Can birth trauma be confused for abuse?
An unexpected infant death is usually investigated with a complete autopsy. If evidence of prior trauma is found at autopsy in these cases, suspicion is raised for nonaccidental trauma. In a young infant, the residua of trauma received during birth has the potential to be incorrectly interpreted as nonaccidental trauma. We report a the findings of a 4 1/2-month-old-infant that died unexpectedly with a healing linear skull fracture and a circular lesion over the calvarium found at autopsy. Though this lesion was concerning, the remainder of the autopsy and the histological findings did not support a diagnosis of recent trauma. Review of the literature describing birth injuries made the diagnosis of healing, residual birth trauma more convincing in this case.
Patonay
Bryan C
BC
Pitt County Memorial Hospital, Pathology and Laboratory Medicine, 2100 Statonsburg Road, PO Box 6028, Greenville, NC 27835, USA.
Oliver
William R
WR
D001720:Birth Injuries / Q000175:diagnosis*; D002585:Cesarean Section; D002649:Child Abuse / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D049429:Forensic Pathology; D006407:Hematoma, Epidural, Cranial / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D012887:Skull Fractures / Q000473:pathology*; D013398:Sudden Infant Death / Q000175:diagnosis*; D014427:Twins; D014945:Wound Healing