Child Abuse and Infanticide Overview
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Questions and Answers

Which of the following is NOT considered a type of child abuse?

  • Emotional Abuse
  • Bullying (correct)
  • Physical Abuse
  • Negligence

Which feature is NOT typically associated with Child Physical Abuse (CPA)?

  • Delay in seeking medical assistance
  • Multiple hospital visits for various injuries
  • Consistent explanation correlating with injuries (correct)
  • Repeated injuries of different ages

Which characteristic most commonly causes death in cases of child abuse?

  • Internal injuries
  • Fractures in limbs
  • Head injuries (correct)
  • Burns from hot liquids

Infanticide applies exclusively to which of the following scenarios?

<p>Deliberate killing of a viable infant (D)</p> Signup and view all the answers

In determining if a child was a victim of abuse, which statement holds true?

<p>Negative external findings do not rule out child physical abuse (D)</p> Signup and view all the answers

Which of the following best describes the timing most commonly associated with infanticide cases?

<p>Usually occurs within hours of birth (C)</p> Signup and view all the answers

What kind of injuries are indicative of physical abuse in children?

<p>Multiple bruising with different colors and patterns (C)</p> Signup and view all the answers

What is the defining condition for calling an act infanticide?

<p>Deliberate killing of a live born infant under one year (D)</p> Signup and view all the answers

What occurs to the weight of the lungs during respiration according to the provided principles?

<p>The weight of respired lungs increases (A)</p> Signup and view all the answers

Which procedure is carried out to test the buoyancy of the lungs after respiration?

<p>Hydrostatic test (C)</p> Signup and view all the answers

What indicates that a newborn lived for approximately 6 hours after birth during the stomach-bowel test?

<p>All parts float in stomach, duodenum &amp; upper intestines (B)</p> Signup and view all the answers

In the static test for lungs, what happens to the lungs' weight when they are respired?

<p>Weight doubles (A)</p> Signup and view all the answers

What is the primary principle behind the hydrostatic test?

<p>Respired lungs have lower specific gravity (A)</p> Signup and view all the answers

What is indicated by all parts of the lungs sinking during the hydrostatic test?

<p>Non-respiration (C)</p> Signup and view all the answers

What internal sign is indicative of a newborn having been born alive?

<p>Collection of colostrum corpuscles in gastric contents (B)</p> Signup and view all the answers

What is one of the roles of a forensic pathologist in infanticide cases?

<p>Estimating whether the infant was born alive or stillborn (B)</p> Signup and view all the answers

How is the stomach-bowel test critical in determining respiratory evidence?

<p>It assesses the floatation of the stomach and intestines (D)</p> Signup and view all the answers

At what stage does the ductus arteriosus experience actual obliteration?

<p>After 6 weeks post-delivery (D)</p> Signup and view all the answers

Which factor is NOT considered when estimating the period of survival of an infant after its live-birth?

<p>Length of time from delivery to birth (C)</p> Signup and view all the answers

What external sign indicates that a newborn was born alive?

<p>Formation of umbilicus after 2 weeks (B)</p> Signup and view all the answers

What is a natural cause of death for a newborn that a forensic pathologist would identify?

<p>Congenital malformations (A)</p> Signup and view all the answers

Which of the following is indicative of a stillborn infant during delivery?

<p>Presence of rancid smell and flaccidity of the body (A)</p> Signup and view all the answers

What sign indicates that the foramen ovale has closed?

<p>Closure after 1 week of birth (B)</p> Signup and view all the answers

Which test helps estimate the signs of respiration in a newborn?

<p>Hydrostatic test (A)</p> Signup and view all the answers

Which of the following conditions is categorized as an act of commission?

<p>Infanticide through deliberate harm (A)</p> Signup and view all the answers

What is a key feature of respired lungs observed in a forensic examination?

<p>Mottled or mosaic appearance (B)</p> Signup and view all the answers

What physiological change occurs in the umbilical vessels 2 weeks after birth?

<p>Formation of fibrous cord (C)</p> Signup and view all the answers

Which sign is NOT helpful in estimating the age of an infant after birth?

<p>Length of the umbilical cord (A)</p> Signup and view all the answers

What indicates that the umbilical cord was cut after the birth of a live infant?

