен Д., Мюк Ф., Бехштейн Л., Вирт С., Гримм Й. Использование метода посмертной компьютерной томографии для определения статуса вентиляции легких у новорожденных // Неонатология: новости, мнения, обучение. 2022. Т. 10. № 3. С. 73-81.
19. Коротаева М.А. К вопросу установления начала жизни при квалификации детоубийства // Гуманитарные, социально-экономические и общественные науки. 2018. №3. С. 99-101.
20. Пиголкин Ю.И. Судебная медицина. Национальное руководство. Москва: ГЭОТАР-Медиа. 2021. 672 с.
21. Alfsen G.C., Ellingsen C.L., Hernæs L. The child has lived and breathed. Forensic examinations of newborns 1910-1912 // Tidsskr Nor Laegeforen. 2013 Dec 10; 133[23-24]:2498-501. English, Norwegian. PMID: 24326503. https://doi.org/10.4045/tidsskr.13.0898. (Дата обращения 19.12.2021)
22. Baber Y., Iles L., OʼDonnell C. Determining live birth: an unusual case // The American Journal of Forensic Medicine and Pathology. 2015 Dec; 36(4):262-264. DOI: 10.1097/PAF.0000000000000198.
23. Byard R.W. Sudden death in the young. 3rd ed. New York: Cambridge University Press; 3rd edition. 2010. 700 p.
24. Coroners Act 2003 [Internet]. Brisbane: State of Queensland; 2017 Jun 30 142 p. Available from: https://www.legislation.qld.gov.au/view/pdf/inforce/current/act-2003-013. [cited 2018 Aug 31].
25. DiMaio V.J.M. Handbook of Forensic Pathology. 2nd edition. Boca Raton: CRC Press; 2007. 326 p.
26. Gilbert-Barness E., Kapur R., Oligny L.L., Siebert J. Potter’s pathology of the fetus, infant and child. 2nd edition. Volume 1. Philadelphia: Mosby; 2007. 2320 p.
27. Große Ostendorf A.L., Rothschild M.A., Müller A.M., Banaschak S. Is the lung floating test a valuable tool or obsolete? A prospective autopsy study // International Journal of Legal Medicine. 2013 Mar; 127[2]:447-51. PMID: 22733108. https://doi.org/10.1007/s00414-012-0727-1. (Дата обращения 29.01.2022)
28. Guddat S.S., Gapert R., Tsokos M., Oesterhelweg L. Proof of live birth using postmortem multislice computed tomography [pmMSCT] in cases of suspected neonaticide: advantages of diagnostic imaging compared to conventional autopsy // Forensic Science, Medicine and Pathology. 2013 Mar; 9[1]: 3-12. PMID: 22760696. https://doi.org/10.1007/s12024-012-9361-y. (Дата обращения 23.12.2021)
29. Herman-Giddens M.E., Smith J.B., Mittal M. et al., Newborns killed or left to die by a parent: a population-based study // JAMA. 2003 Mar 19; 289[11]:1425-9. PMID: 12636466.
30. Hirvonen J., Tiisala R., Uotila U. et al. Roentgenological and autopsy studies on the gas content of the lungs and gastro-intestinal tract in living and stillborn infants, and sources of error in resuscitation // Deutsche Zeitschrift für die gesamte gerichtliche Medizin. 1969; 65[2]:73-86. PMID: 4895181. https://doi.org/10.1007/bf00583966. (Дата обращения 14.12.2021)
31. Janssen W. Forensic histopathology. Berlin: Springer-Verlag; 1984.402 p.
32. Kellett R.J. Infanticide and child destruction--the historical, legal and pathological aspects // Forensic Sci Int. 1992 Feb; 53[1]:1-28. PMID: 1568678. https://www.sciencedirect.com/science/article/abs/pii/037907389290129K?via%3Dihub. (Дата обращения 30.11.2021)
33. Kiho L., Malcomson R.D.G. Keeling’s fetal and neonatal pathology. New York: Springer International; c2015. Chapter 34, Forensic aspects of perinatal Pathology; p. 863-73.
