Infanticide Practice Questions

Q: Spalding sign is seen in ?

Maceration. ***Maceration*** - **Spalding sign** is a classic radiological finding in **intrauterine fetal death**, characterized by the **overlapping of fetal skull bones** due to liquefaction of the brain and loss of structural support. - This sign typically appears **7-10 days after fetal demise** and is a hallmark of **maceration**, the aseptic autolysis of a dead fetus retained in utero in the presence of amniotic fluid. - Maceration involves softening and peeling of skin, reddish discoloration, and progressive tissue breakdown in a **moist intrauterine environment**. *Mummification* - **Mummification** is an alternative form of fetal death in utero that occurs in **dry conditions** (typically in twin pregnancies where one twin dies and amniotic fluid is absent). - The fetus becomes **desiccated, shriveled, and preserved** rather than undergoing liquefaction. - Spalding sign is **not seen** in mummification because the skull remains intact without liquefactive changes. *Drowning* - **Drowning** is death by suffocation in a liquid medium and is unrelated to intrauterine fetal pathology. - Not associated with Spalding sign, which is specific to retained dead fetus in utero. *Starvation* - **Starvation** refers to severe nutritional deprivation leading to wasting and organ failure. - Not associated with specific radiological signs of fetal death like Spalding sign.

Q: What is the Hydrostatic test used for?

To determine if lungs have breathed air. ***To determine if lungs have breathed air*** - The **hydrostatic test (Glaister's test)** is a classical forensic test used to determine if a newborn was **born alive** (live birth) or dead (stillbirth). - The test involves placing fetal lung tissue in water: if it **floats**, the lungs contain air, indicating the baby **breathed after birth**; if it **sinks**, the lungs are airless (atelectatic), suggesting stillbirth. - This is the **primary medicolegal purpose** of the test in cases of suspected infanticide or disputed live birth. - The test has **four stages**: floating of the entire lung mass, individual lung pieces, small lung fragments, and lung tissue when squeezed between fingers. *To assess lung maturity* - The hydrostatic test does NOT assess **developmental maturity** of lungs (gestational age or surfactant production). - Lung maturity is evaluated by tests like the **lecithin/sphingomyelin (L/S) ratio** or **phosphatidylglycerol presence** in amniotic fluid. - While a mature lung is capable of aeration, the hydrostatic test specifically detects **respiration**, not maturity. *To measure lung capacity* - **Lung capacity** refers to specific volume measurements (vital capacity, tidal volume, etc.) obtained through **spirometry** in living individuals. - The hydrostatic test is a **qualitative forensic test**, not a quantitative pulmonary function measurement. *To detect lung infections* - **Lung infections** are diagnosed through **microbiological cultures**, imaging (chest X-ray/CT), and histopathology. - While infection/pneumonia could theoretically alter lung density, this is NOT the purpose of the hydrostatic test. - The test is about **aeration status** for medicolegal determination of live birth, not infection detection.

Q: Which of the following tests is NOT used in the medico-legal investigation of suspected infanticide?

Widal test. ***Widal test*** - The **Widal test** is a serological test used to diagnose **typhoid fever** by detecting antibodies against *Salmonella typhi* antigens, not for infanticide. - It assesses the presence of **O and H agglutinins** in the patient's serum after exposure to the bacteria. *Ploucquet test* - The **Ploucquet test** assesses the **weight of the lungs** relative to the total body weight to determine if the infant has breathed. - In a stillborn infant, the ratio of lung weight to body weight is typically lower than in a liveborn infant who has breathed. *Fodere's test* - **Fodere's test**, also known as the **gastrointestinal air test**, examines the presence of air in the **gastrointestinal tract** of an infant. - The presence of air indicates that the infant has **breathed and swallowed**, suggesting live birth. *Hydrostatic test* - The **hydrostatic test** (or lung float test) involves placing the infant's lungs in water to determine if they **float or sink**. - **Floating lungs** indicate the presence of air, suggesting the infant took a breath, while **sinking lungs** suggest no respiration.

Q: Caput succedaneum indicates that the fetus was alive until which point?

Immediately after birth. ***Immediately after birth*** - **Caput succedaneum** is a benign condition characterized by a **diffuse, edematous swelling** of the fetal scalp, crossing suture lines. - It results from pressure on the fetal head during vertex delivery, causing **extravasation of fluid** into the subcutaneous tissue, indicating the fetus was alive and circulating blood until birth. *Till 2-3 days after birth* - This option is incorrect because **caput succedaneum** is a direct consequence of the **birthing process** itself, forming during labor and delivery. - The presence of this scalp swelling signifies that the baby was alive and experienced the forces of birth, not that it survived for several days afterward. *2-3 weeks after birth* - This option is incorrect as **caput succedaneum** typically resolves within a few days of birth. - Its presence is a temporary finding related to the immediate perinatal period and does not indicate survival for several weeks. *2-3 months after birth* - This option is incorrect because **caput succedaneum** is a transient condition appearing at birth and usually disappearing within a few days. - It has no implication for the baby's survival beyond the immediate postnatal period, let alone for several months.

