Condition after hanging ICD 10. Signs of strangulation white and blue asphyxia. Types of mechanical asphyxia

45.2. General asphyxial signs during internal examination of a corpse

Each type of mechanical asphyxia can be the result of either murder, suicide or an accident.

Chapter 46. Hanging

46.1.Mechanism of compression of the neck organs

Of all types of mechanical asphyxia, hanging accounts for 60%.

Hanging is a type of mechanical asphyxia in which compression of the neck organs with a noose occurs under the influence of the weight of the entire body or its parts.

There is a complete hanging - free hanging of the body and incomplete - having a fulcrum.

46.2. Loops and their types, options for location on the neck

Loops are divided according to the characteristics of the material from which the loop is made: rigid (chain, wire, cable, etc.), semi-rigid (belt, rope, etc.), soft (towel, tie, scarf, etc.), combined (from various materials with soft lining).

By design: closed sliding, when the loop is tightened through the knot under the weight of the body or its parts; closed, stationary, when the knot is tied in such a way that free sliding of the material from which the loop is made is excluded; open loops when the knot is missing.

By number of moves: single, double, multiple.

The location of the node can be anterior, posterior and lateral. The posterior position of the node is considered typical, while the posterior and lateral positions are considered atypical.

When hanging, in some cases there may be no loop, and compression of the neck organs occurs with various blunt hard objects: the back of a chair, bed, rung of a ladder, fork of tree branches, etc.

46.3. Strangulation groove, its description

A strangulation groove is a mark caused by compression of a loop or a blunt hard object on the skin of the neck. The groove is formed by the pressure of the loop material on the skin and underlying tissue. The surface layers of the skin (epidermis) are peeled off; after removing the loop, the damaged areas of the skin quickly dry out and become thicker.

The severity of the strangulation furrow depends on the material from which the loop is made and the degree of damage to the surface layers of the skin (epidermis). A hard loop always forms a deep groove, a semi-rigid one is deeper than a soft one with well-defined boundaries, a soft one produces a strangulation groove that is weakly expressed with unclear boundaries and differs little from the usual color of the skin.

When describing the strangulation groove, indicate its localization (in which part of the neck), the structure of the groove (single, double, etc.), display of the relief of the material, closed or open (in the area of ​​the occipital protuberance) direction, width, depth, density, features of the edges and the bottom of the groove, the presence or absence of hemorrhages in the area of ​​the groove and its other individual characteristics and properties.

46.4. Signs of hanging when examining a corpse:

46.4.1. During an external examination of a corpse in the case of hanging, along with general asphyxial signs, there may be pinching of the tip of the tongue between the teeth and its protrusion from the oral cavity.

Features of the strangulation groove during hanging:

When hanging in a vertical position, cadaveric spots are located on the lower parts of the body, limbs and hands.

On the skin of a corpse, in addition to the strangulation groove, various damage is possible that could have occurred during the period of convulsions and they must be distinguished from damage that could have occurred as a result of struggle and self-defense.

If the loop tightly covers the neck, then the strangulation groove will be closed; when hanging in a horizontal or semi-horizontal position, the strangulation groove can be horizontal.

46.4.2. During internal examination of a corpse

Hemorrhages in the subcutaneous fatty tissue and neck muscles along the strangulation groove, in the internal legs of the sternocleidomastoid muscles of the neck, fractures of the cartilages of the larynx and horns of the hyoid bone, transverse ruptures of the inner lining of the carotid arteries (Ammus sign) and general asphyxial signs characteristic of internal examination corpse.

46.5. Intravital and postmortem strangulation furrow

The strangulation groove can also form postmortem, i.e. when a corpse is hung up to hide the traces of a crime. Therefore, it is important to establish whether the strangulation groove has intravital or postmortem origin.

A lifetime strangulation groove has intradermal hemorrhages along the strangulation groove (usually in the bottom, lower edge and intermediate ridge), hemorrhages in the subcutaneous tissue, and neck muscles according to the course of the strangulation groove.