34. Kuroda S., Nagamori H., Ebe M., Sasaki M. Medico-legal studies on the fetus and infant: with special references to histological characteristics of the lungs of liveborn and stillborn infants // Tohoku J Exp Med. 1965 Feb 25; 85[1]:40-54. PMID: 14285067. https://doi.org/10.1620/tjem.85.40. (Дата обращения 01.02.2022)
35. Lavezzi W.A., Keough K.M., Der’Ohannesian P. et al. The use of pulmonary interstitial emphysema as an indicator of live birth // Am J Forensic Med Pathol. 2003 Mar; 24[1]:87-91. PMID: 12605006. https://doi.org/10.1097/01.PAF.0000052108.20359.C8. (Дата обращения 26.01.2022)
36. Lavezzi W.A., McKenna B.J., Wolf B.C. The significance of pulmonary interstitial emphysema in live birth determination // Journal of Forensic Sciences. 2004 May; 49[3]:546-52. PMID: 15171175. https://pubmed.ncbi.nlm.nih.gov/15171175/.(Дата обращения 26.01.2022)
37. Levels & Trends in Child Mortality. Report 2014 2019. Estimates developed by the Estimates Developed by the UN Inter-agency Group for UN Inter-agency Group for Child Mortality Estimation. UNICEF, WHO, World Bank Group, United Nations. https://www.unicef.org/reports/levels-and-trends-child-mortality-report-2019 (Дата обращения 10.12.2021)
38. Mazuchowski E.L., Franco D.M., Berran P.J., Harcke H.T. The virtual hydrostatic test // The American Journal of Forensic Medicine and Pathology. 2017 Mar; 38[1]:24-8. PMID: 28005583. https://doi.org/10.1097/PAF.0000000000000287. (Дата обращения 28.01.2022)
39. Milroy C. Neonatal deaths, infanticide, and the hydrostatic (floatation) test: historical perspectives // Acad Forensic Pathol. 2012 Dec; 2[4]:338-45. https://doi.org/10.23907/2012.052. (Дата обращения 22.12.2021)
40. Neri M., D’Errico S., Fiore C. et al. Stillborn or liveborn? Comparing umbilical cord immunohistochemical expression of vitality markers (tryptase, alpha [1]-antichymotrypsin and CD68] by quantitative analysis and confocal laser scanning microscopy. Pathol Res Pract. 2009; 205[8]:534-41. PMID: 19250758. https://doi.org/10.1016/j.prp.2009.01.011. (Дата обращения 29.01.2022)
41. Saukko P., Knight B. Knights forensic pathology. 4th ed. Boca Raton: CRC Press; 2016. 666 p.
42. Schulte B., Rothschild M.A., Vennemann M., Banaschak S. Examination of [suspected] neonaticides in Germany: a critical report on a comparative study // International Journal of Legal Medicine. 2013 May; 127[3]:621-5. PMID: 23471590. https://doi.org/10.1007/s00414-013-0841-8. (Дата обращения 26.12.2021)
43. Spitz W.U. Spitz and Fisher’s medicolegal investigation of death.4th ed. Springfield [IL]: Charles C Thomas; 2006. 1325 p.
44. World Health Organization. International statistical classification of diseases and related health problems. Tenth Revision. Vol 2. Geneva, Switzerland: World Health Organization, 1993:129.
45. World Health Organisation: Health statistics and information systems [Internet]. Geneva: World Health Organisation; 2018. https://www.who.int/data/gho/publications/world-health-statistics. (Дата обращения 7.12.2021)
References: [1-20]
1. Ardashkin A.P., Nedugov G.V. Sudebno-meditsinskaya ekspertiza trupov plodov i novorozhdennykh (ekspertno-pravovaya kharakteristika, gistologicheskaya diagnostika) [Forensic medical examination of fetal and newborn corpses (expert legal characteristics, histological diagnostics)]. Samara: Ofort. 2006. 145 p. [In Russian].