Q: Which of the following is NOT a finding in a dead-born fetus?

Caput succedaneum. ***Caput succedaneum*** - **Caput succedaneum** is a swelling on the baby's scalp that is present at birth, caused by pressure during a vaginal delivery. It is a sign of a **live birth** and indicates that the birth canal compressed the baby's head, leading to localized edema. - Since it is a result of forces experienced during the process of a live delivery, its presence would indicate that the fetus was **alive at the time of delivery**, not dead-born. *Spalding's sign* - **Spalding's sign** refers to the overlapping of the fetal skull bones (sutures) visualized on ultrasound or X-ray, which occurs due to **liquefaction of the brain** after fetal death and subsequent collapse of the skull. - This sign is a reliable indicator of **intrauterine fetal demise** and often appears within a week of death. *Robe's sign* - **Robe's sign** (also known as Robert's sign) describes the presence of **gas in the fetal circulatory system** or abdominal cavity, visible on X-ray or ultrasound. - This gas is produced by **bacterial decomposition** of the fetal tissues after death, making it a definitive sign of fetal demise, usually seen several days after death. *Maceration* - **Maceration** is the softening, discoloration (reddish-brown to black), and eventual aseptic autolysis of fetal tissues, especially the skin, that occurs when a fetus dies in utero and remains there. - The degree of maceration is directly related to the **duration of fetal death**, with more severe changes indicating a longer time since death.

Q: A neonate born at home is found dead with skull base fracture, depressed temporal bone fracture, and brain contusions. What is the most likely manner of death?

Homicide. ***Homicide*** - The combination of **skull base fracture**, **depressed temporal bone fracture**, and **brain contusions** in a neonate strongly indicates **non-accidental trauma** (infanticide) - These are **high-energy injuries** requiring **forceful impact**, incompatible with normal birth trauma or typical handling - The pattern of multiple severe traumatic injuries points to **intentional harm** *Natural causes* - Natural infant deaths result from congenital anomalies, infections, or genetic disorders - **Traumatic skull fractures** and **brain contusions** are not manifestations of natural disease processes *Undetermined* - Used when insufficient evidence exists to classify the manner of death - The **specific pattern of severe traumatic injuries** provides clear evidence of non-natural violent death, making this classification inappropriate *Accidental death* - Normal birth trauma may cause minor injuries (cephalohematoma, linear skull fractures) - The presence of **multiple severe fractures** (skull base + depressed temporal bone) with **brain contusions** exceeds the injury pattern of accidental birth trauma or postnatal accidents - Such extensive injuries in a neonate indicate intentional violence rather than accident

Question 1

Spalding sign is seen in ?

Accepted Answer

Maceration

Answer

Drowning

Answer

Mummification

Answer

Starvation

Question 2

What is the Hydrostatic test used for?

Accepted Answer

To determine if lungs have breathed air

Answer

To detect lung infections

Answer

To assess lung maturity

Answer

To measure lung capacity

Question 3

Which of the following tests is NOT used in the medico-legal investigation of suspected infanticide?

Accepted Answer

Widal test

Answer

Ploucquet test

Answer

Fodere's test

Answer

Hydrostatic test

Question 4

Caput succedaneum indicates that the fetus was alive until which point?

Accepted Answer

Immediately after birth

Answer

Till 2-3 days after birth

Answer

2-3 weeks after birth

Answer

2-3 months after birth

Question 5

What is the primary role of a forensic medical examiner in cases involving a 'supposed child' in medico-legal practice?

Accepted Answer

To determine whether the child was born alive or was stillborn

Answer

To estimate the gestational age of the deceased infant

Answer

To conduct DNA paternity testing in disputed parentage cases

Answer

To investigate child abuse or neglect in living children

Question 6

Which of the following is NOT a finding in a dead-born fetus?

Accepted Answer

Caput succedaneum

Answer

Spalding's sign

Answer

Robe's sign

Answer

Maceration

Question 7

A neonate born at home is found dead with skull base fracture, depressed temporal bone fracture, and brain contusions. What is the most likely manner of death?

Accepted Answer

Homicide

Answer

Natural causes

Answer

Undetermined

Answer

Accidental death

Infanticide — MCQs

Infanticide — MCQs

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