The postmortem strangulation groove is pale, weakly expressed, there are no hemorrhages in the area of ​​the strangulation groove.

Hanging is the most common method of suicide; hanging during a murder occurs extremely sharply in investigative and expert practice; hanging as a result of an accident is observed in 1% of cases of the total number of hangings; simulated hanging is hanging a corpse to conceal a murder.

Chapter 47

47.1. Compression mechanism of the neck organs

Strapping with a noose is squeezing the organs of the neck into a noose by tightening it with an outside force or with any devices (mechanisms, for example moving parts of machines, etc.).

Most often, tightening occurs with the hand of an outsider, but the loop can also be tightened with one’s own hand, for example, using a twist. On the neck of the corpse, as in the case of hanging, there will be a strangulation groove.

47.2. Signs of strangulation with a loop during external and internal examination of a corpse, features of the strangulation groove

During an external examination of a corpse in the case of strangulation with a loop, along with general asphyxial signs, the features of the strangulation groove are important.

Features of the strangulation groove in case of strangulation with a loop:

Has the same signs of survival as in the case of hanging.

In addition, upon external examination of the corpse, there may be injuries on the face, neck, and other parts of the body (traces of struggle and self-defense).

During an internal examination of a corpse, there are more often fractures of the cartilage of the larynx and hyoid bone, hemorrhages in the soft tissues according to the fractures, hemorrhages in the soft tissues according to the course of the strangulation groove and general asphyxial signs.

By the type of violent death, strangulation with a noose is most often murder. Accidents often occur when loose parts of clothing (tie, scarf) get caught in rotating mechanisms. Suicide rarely occurs, for example, when tightening a loop with a twist, the handle of a spoon, etc.

Chapter 48. Issues resolved by forensic medical examination in the case of hanging or strangulation with a noose

2. Was there a hanging or strangulation in this case?

3. Was the strangulation groove formed during life or after death?

4. What are the features of the loop?

5. In what position of the body did the hanging occur?

6. How long was the corpse in the noose?

7. Are there other injuries on the corpse, their nature, location, mechanism and age of formation?

8. Did the victim drink alcohol shortly before death?

Chapter 49

49.1. The mechanism of compression of the neck organs by hands

Compression is most often applied to the fingers and hands, less often to the forearm and shoulder. Compression of the neck with the fingers can be in any mutual position of the victim and the attacker, with the forearm when pressing the neck of a lying person, or by grabbing when the attacker is positioned from behind. In the latter position, the neck may be compressed between the shoulder and forearm.

Neck compression can be done with one hand, usually from the front, or with two hands, usually applied from the back.

Death occurs from compression of the carotid arteries, veins and nerves or from reflex cardiac arrest.

49.2. Signs during external and internal examination of a corpse in case of manual strangulation

Signs indicating compression of the neck by fingers are small grouped bruises, arched, crescent-shaped, short strip-like abrasions. Abrasions are formed from the protruding ends of the nail plates due to pressure or sliding of the nails. Often abrasions are located against the background of bruises or limit them on one side.

The location of abrasions and bruises, the direction of the convexity of the arches depends on the ratio of the length of the fingers and the circumference of the neck, the position of the attacker relative to the victim (front, back). The number of injuries to the neck depends on whether the compression was single or multiple, with one or two hands.

By the quantitative ratio of abrasions and bruises on different surfaces of the neck, one can sometimes judge which hand squeezed the neck - the right, left, or both hands at the same time.

When the neck is compressed with the fingers of the right hand, the main damage is located on the left side of the neck. If the strangulation was carried out with the left hand, then the main damage will be located on the right side of the neck. When compressed with both hands, there are lesions on the skin of both anterolateral surfaces of the neck.

When you put pressure on a baby's neck with your hands, if the attacker's hands were applied from the front, abrasions and bruises are located on the back of the neck, since there is almost complete closure of the fingers.

