Histomorphological analysis in panel forensic medical examinations in stillbirth cases

BACKGROUND: Panel forensic medical examinations are among the methods used by Russian investigative authorities for preliminary inquiries and criminal investigations into inadequate obstetric care. Forensic histological analysis of archival autopsy materials and placental tissue is a critical component of panel forensic medical examinations when investigating intrauterine fetal death. AIM: The work aimed to analyze panel forensic medical examinations in stillbirth cases and determine the need for forensic histological examination of archival autopsy materials and placental tissue based on current scientific approaches. METHODS: An observational, single-center, cross-sectional study was conducted using archival records from the Bureau of Forensic Medical Examination of Stavropol Territory. Inclusion criteria: cases of panel forensic medical examinations related to intrauterine fetal death (both antenatal and intranatal). RESULTS: The study included panel forensic medical examinations of intrauterine fetal death cases (n = 68) from January 1, 2015, to December 31, 2022. In 79.4% of cases (n = 54), the examinations were initiated by investigators from the Investigative Committee; in 16.2% (n = 11), by investigators/officers from the Ministry of Internal Affairs; and in 4.4% (n = 3), by judges. In 86.7% of cases, the examinations were conducted as part of preliminary inquiries. The causes of stillbirth were antenatal fetal death in 57.4% (n = 39), intranatal fetal death in 39.7% (n = 27), and congenital abnormalities in 2.9% (n = 2). In 97.1% (n = 66) of panel examinations involving intrauterine fetal death, histologists performed forensic histological examination of autopsy material and the placenta. CONCLUSION: The analysis showed that 39.1% of panel forensic medical examinations in obstetrics and gynecology were related to stillbirth. To improve the quality of expert examinations in this area, forensic histological examinations of autopsy material and the placenta are required. Improving the methodology for panel forensic medical examinations in stillbirth is a pressing issue that necessitates interdisciplinary collaboration among forensic medical experts, pathologists, obstetricians-gynecologists, and neonatologists.