<p>Ring of hyperemia after 1 day (C)</p> Signup and view all the answers

What characteristic of a child's stool suggests that they were born alive?

<p>Well-formed yellow stools (C)</p> Signup and view all the answers

Which condition indicates a death that occurred before delivery?

<p>Maceration characterized by specific discoloration (A)</p> Signup and view all the answers

What is one potential cause of Sudden Infant Death Syndrome (SIDS)?

<p>Overlaying and suffocation (A)</p> Signup and view all the answers

What is a sign of live birth indicated by the skin condition of a newborn?

<p>Desquamation completed after 2 weeks (C)</p> Signup and view all the answers

In cases of infanticide, which factor could indicate violence as the cause of death?

<p>Stab wounds (C)</p> Signup and view all the answers

Which of the following is NOT a characteristic associated with SIDS?

<p>Slight preponderance of females (C)</p> Signup and view all the answers

What is a common misconception regarding the causes of infant death in the first few months?

<p>Infant deaths rarely occur due to viral infections (C)</p> Signup and view all the answers

Which of the following methods is NOT typically associated with acts of commission in infanticide?

<p>Accidental strangulation (D)</p> Signup and view all the answers

What role does a forensic pathologist play in cases of infanticide?

<p>Determine the causes of death (A)</p> Signup and view all the answers

Which statement is true regarding the time period when SIDS is most common?

<p>Most fatalities occur between 2 weeks to 2 years (C)</p> Signup and view all the answers

Which autopsy finding is crucial for diagnosing Sudden Infant Death Syndrome?

<p>Failure to find an adequate cause of death (A)</p> Signup and view all the answers

What is the purpose of estimating the maturity and viability of a child in infanticide cases?

<p>To assess if the infant could survive birth without medical assistance (A)</p> Signup and view all the answers

Which of the following is NOT a method for identifying a child in an infanticide case?

<p>Analysis of the death certificate (A)</p> Signup and view all the answers

What is an important non-medical evidence that can indicate a live birth?

<p>Observed reflex actions like sneezing or crying (A)</p> Signup and view all the answers

At what gestation age is a neonate considered to have a strong presumption of not surviving without medical attention?

<p>28 weeks (D)</p> Signup and view all the answers

Which of the following signs is indicative of a neonate being born stillborn?

<p>Presence of desquamation of the skin (A)</p> Signup and view all the answers

What information is essential for the identification of the mother in an infanticide case?

<p>All identifying details related to the crime scene (A)</p> Signup and view all the answers

Which of the following best describes the process of estimating whether an infant was born alive or stillborn?

<p>It combines both non-medical and medical evidence evaluations. (B)</p> Signup and view all the answers

What is the minimum gestational age at which a child is considered premature regardless of weight?

<p>37 weeks (D)</p> Signup and view all the answers

Flashcards

Identifying the Mother in Infanticide

The process of determining the mother's identity during an infanticide investigation involves considering various factors such as the discovery location, objects associated with the body, signs on the umbilical cord, ethnic traits, congenital anomalies, blood typing, and DNA profiling.

Premature vs. Viable Infants

A baby born before completing 37 weeks of gestation, regardless of weight, is considered premature. However, viability is generally assumed to start at 28 weeks. Premature infants born before 28 weeks are unlikely to survive outside of a medical environment.

Determining Live Birth in Infanticide

The forensic pathologist assesses whether an infant was born alive by examining both non-medical and medical evidence.

Non-Medical Evidence of Live Birth

Non-medical evidence suggesting live birth might include eyewitness accounts of the infant moving, crying, sneezing, or opening its eyes.

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Medical Evidence of Live Birth

Medical evidence indicating live birth can include changes at the base of the umbilical cord, skin desquamation, external and internal signs of respiration, and signs of air in the trachea and lungs.

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Forensic Pathologist's Role in Infanticide

The role of the forensic pathologist in infanticide is to identify the child and potentially the mother, assess the maturity and viability of the child, determine if the child was born alive or stillborn, and estimate the duration of survival.

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Hyperemia around the umbilical cord

A ring of redness that appears around the base of the umbilical cord within one day of birth.

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Ulceration around the umbilical cord

An ulcer starts to form in the ring of hyperemia around the umbilical cord within two days of birth.

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Umblical cord detachment

The umbilical cord falls off after approximately one week of birth.