When pressing with gloved hands or through some soft object, no damage may form on the skin of the neck, or deposits of an indeterminate shape may occur, most often in the projection of the cartilage of the larynx. The same is observed when the neck is compressed between the forearm and shoulder. In these cases, it is possible to establish the fact of neck compression only through internal examination by extensive hemorrhages in the muscles, fractures of the hyoid bone, cartilage of the larynx, and trachea.

During an external examination of a corpse in the case of manual strangulation, in addition to injuries in the neck area, there will be general asphyxial signs.

In case of manual strangulation, internal examination reveals more significant damage than external examination. In the soft tissues of the neck there are extensive hemorrhages, hemorrhages in the area of ​​the root of the tongue, fractures of the hyoid bone, laryngeal cartilage and, less commonly, tracheal rings. As with any other type of mechanical asphyxia, general asphyxia signs.

By the nature of violent death, strangulation by hand is always murder. Resistance may cause various injuries to the victim's body. More typical are injuries in the occipital region that occur when the back of the head is pressed against hard objects. In addition, there may be abrasions, bruises, rib fractures, and liver ruptures when the chest is compressed by the attacker’s knee while pressing the body to the ground or floor.

Suicide by self-strangulation with hands is impossible, since the person quickly loses consciousness and the muscles of the hands relax.

49.3. Issues resolved by forensic medical examination in the case of manual strangulation

1. Are there any injuries on the neck of the corpse that are characteristic of squeezing the neck with hands, what are their location and characteristics? Was death really caused by strangulation by hand?

2. What is the mechanism and duration of formation of these lesions?

3. Did you squeeze your neck with one (right or left) or two hands?

4. How were the victim and the attacker positioned in relation to each other at the moment of compression of the neck?

5. Are there other injuries, what is their nature, location, mechanism and age of formation?

6. Did the victim drink alcohol shortly before his death?

Chapter 50. Compression of the chest and abdomen (compression asphyxia)

50.1. Conditions that cause compression of the chest and abdomen

The circumstances under which compression of the chest and abdomen occurs are very diverse. Many cases of death in unorganized crowds have been described.

There are frequent cases of death as a result of compression of the chest and abdomen during landslides, landslides of soil, sand, coal, in quarries or trenches, in snow avalanches, in mines. A large number of people die during earthquakes, hurricanes, due to the destruction of buildings, falling poles, trees and other heavy objects. Often occurs when vehicles roll over.

More often, cases of compression asphyxia occur in industrial conditions when a car or other vehicles, various machines and mechanisms, building structures are overturned, or victims are covered with earth, sand and other substances.

In the vast majority of cases, death from compression of the chest and abdomen is an accident, but there are cases of murder and suicide.

Compression of the chest and abdomen with heavy blunt objects leads to limitation or complete cessation of respiratory movements and a sharp disruption of the cardiovascular system.

Death occurs only with compression of the chest or simultaneous compression of the abdomen; compression of only the abdomen for a long time (60 minutes) is not accompanied by serious dysfunction of internal organs and does not lead to death.

The severity of signs of mechanical asphyxia depends on the strength and duration of compression.

50.2. Signs of compression asphyxia during external and internal examination of a corpse

During external examination of a corpse:

During internal examination of a corpse:

Compression of the chest and abdomen, especially by massive blunt objects, is accompanied by the formation of mechanical damage to soft tissues, bones of the chest (the most common damage to the ribs), and damage to internal organs.

In the presence of mechanical damage caused by the compression mechanism (fractures of ribs, other bones, damage to internal organs), the forensic expert has to carry out a differential diagnosis between compression asphyxia and blunt trauma. In this case, the circumstances of the incident and the identification of general asphyxia signs are taken into account; signs characteristic of compression of the chest and abdomen; analysis of detected mechanical damage to soft tissues, skeletal bones, internal organs and assessment of their role in the cause of death.

50.3. Issues resolved by forensic medical examination for compression asphyxia

1. What is the cause of death? Did death occur from compression of the chest and abdomen by any heavy objects, earth, etc.?