2. Viter V.I., Vavilov A.Yu., Babushkina K.A., Khasanyanova S.V. Sudebno-meditsinskaya ekspertiza trupov plodov i novorozhdennykh: Uchebnoe posobie [Forensic medical examination of fetal and newborn corpses: Textbook]. 2016. pp. 12-14. [In Russian].
3. Klevno V.A., Chumakova Yu.V., Dubrova S.E., Muranova N.S., Popova O.M. Zhivorozhdennost' i mertvorozhdennost': voprosy sudebnoi meditsiny i rentgenologii. Sluchai iz ekspertnoi praktiki [Live births and stillbirths: issues of forensic medicine and radiology. Cases from expert practice]. Sudebnaya meditsina [Forensic medicine]. 2021. T. 7. № 2. pp. 101-107. [In Russian].
4. Korobeev A.I., Shirshov A.A. Kriterii zhivorozhdeniya pri opredelenii zhizni kak ob"ekta ugolovno-pravovoi okhrany. [Criteria of live birth in determining life as an object of criminal law protection]. Lex Russica [Russian law]. 2020. T. 73. № 5. pp. 64—72. DOI: 10.17803/1729-5920.2020.162.5.064-072. [In Russian].
5. Kryukov V.N., Buromskoi I.V. Praktikum po sudebnoi meditsine. Izdanie 3. Sudebno-meditsinskoe issledovanie trupov plodov i novorozhdennykh: Uchebnoe posobie [A workshop on forensic medicine. Edition 3. Forensic medical examination of fetal and newborn corpses: Textbook]. Moskva: OOO Firma «Svetoton LTD». 2007. 38 p. [In Russian].
6. Kungurova V.V. Morfologiya platsenty v svete resheniya voprosa zhivorozhdennosti i mertvorozhdennosti v sudebno-meditsinskoi praktike [Morphology of the placenta in the light of solving the issue of live birth and stillbirth in forensic medical practice]. Problemy ekspertizy v meditsine [Problems of expertise in medicine]. 2008. T. 7. № 3. pp. 3–41. [In Russian].
7. Mal'kov P.G., Frank G.A., Pal'tsev M.A. Standartnye tekhnologicheskie protsedury pri provedenii patologoanatomicheskikh issledovanii: Klinicheskie rekomendatsii [Standard technological procedures for conducting pathoanatomic studies: Clinical recommendations]. M.: Prakticheskaya meditsina. 2017. 137 p. [In Russian].
8. Machinskii P.A., Tishkov S.V. Sudebno-meditsinskoe issledovanie trupov plodov i novorozhdennykh v uchebnom protsesse. Soobshchenie 4. Ponyatiya «zhivorozhdennost'» i «mertvorozhdennost'» [Forensic medical examination of fetal and newborn corpses in the educational process. Message 4. The concepts of "live birth" and "stillbirth"]. V pomoshch' prakticheskomu vrachu [To help a practical doctor]. 2015. pp. 52-55. [In Russian].
9. Mezhdunarodnaya klassifikatsiya boleznei 10-go peresmotra (MKB-10). [International Classification of Diseases of the 10th revision (ICD-10)]. http://mkb-10.com. (accessed 27.01.2022) [In Russian].
10. Mustafina-Bredikhina D.M. Pravovye osnovy oformleniya zhivorozhdeniya, zhiznesposobnost' i pravo na zhizn'. Chast' 1 [The legal basis for the registration of a live birth, viability and the right to life. Part 1]. Neonatologiya: novosti, mneniya, obsuzhdenie [Neonatology: news, opinions, discussion]. 2020. T. 8. № 2. pp. 54–57. DOI: 10.33029/2308-2402-2020-8-2-54-57. (accessed 27.11.2021) [In Russian].
