INTRAUTERINE FETAL DEATH: A FORENSIC-PATHOLOGY STUDY ABOUT THE ESTIMATION OF TIME OF DEATH

In forensic pathology is of fundamental importance the diagnosis of time of death. If such an investigation is often complex with a well-preserved corpse, it is even more difficult in the case of a fetus dead in-utero affected by macerative post-mortal phenomena. The criteria currently available in pathological and obstetrical literature date back to the '60s and '70s and focus on macro- and microscopic characteristics of fetus and placenta almost never scientifically validated. They can turn to be inappropriate or useless in clinical practice, where the medical examiner often experience a complete mismatch between morphological and clinical data. The present study therefore arises from the necessity to update these thanatological criteria. The actual validity of thanatological criteria proposed in literature has been assessed through a retrospective review of a selected population of 55 fetuses spontaneously dead in utero. The analysis was conducted for each case by applying the criteria previously analyzed in the literature (photographic documentation; histological evaluation of organs and placenta). It was then verified the actual correspondence between the morphological data, clinical data and estimated time of death based on known criteria, identifying the main problems and the possible influence of intrinsic or extrinsic factors. Thereafter it has been developed an experimental prospective phase, focus the to the most critical phases of death-birth time (death within 12-24 hours). A TEM analysis was then conducted on skin and muscle samples from voluntary interruptions of pregnancy underwent an experimental macerative protocol, in order to identify possible stages of cell organelles degeneration positively correlated to the time of death. The main novelty emerged from the TEM study was a progressive vacuolization of cell structures.