2. Intravital or postmortem damage discovered during examination of the corpse?

3. What injuries were discovered during the examination of the corpse, what is their nature, location, mechanism and age of formation?

4. Did the victim drink alcohol shortly before death?

Chapter 51. Closing the airways and passages

Mechanical asphyxia from the closure of the respiratory openings and tracts is often called obstructive or suffocation. Depending on the conditions and circumstances of the incident, the following are distinguished: closing the openings of the mouth and nose; closure of the airway lumen with foreign objects; closing the airway lumen with loose objects; closure of the airway with liquids (drowning).

51.1. Closing the openings of the mouth and nose

It is rare in forensic practice and is carried out by pressing any soft object: a pillow, scarf, handkerchief or the open palm of a person. As a rule, strangulation in this way occurs in people who are unconscious, in weakened patients, while intoxicated, during sleep, as well as newborn children.

Choking from covering the mouth and nose can also occur as a result of an accident in people who are highly intoxicated while lying face down on a pillow or other soft object. The same death can occur in patients with epilepsy during a seizure, or in newborn children.

The presence and severity of damage when closing the openings of the nose and mouth depend on the characteristics of the object; soft objects (pillow, scarf, etc.) may not leave visible damage on the skin of the face.

51.1.1. Signs during external examination of a corpse.

At the same time, when covering the nose and mouth with one’s hand, damage to the nails and fingertips almost always occurs in the form of abrasions and bruises. On the mucous membrane of the lips, especially on their inner surface, on the gums you can find bruises, abrasions, wounds of the mucous membrane from pressing the lips to the teeth, from getting fingers into the oral cavity.

In cases of gross violence, which can occur with sharp resistance from the victim, teeth can also be damaged.

Prolonged pressing of the face against any object, even a soft one, may be accompanied by a flattening of the nose, lips, and a pale color of the skin in this area compared to the bluish color of the surrounding skin.

In the oral cavity, pharynx, trachea, large bronchi, foreign particles can be found (feathers from a pillow, fluff, hairs of wool, lumps of cotton wool, scraps of thread, etc.)

With this type of mechanical asphyxia, air access to the respiratory tract is stopped, death occurs within 5-7 minutes.

51.1.2. During an internal examination, in addition to the general sharp venous congestion of the internal organs, multiple pinpoint hemorrhages under the outer membranes of the lungs and heart, hemorrhages in the mucous membrane of the respiratory tract are sometimes detected.

51.2. Closure of the airways by foreign objects

The entry of pieces of food into the respiratory tract usually occurs in adults, and often occurs in a state of alcohol intoxication.

Death may not occur immediately.

A wide variety of objects, in terms of hardness and size, can get into the lumen of the respiratory tract: coins, buttons, pieces of food, medicine tablets, bean grains, parts of children's toys, dentures, soft objects, etc.

Soft objects (gags) are inserted into the victim's mouth, closing the oral cavity to the back of the throat.

A gag can also be a hard object (bottle, corks, etc.).

During play, laughter, crying, coughing, such an object enters the respiratory tract, reaches the glottis, descends to the bifurcation (division of the trachea into 2 large bronchi) and even enters individual bronchi.

This type of mechanical asphyxia occurs much more often, especially in childhood.

The entry of pieces of food into the respiratory tract usually occurs in adults and often occurs in a state of alcoholic intoxication.

Death can occur from reflex cardiac arrest, occurring within a few seconds, and death may occur with the usual course of respiratory failure, occurring within 4-5 minutes. In some cases, foreign bodies that enter the respiratory tract may remain there for a number of years, causing severe purulent complications requiring surgical intervention.

Signs during examination of a corpse

Closure of the airway lumen by foreign objects is easily recognized during a forensic medical examination of a corpse.

A gag in the mouth and pharynx is detected during external examination of the corpse. When a gag is inserted with great force, tears and ruptures of the mucous membrane of the vestibule and oral cavity, and tooth fractures can occur.

