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MCQ – 93498

Question

During an autopsy of a fetal death case, what is the correct order of examination to differentiate between live birth and stillbirth?

A.

Abdomen > Head > Thorax

B.

Thorax > Head > Abdomen

C.

Head > Abdomen > Thorax

D.

Head > Thorax > Abdomen

Show Answer

Correct Answer » A

Explanation

  • In fetal autopsy for differentiation of live birth and stillbirth, the abdomen is opened first.
  • This is done to examine the level of the diaphragm before the thoracic cavity is disturbed.
  • If the infant has breathed:
    • Lungs expand
    • Diaphragm descends
  • If stillborn:
    • Lungs remain collapsed
    • Diaphragm remains high
  • After abdomen, the head and then thorax are examined.

Differentiation of Live Birth vs Stillbirth

Important findings:

  • Hydrostatic lung test
  • Position of diaphragm
  • Presence of air in stomach/intestine
  • Middle ear aeration

Diaphragm Position

  • Live birth:
    • Diaphragm lower due to expanded lungs
  • Stillbirth:
    • Diaphragm higher because lungs are unexpanded

Hydrostatic Test

  • Lungs float → child breathed
  • Lungs sink → no respiration
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