[Intrapartum death or infanticide? A contribution to intrapartum asphyxia]

On occasion of the autopsy of a 32-34-week-old fetus delivered with fetal membrane intact (caul/amnion birth), heavy hypoxic changes in the cardiac muscle, the liver and the kidney epithelia were found. On the other hand, there was no sign of aspiration although a sign of aspiration was to be expected, as the fetus was lying in the amniotic fluids. The systematic examination of 68 cases of intrapartal deaths of various causes demonstrated that intrapartal aspiration in the amniotic fluid only takes place, when the function of the umbilical cord is obstructed. If pressure is lacking, as for example, in amniotic (fluid) substances, or meconium, in the respiratory tract is either found not at all, or only in small quantities. For the purposes of forensic medicine, this means that death by intrapartal asphyxia can also be assumed when findings demonstrate simultaneously that aspiration is absent and hypoxic changes of the organs are present.