Foreign bodies in the larynx, trachea, and bronchi are detected during internal examination of the corpse. In most cases, they were found in the area of ​​the entrance to the larynx and in its lumen between the vocal folds. Complete blockage of the lumen of the larynx with a large piece of food or other object, as a rule, leads to atelectasis (collapse) of the lungs.

In addition, when examining a corpse in the event of the lumen of the respiratory tract being closed by foreign objects, characteristic general asphyxial signs are found both during external and internal examination of the corpse.

Closure of the airways by a foreign body most often occurs accidentally - an accident.

Homicide by insertion of foreign bodies is rare and usually occurs as infanticide; Only in some cases does the killing of adults who were intoxicated occur, or when the victim is tied up and a gag is inserted into the mouth.

Suicide by introducing foreign bodies into the oral cavity and pharynx is observed in mental patients and occurs in psychiatric hospitals.

51.3. Closure of the airway lumen with bulk substances, gastric contents, blood (aspiration asphyxia)

Occurs in 10% of cases of all types of mechanical asphyxia.

Aspiration (blockage) of the respiratory tract with bulk substances (cement, sand, peat, small slag, flour, grains).

Aspiration of gastric contents and blood, as a rule, complicates the course of various diseases, pathological conditions and injuries - alcohol intoxication, epilepsy, traumatic brain injury, etc., which are accompanied by loss of consciousness or loss of sensitivity of the mucous membrane of the respiratory tract. Aspiration of gastric contents is especially common during severe alcohol intoxication, which reduces the sensitivity of the respiratory tract, up to the complete suppression of protective reflexes (cough, etc.), as a result of which food masses are aspirated into the respiratory tract and easily penetrate the trachea, bronchi, reaching the alveoli.

With deep penetration of gastric contents, the lungs become swollen, lumpy, sunken areas of the lung tissue are dark red in color, and bulging areas are light gray in color. On the surface of the cut, particles of gastric contents protruding from the bronchi are visible (they are especially noticeable when pressing on the cut lung). The contents of the stomach can enter the respiratory tract posthumously - due to inept resuscitation measures, rough manipulations with the corpse, and sometimes due to pronounced putrefactive changes. However, there are few gastric contents, they do not penetrate deeper than the larynx and the upper part of the trachea, and their presence throughout the respiratory tract to the small bronchi and alveoli indicates their active penetration during life.

Aspiration of blood occurs with nosebleeds, traumatic brain injury with fractures of the base of the skull, when the victim is unconscious. Blood is in the respiratory tract, reaching the alveoli.

When examining a corpse, loose bodies are found on clothing, the face, and they fill the nasal passages and oral cavity. Due to involuntary respiratory movements, sand and grains often penetrate the esophagus and stomach. A large number of loose bodies are found in the respiratory tract, which can be located all the way to the alveoli.

During aspiration of bulk substances, gastric contents, and blood, external and internal examination of the corpse reveals characteristic general asphyxial signs.

The main feature of the internal examination of a corpse in case of suspected death from the lumen of the respiratory tract due to foreign bodies, gastric contents, or granular substances is the opening of the lumen of the larynx, trachea and large bronchi on the spot, before removing the organ complex.

Due to the nature of violent death, the closure of the airway lumen with bulk substances, gastric contents, or blood is usually an accident.

51.4. The main issues resolved by forensic medical examination when closing the openings of the mouth, nose, and respiratory tract

1. Did death occur from the closure of the openings of the nose and mouth?

2. Did you use your hands to close the openings of the mouth and nose with any objects (what damage was found on the face)?

3. Did death occur due to the closure of the respiratory tract by any objects and what kind of objects?

4. If foreign bodies are detected in the respiratory tract, determine whether they were introduced during life or after death?

5. Is there evidence of insertion of a foreign object by an outside hand?

6. Are there any injuries that indicate possible struggle and self-defense?

7. Did the victim drink alcohol shortly before the death?

Chapter 52. Drowning

Drowning is a special type of mechanical asphyxia, which occurs when the body is completely or partially immersed in a liquid medium (usually water) and proceeds differently depending on the conditions of the incident and the characteristics of the victim’s body.