11. Mustafina-Bredikhina D.M. Pravovye osnovy oformleniya zhivorozhdeniya, zhiznesposobnost' i pravo na zhizn'. Chast' 2. [The legal basis for the registration of a live birth, viability and the right to life. Part 2]. Neonatologiya: novosti, mneniya, obsuzhdenie. [Neonatology: news, opinions, discussion]. 2020. T. 8. № 3. pp. 50–53. https://doi.org/10.33029/2308-2402-2020-8-3-50-53. (accessed 27.11.2021) [In Russian].
12. Nasyrov R.A., Mel'nikova V.F., Krasnogorskaya O.L., Popova E.D., Narkevich T.A., Sidorova N.A., Paneyakh M.B., Fedotova E.P. Printsipy provedeniya patomorfologicheskikh issledovanii v sluchayakh perinatal'noi smerti [Principles of pathomorphological research in cases of perinatal death]. Pediatr [Pediatrician]. 2018. T.9. №3. pp. 85–105. DOI: 10.17816/PED9385-105. [In Russian].
13. Remneva O.V., Chernova A.E., Nesterov Yu.N., Burkova T.V. Intranatal'naya gibel' ploda v srochnykh rodakh: kliniko-patomorfologicheskie sopostavleniya [Intranatal fetal death in urgent labor: clinical and pathomorphological comparisons]. Byulleten' meditsinskoi nauki [Bulletin of Medical Science]. 2017. T. 7. № 3. pp. 47-52. [In Russian].
14. Pal'tsev M.A., Kakturskii L.V., Zairat'yants O.V. Patologicheskaya anatomiya: Natsional'noe rukovodstvo [Pathological Anatomy: A National Guide]. M.: GEOTAR-Media. 2011. 1264 p. [In Russian].
15. Pigolkin Yu.I., Dubrovin I.A. Sudebnaya meditsina: Uchebnik [Forensic Medicine: Textbook]. M.: OOO «Izdatel'stvo «Meditsinskoe informatsionnoe agentstvo». 2015. pp. 49–52. [In Russian].
16. Strukov A.I., Serov V.V. Patologicheskaya anatomiya: Uchebnik [Pathological Anatomy: Textbook]. M.: Litterra. 2010. 880 p. [In Russian].
17. Tagaev N.N. Sudebnaya meditsina. Uchebnoe posobie [Forensic medicine. Study guide]. Khar'kov: «Fakt», 2003. — 1253 p. [In Russian].
18. Fisher F.T., Shverer M., Lokhner S., Maksien D., Myuk F., Bekhshtein L., Virt S., Grimm I. Ispol'zovanie metoda posmertnoi komp'yuternoi tomografii dlya opredeleniya statusa ventilyatsii legkikh u novorozhdennykh [Using the method of postmortem computed tomography to determine the status of lung ventilation in newborns]. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: news, opinions, training]. 2022. T. 10. № 3. pp. 73-81. [In Russian].
19. Korotaeva M.A. K voprosu ustanovleniya nachala zhizni pri kvalifikatsii detoubiistva. [On the issue of establishing the beginning of life in the qualification of infanticide]. Gumanitarnye, sotsial'no-ekonomicheskie i obshchestvennye nauki. [Humanities, socio-economic and social sciences]. 2018. №3. pp. 99-101. [In Russian].
20. Pigolkin Yu.I. Sudebnaya meditsina. Natsional'noe rukovodstvo. [Forensic medicine. National leadership]. Moskva: GEOTAR-Media. 2021. 672 p. [In Russian].
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Karin B.T., Marat A.M., Chuvakova T.K., Nurmagambetova B.K., Khamidullina Z.G., Jaxalykova K.К., Aimagambetova G.N., Yeltaeva A.A., Usmanova U.U. Definition of pathomorphological criteria for live birth // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 2, pp. 225-235. DOI 10.34689/SH.2023.25.2.029Related publications:
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