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Formation of the umbilicus

The umbilical cord forms into the umbilicus approximately two weeks after birth.

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Desquamation of the skin

The shedding of the skin is a sign of live birth and starts two days after birth, completing within two weeks.

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A.M. injury

Any injury to the newborn that occurs during the birth process or shortly after. Examples include forceps application or accidental cut.

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Well-formed stools

A well-formed stool is passed by a baby during the first few days after birth. This is a sign of a live birth and can be differentiated from meconium (first stool passed by stillborn babies).

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Absence of maceration

A ma­cerated child is characterized by a brown red discoloration of the skin, a rancid smell, flaccidity of the body, and undue mobility of skull bones, indicating death occurred in utero before delivery.

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Infanticide Role of Forensic Pathologist

Forensic pathologist's role in a case where an infant has been killed. It involves determining whether the infant was born alive, assessing the time of death, and identifying the cause of death.

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Born Alive vs. Stillborn

The pathologist determines if the infant was born alive or stillborn.

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Internal Signs of Live Birth

Signs indicating the infant was born alive, such as colostrum found in the stomach or yellow, formed stools in the intestines.

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Period of Survival Estimation

The pathologist estimates the time elapsed since the infant's birth based on changes like skin desquamation, stomach and intestine floatation, umbilical cord changes, and injury healing.

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Changes in Umbilical Vessels

Changes that occur to the umbilical vessels after birth, starting with shrunken vessels filled with red blood clots and ending with the vessel becoming a fibrous cord.

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Changes in Fetal Circulation

Closure of the Foramen Ovale, usually within a week of birth, and obliteration of the Ductus Arteriosus, typically within 6 weeks after birth.

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Causes of Death for Newborns

Possible causes of death in newborns can be divided into natural and accidental occurrences, negligence, and violence.

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Natural and Accidental Causes

Natural and accidental causes of death in newborns include immaturity, congenital malformations, complications during labor (difficult or precipitate), and other health issues.

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Sudden Infant Death Syndrome (SIDS)

A sudden and unexpected death of an infant where a thorough autopsy cannot find a clear cause.

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Infanticide

The act of killing a newly born infant by a parent or guardian. This involves intentional harm.

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Negligence (Act of omission) in Infanticide

A type of infanticide where the infant's death is caused by negligence or an omission of care.

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Violence (Act of commission) in Infanticide

A type of infanticide where the death results from intentional acts of violence against the infant.

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SIDS: Diagnosis of Exclusion

A diagnosis of exclusion, meaning it can only be concluded after ruling out all other possible causes of death.

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Role of Forensic Pathologist in Infanticide

The main role of a forensic pathologist in an infanticide case is to determine the exact cause of death of the infant.

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SIDS: Age Range

Sudden Infant Death Syndrome is most common in infants between 2 weeks and 2 years old.

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SIDS: Preponderance and Season

Sudden Infant Death Syndrome is more common in males and in the colder months of the year.

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Determining if a baby has taken a breath after birth

The process of determining if a baby has taken a breath after birth. This is a critical evaluation in infanticide cases to establish whether the baby was born alive.

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Lung Weight Test

The process of measuring the weight of the lungs to estimate if the baby has breathed. Non-respired lungs weigh approximately 40 grams, while respired lungs weigh around 80 grams.

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Hydrostatic Test (Lung Floatation Test)

The process of using the buoyancy of lungs in water to assess if the baby has breathed. Respired lungs are less dense and tend to float, while non-respired lungs sink.

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Stomach-Bowel Test

The process of examining the stomach and intestines to determine if air has entered the digestive system after birth. Air swallowed during the first breaths can move through the digestive tract.

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Floatation of the lungs

A sign that the infant has taken a breath after birth, demonstrated by the lungs having a lower specific gravity and tending to float in water.

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Sinking of the lungs

A sign that the infant has not taken a breath after birth, demonstrated by the lungs being denser and sinking in water.

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Floatation of the Stomach, Duodenum & Upper Intestines

A sign that the infant has lived for at least 3 hours, indicated by the stomach, duodenum, and upper intestines floating in water.

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Floatation of All Parts of the Digestive Tract

A sign that the infant has lived for at least 6 hours, indicated by all parts of the digestive tract (stomach, duodenum, and intestines) floating in water.

