Observational study revealed key roles of histological examination in forensic evaluations of stillbirth, indicating the need for improved methodologies.
Background: The methodology for conducting verification activities and investigating crimes related to poor-quality medical care in obstetrics by investigative bodies of the Russian Federation includes the appointment of commission forensic medical examinations. Carrying out a forensic histological examination of archival autopsy material and the placenta is an important stage of commission forensic medical examinations based on case materials in cases of intrauterine fetal death. Aim: to study the features of conducting commission forensic medical examinations in cases of stillbirth and to clarify the need for forensic histological examination of archival autopsy material and the placenta from a modern scientific standpoint. Materials and methods: an observational single-center retrospective selective cross-sectional study was conducted on the basis of the archive of the department of complex examinations of the State Healthcare Institution of the Stavropol Territory "Regional Bureau of Forensic Medical Examination". The study included commission forensic medical examinations in cases of intrauterine fetal death (n = 68) for the period from 01.01.2015 to 31.12.2022. Results: During the analyzed period, out of 68 (100%) commission forensic medical examinations in cases of stillbirth, 54 (79.4%) were appointed by investigators of the Investigative Committee, 11 (16.2%) - by investigators/inquiry officers/operational officers of the Ministry of Internal Affairs departments, 3 (4.4%) - by judges. In most cases, the appointment of examinations of this category was carried out within the framework of verification materials - 59 observations (86.7%). The cause of stillbirth was antenatal fetal death - 39 cases (57.4%), intranatal fetal death - 27 (39.73%), congenital developmental anomalies - 2 (2.9%). During the commission examinations of intrauterine fetal death in the State Budgetary Healthcare Institution of the Stavropol Territory "Regional Bureau of Forensic Medical Examination", in 66 cases (97.1%), forensic histological examination of autopsy material and placenta was carried out by histology experts. Conclusion. The analysis showed that among the commission forensic medical examinations of the obstetric and gynecological profile, the share of examinations in cases of stillbirth was 39.1%. In order to improve the quality of examinations in this category, it is necessary to conduct a forensic histological study of autopsy material and placenta.
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Margarita Berlay (2025) studied this question.