: Forensic medical autopsy in cases of violent death of newborns: a look at physical abuse

Abstract

Abstract

Introduction: Child abuse is one of the main causes of death in children under one year
of age and poses a serious challenge for forensic medicine to differentiate between an
intentional cause of death versus an accidental one.

Objective: To describe the main findings in the forensic medical evaluation of newborns from an approach that focus on child abuse as a cause of death.

Results: A total of 41 articles were included for review. External injuries in case of abuse
are distributed in the eyes, lips, oral mucosa, nose, posterior thorax, posterior and lateral
aspect of the thighs and soles of the feet. The fractures with the highest specificity for
child abuse are: metaphyseal fractures, lateral and posterior fractures of the ribs, fractures of the sternum, scapula, and vertebral articular processes. Subdural hemorrhage,
hypoxic ischemic encephalopathy, and retinal hemorrhages are the most frequent organic lesions.

Conclusions: Skin, soft tissue and bone lesions have a common distribution in cases of
child abuse and have proven to be useful in forensic medical evaluation.