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What are the four main types of Child Abuse?

Child Abuse is categorized into four main types: Physical, Sexual, Emotional, and Neglect. Each type involves harm to a child's well-being, whether it's through direct injury, exploitation, emotional damage, or failure to provide basic needs.

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Define Child Physical Abuse (CPA).

Child Physical Abuse involves repeated intentional injury inflicted on a child by a caregiver or watcher. This includes acts that cause physical pain, injury, or suffering.

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When is the Hydrostatic test not necessary?

The Hydrostatic test is not necessary in a foetus that is considered a monster, a macerated foetus, or a foetus where the umbilical cord has separated and a scar has formed.

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What is Child Neglect?

Neglect is the failure to provide basic needs for a child's survival and well-being, such as food, shelter, clothing, medical care, and emotional support.

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Define Infanticide.

Infanticide is the intentional killing of a newly born, live-born, and viable infant. Only the mother can benefit from this legal distinction, and the child must be under one year old.

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What is Shaken Baby Syndrome?

Shaken Baby Syndrome is a severe form of CPA caused by violent shaking, which can lead to brain damage, internal bleeding, and even death.

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What is Child Sexual Abuse?

Child Sexual Abuse involves any sexual act, exploitation, or abuse of a child, including indecent exposure, sexual assault, and sexual exploitation.

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What is Child Emotional Abuse?

Emotional Abuse involves actions or omissions by caregivers that cause emotional harm to a child. This can include verbal abuse, threats, intimidation, and other forms of psychological manipulation.

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Study Notes

Child Abuse

  • Child abuse encompasses physical, sexual, emotional (psychological), and negligence.

Child Physical Abuse (CPA)

  • Definition: Repeated willful injury of a child by inadequate parents, guardians, or caretakers.
  • General Features: Repeated injuries (different ages, sites, and patterns), delay in seeking medical assistance, multiple hospital visits for treatment of injuries, inconsistent explanations for the injuries.
  • Injuries:
    • External: Multiple bruises of varying colors, burns (cigarette burns, hot water), multiple fractures (limbs, ribs, skull), retinal and vitreous hemorrhages, torn frenulum, visceral injuries.
    • Internal: Bruising, burns, fractures, subdural and retinal hemorrhages, cerebral trauma, axonal damage. Note negative external findings don't exclude abuse.
  • Head injuries are the most frequent cause of death in child abuse (direct trauma or shaking/shaken baby syndrome).

Infanticide

  • Definition: Deliberate killing of a newly born, live-born, and viable infant.
  • Importance notes:
    • Only the mother can benefit from this alternative to murder.
    • The child must be less than one year old, although the majority of cases occur within hours or minutes of birth.
    • The child must be viable (the end of the 7th intrauterine month).
    • The death must result from a willful act of omission or commission.

Role of Forensic Pathologist in Infanticide Cases (MLI)

  • Assist in identifying the child and mother (unknown or suspected).
  • Estimate child's maturity and viability.
  • Determine if the child was born alive or stillborn (non-medical or medical evidence).
    • Changes at umbilical cord (1 day after: ring of hyperemia, 2 days after: ulceration begins),
    • Desquamation of skin
    • well-formed stools
    • absence of maceration.
  • Estimate the period of survival.
    • Changes in the skin/umbilical cord/vessels
    • Obliteration of the ductus arteriosus, closure of foramen ovale
  • Determine the cause of death.
    • Natural or accidental causes (e.g., immaturity, congenital malformations), negligence, violence.
    • Violence types: cut throat, stab wounds, blunt force trauma, asphyxia, poisoning.

Sudden Infant Death Syndrome (SIDS)

  • Definition: Unexpected sudden death of an infant, with no clear cause found on autopsy or scene examination.
  • Etiology: Unknown, but possible factors include: Overlaying, Infections, Allergies, Respiratory/cardio issues, Hypernatremia, Neurological issues, Poisoning, Temperature Fluctuations.
  • Main features: Peak age range is 2 weeks to 2 years, with a peak at 2-3 months. Slight male preponderance. More common in colder/wetter months; in poor housing/low occupational status; Greater incidence in one twin.
  • Autopsy: SIDS is a diagnosis by exclusion, ruling out all other causes.
  • MLI: Exclude fatal child abuse, counseling of parents.

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