Micro-CT for the differentiation between live birth and stillbirth: A pilot study

The distinction between live births and stillbirths is crucial for determining the appropriate legal consequences. Historically, researchers have operated under the principle that an infant's lungs will be filled with air upon death, whereas a fetus's lungs will not. The flotation test for the lungs is the primary method still used in many jurisdictions. However, there are concerns regarding its reliability. For this reason, we conducted a pilot study to evaluate the feasibility of postmortem micro-computed tomography (micro-CT) for differentiating between formalin-fixed aerated and nonaerated lungs. Lung samples from aerated (Group 1) and nonaerated (Group 2) subjects were scanned using micro-CT. We calculated the gas volume percentage (GV%) in each sample. Group 1 (aerated lungs) showed a mean GV% of 9.52 ± 6.77, while Group 2 (nonaerated lungs) showed a mean GV% of 0.58 ± 0.66. These findings suggest that micro-CT can qualitatively and quantitatively detect pulmonary aeration and may serve as a valuable tool in forensic investigations involving suspected neonaticide, feticide, and intrauterine fetal demise.