The medium of drowning is most often water, and the scene of the incident is natural bodies of water (rivers, lakes, seas), into which the human body is completely immersed. Drowning occurs in small shallow bodies of water (ditches, streams, puddles), when liquid covers only the head or even only the face of the deceased, who is often in a state of severe alcohol intoxication. Drowning can occur in limited containers (baths, barrels, tanks) filled with water or other liquid (gasoline, oil, milk, beer, etc.).

52.1. Types of drowning

Drowning is divided into aspiration (true, wet), asphyxial (spastic, dry) and syncope (reflex).

True (aspiration drowning) is characterized by the obligatory penetration of water into the lungs with its subsequent entry into the blood, and occurs in 65-70% of cases.

In the spastic (asphyxial) type of drowning, due to water irritation of the respiratory tract receptors, a reflex spasm of the larynx occurs and water does not enter the lungs; this type of drowning often occurs when it gets into contaminated water containing impurities of chemicals, sand and other suspended particles; occurs in 10-20% of cases.

Reflex (syncope) drowning is characterized by a primary arrest of cardiac activity and breathing almost immediately after a person enters the water. It occurs in people who are emotionally excitable and can be the result of reflex effects: cold shock, an allergic reaction to substances contained in water, reflexes from the eyes, mucous membrane of the nose, middle ear, facial skin, etc. It is more correct to consider it one of the types of death in water, rather than drowning, occurs in 10-15% of cases.

52.2. Signs of drowning

In case of true drowning, external examination of the corpse is characterized by the following signs:

During internal examination of the corpse the following signs:

52.6. Laboratory research methods for drowning

Research on diatom plankton. Plankton are the smallest animal and plant organisms that live in the water of natural reservoirs. Of all plankton, diatoms are of greatest forensic importance - a type of phytoplankton (plant plankton), since they have a shell of inorganic silicon compounds. Together with water, plankton enters the bloodstream and spreads throughout the body, lingering in parenchymal organs (liver, kidneys, etc.) and bone marrow.

The discovery of diatom shells in the kidney, liver, bone marrow, and long tubular bones is a reliable sign of drowning in water, their composition matching the plankton of the reservoir from which the corpse was extracted. For a comparative study of the characteristics of the plankton found in the corpse, it is necessary to simultaneously examine the water from which the corpse was extracted.

Histological examination. Histological examination of the internal organs of corpses removed from water is mandatory. In the lungs, microscopic examination reveals a predominance of emphysema (bloating) over small foci of atelectasis (collapse), which are located mainly in the central areas of the lungs.

Oil sample. The test is based on the ability of oil and petroleum products to produce bright fluorescence in ultraviolet rays: from greenish-blue, blue to yellow-brown. Fluorescence is detected in the contents and on the mucous membrane of the stomach and duodenum. A reliable sign of drowning is a positive oil sample in cases of drowning in navigable rivers.

Other physical and technical research methods. Determination of blood electrolyte concentrations, measurement of electrical conductivity, viscosity, blood density. Determining the freezing point of blood in the left half, the blood is diluted with water, so the freezing point of the blood will be different, which is determined by cryoscopy.

Forensic chemical research. Taking blood and urine for quantitative determination of ethyl alcohol using gas chromatography.

All of these methods help to establish with greater objectivity the fact of death from drowning.

52.7. Issues resolved by forensic medical examination during drowning

1. Was death due to drowning or another cause?

2. In what liquid (medium) did the drowning occur?

3. Are there any reasons that could have contributed to the drowning?

4. How long was the corpse in the water?

5. If there are injuries on the corpse, what is their nature, location, mechanism, did they occur intravitum or after death?

6. What diseases were discovered during the examination of the corpse? Did they cause death in the water?

7. Did the deceased drink alcohol shortly before death?

Chapter 53. Asphyxia in a confined space

Death from lack of oxygen occurs in confined spaces such as refrigerators, chests, compartments of sunken ships, airplane cabins, in insulating gas masks, in plastic bags placed over the head. The accumulation of carbon dioxide and the decrease in the amount of oxygen occurs gradually.

