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Can Birth Trauma Be Confused for Abuse?

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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.

Keywords: autopsy; birth injuries; child abuse; forensic pathology; forensic science; histology; sudden infant death

Document Type: Research Article


Affiliations: Pitt County Memorial Hospital, Pathology and Laboratory Medicine, 2100 Statonsburg Road, PO Box 6028, Greenville, NC 27835.

Publication date: July 1, 2010


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