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The lecture sudden death in infancy is designed by following the instructions of the book of Forensic Medicine i.e. ¨Knight's Forensic Pathology¨. This lecture is well explicated by our medical specialist Dr. Hina Khan by primarily discussing about the certain cause of infant demise along with certain risk factors which can contribute to the phenomena. Moreover, external and laboratory findings accompanied with autopsy findings have been shed light upon. In the end, the medicolegal problems in cot deaths have also been thoroughly elucidated and the significance of parents counselling has also been highlighted.
There are various causes which are responsible for unexpected infant death. It can be attributed to by certain infections (pneumonia, myocarditis), Reye syndrome, metabolic diseases (hyperinsulinism) and hyperthermia. Other causative factors include Shaken baby syndrome, poisoning, traumas and Munchausen syndrome by proxy. Incident rate contributed to by congenital malformations is the highest amongst other causes.
Out of a range of risk factors, responsible for deceased infant, age is a significant contributor. Death is highest at the age of 14 days, for congenital anomalies in mortalities per 104. In addition to this, gender and twining also poses a threat. Seasonal variation of Sudden infant death syndrome (SIDS) varies with the region. Social strata and housing of that infant also is a contributor
External and Laboratory Findings
Oedema fluid can exude out from mouth, hands may be clenched, deceased infant may show frank bleeding and stomach contents can be seen on the face. Histological findings in case of SIDS are primarily the pulmonary inflammation and peribronchiolar cell infiltration. Out of an amalgam of causation theories, few marks allergy to cow milk, biotin deficiency in addition to hyperthermia and immunodeficiency as major contributors of the demise.
Autopsy appearances vary. In case of SIDS, whole-body post-mortem imaging and radiological survey of the infant is carried out. Despite this, all external surfaces must be grossly examined, and a full histological survey must also be executed. The deceased must present with certain respiratory infections, pulmonary oedema in addition to some other anomalies like Down syndrome and congenital heath disease.
Medicolegal Problems in Cot Deaths
Out of the range of medicolegal issues, one involves the differentiation of SIDS from external suffocation. In case of the former, intrathoracic petechiae to the thymic cortex can be instituted. However, multiple sudden infant deaths can be the possibility of foul play or some familial metabolic or genetic ailments. Counselling of the parents, in this regard, must be carried out.