Case ReportOpen Access

Perinatal Post-Mortem Examinations in a Developing Community

Onuigbo W1* and Twomey D2

1Department of Pathology, Orthopaedic Hospital, Enugu, Nigeria
2Mater Hospital, Afikpo, Nigeria

*Corresponding Author: 
Onuigbo W
  Department of Pathology
  Orthopaedic Hospital, Enugu 40001, Nigeria
  E-mail: wilson.onuigbo@gmail.com

Received: July 19, 2017; Published: November 18, 2018

Citation: Onuigbo W and Twomey D (2018) Perinatal Post-Mortem Examinations in a Developing Community. J Forensic crime investi 2(1): 103

Abstract

Neonate is defined as a new born child, especially a child less than a month old. This word is said to have been first used in 1932. The importance of perinatal pathology is attested to by a recent report from a group working in Iraq, Chile, and Canada. Therefore, this paper documents the research on dead neonates of the Igbo Ethnic Group in South-Eastern Nigeria. All were males surprisingly.

Keywords: Perinatal Post-Mortem; Developing Community; Neonates

Introduction

The Merriam-Webster’s Collegiate Dictionary defines “Neonate” as “a new born child especially a child less than one moth old” [1]. Moreover, it added that this word first came into use in 1932. Now, perinatal or neonatal postmortem is of such importance that researchers based in Iraq, Chile, and Canada combined to publish a paper on it [2]. Apparently, all their cases died at home. Therefore, the present paper documents similarly dead neonates which were autopsied. Some of their organs were sent to a Regional Pathology Laboratory at Enugu, the erstwhile Capital City of Eastern Nigeria. The patients were all of the Igbo ethnic group [3].

Co-author’s Case Report

A Para O woman attended Dr. Deidre Twomey’s Clinic at the Mater Hospital, Afikpo, throughout pregnancy. Labor lasted 18 hours with gradual descent of the head. No fetal distress was noted. Spontaneous vaginal delivery was conducted by the co-author. However, the infant was born covered with meconium. No heart beat was heard. Cardiac massage as well as oxygen was commenced in addition to endotracheal intubation to no avail. The fresh still birth was autopsied. Thereafter, the positive microscopical results were obtained by the co-author (WO) thus:

The abnormality seen is the presence of numerous keratinous squames in the alveoli. Accordingly, the picture is that of asphyxia from inhalation of meconium as a result of intrauterine hypoxia.

Other Autopsy Findings

Atelectasis - 2 cases
Congenital heart disease - 1 case
Occipital malformation - 1 case
Extramedullary hemopoiesis in liver - 1 case

Discussion

From Italy [4], a group at the University of Milan confessed thus: “The data and arguments presented herein provide a brief survey tending to open, rather than conclude, a far-reaching subject and to motivate medicolegal specialists and pathologists to perform more in-depth study”.

On their part, the researchers in Turkey evaluated forensic perinatal and neonatal autopsies in Istanbul [5]. They concluded that “Data obtained in autopsies and postmortem examinations will make great contributions to the prevention of these deaths”.

An esoteric approach was published in the Journal of Perinatology with reference to advancing the role of postmortem MRI in the neonatal intensive care unit [6]. Indeed, they concluded that such “studies may provide an important adjunct to conventional autopsy and a substitute when the latter is not possible for personal or religious reasons”.

On the local plane, was it fortuitous that all the neonatal cases have been males? Perhaps, this is compatible with the local custom of the Igbos! Thus, according to the anthropological book on this ethnic group [3], it was said of them thus:

A woman desirous of bearing a child resorts to “Omumu” and, with sacrifices, beseeches the goddess to grant her the favour. Should the prayer be answered, appropriate thanksgivings are brought; for a boy, a cock; for a girl, a hen.

It is to be noted that the disparity of the animal gift is in terms of their respective costs in the local markets! Perhaps, this is not merely old fashioned. Thus, the traditional preference for bearing sons was not long ago spotlighted by a local gynaecologist, Dr. Dozie Ikedife [7], with reference to the custom a “nrachi” whereby a woman remains unmarried so as to beget a son for the family! Incidentally, I linked this up with a fatal disease known as “gestosis”. I also added a hypothesis on its curtailment [8].

References
  1. 1. Merriam-Webster (1998) Merriam-Webster’s Collegiate Dictionary. Merriam-Webster Inc. 12th (Edn.) p.831.
  2. 2. Seulieman YA, Rasool M, Al-Ali Z, Ali-Hameed A, Jameel A, et al. (2016) Forensic pathology and newborn screening for inborn errors of metabolism: Implications for the middle east. Arab J Forensic Sci Forensic Med 1: 438-42.
  3. 3. Basden GT (1966) Niger Ibos: a description of the primitive life, customs and animistic beliefs, etc., of the Ibo people of Nigeria. Birth customs, London.
  4. 4. Matturri L, Ottaviai G, Lavezzi Am (2005) Techniques and criteria in pathologic and forensic-medical diagnostics in sudden unexpected infant and perinatal death. Am J Clin Pathol 124: 259-68.
  5. 5. Ozkara E, Canturk G, Canturk N, Ozata AB, Yavuz MF (2009) Evaluation of forensic perinatal and neonatal autopsies in Istanbul. Indian J Pediatr 76: 167.
  6. 6. Leadbetter KZ, Vesoulis ZA, White FV (2017) The role of post-mortem MRI in the neonatal intensive care unit. J Perinatol 37: 93103.
  7. 7. Ikedife D (1980) Eclampsia in multipara. Br Med J 280: 985-6.
  8. 8. Onuigbo WIB (2016) Can allied health care professionals assist obstetricians in preventing gestosis and promoting safe childbirth? Res Chron Hlth Sci 2: 280-2.

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