During autopsy of corpses during external examination, there were abundant cadaveric spots of a dark purple color, cyanosis of the face, lips, hemorrhages in the connective membranes of the eyes, in the skin; during internal examination - congestive congestion of internal organs, swelling and congestion of the brain, hemorrhages in the mucous membranes of the trachea, bronchi, stomach, pulmonary edema.

During a forensic medical examination of the corpses of persons who died in confined spaces, experts resolve the main question raised by the investigation about the cause of death. The main morphological picture of asphyxial death is represented by general asphyxial signs.

As a rule, forensic medical experts do not find it difficult to give an opinion on the cause of death. The totality of the data from the forensic medical examination of the corpse, the forensic histological examination and the circumstances of the case fully fit into the picture of the occurrence of death due to asphyxia, due to a lack of oxygen and excess carbon dioxide in the air, in conditions of people staying in a confined space.

Chapter 54. Forensic medical examination of the corpse of a newborn baby

54.1. Reasons for conducting an examination of the corpse of a newborn baby

54.2. Concept of infanticide

In legal practice, the term “infanticide” is used. Infanticide is the killing by a mother of her newborn baby during or immediately after childbirth.

Currently, the Criminal Code of the Russian Federation contains Article 106 “Murder of a newborn child by a mother.” It says: “The murder of a newborn child by a mother during or immediately after childbirth, as well as the murder by a mother of a newborn child in a psychotraumatic situation or in a state of mental disorder that does not exclude sanity. ".

The victim in this crime is a newborn, which is considered an infant who has lived no more than a day.

Some women giving birth during childbirth or shortly after them may experience labor or postpartum psychosis - the Aschaffenburg affect of confusion; in this state, the mother loses her critical assessment of her actions and can kill her child. In such cases, a forensic psychiatric examination is required.

54.3. To solve and investigate such crimes, it is necessary to resolve the following issues:

1 . Is the baby a newborn?

2. What is the duration of intrauterine life?

3. Is the baby mature?

4. Is the baby viable?

5. Is the baby a live birth?

6. If the baby was born alive, what is the duration of extrauterine life?

7. What is the cause of death of the baby?

8. Was the baby given proper care?

One of the main tasks of a forensic expert is to establish the newborn status of an infant.

In forensic medicine, the neonatal period is considered to be a baby who has lived within 24 hours after birth. This term is related to the legal term infanticide (the killing by a mother of her child during or shortly after childbirth, i.e. within 24 hours).

54.4. Signs of a newborn

Of the listed signs, the absolute sign is the condition of the umbilical cord and the absence of air in the lungs if the child is stillborn.

54.5. Determining the duration of intrauterine life of a baby

Duration of intrauterine life - the time a baby spends in the womb, on average for 10 lunar months (the duration of a lunar month is 28 days). A baby born after weeks of pregnancy is considered full-term.

The period of intrauterine life is determined by the length of the baby’s body using the Haase scheme: if the body length is less than 25 cm, the square root is taken from this number; if the baby’s body length is more than 25 cm, then this number is divided by 5. For example, the baby’s body length is 16 cm, then the intrauterine age is 4 lunar months; if the length is 40 cm, then the intrauterine age is 8 lunar months.

According to the circumference of the head: the circumference of the head is divided by 3.4 and the number of lunar months is obtained. For example, divide the baby's head circumference -32 cm by 3.4 and get 9.4 lunar months.

More accurate determination of the period of intrauterine life based on ossification nuclei (the initial element from which bone tissue is formed). The ossification nucleus looks like a red circle or oval on a gray-white background of cartilage. By the end of the 8th lunar month, ossification nuclei appear in the sternum and calcaneus with a diameter of up to 0.5 cm; by the end of the 9th lunar month - in the talus (foot bones) with a diameter of up to 0.5 cm. At the 10th lunar month - in the epiphysis of the femur (Beklar's nucleus) with a diameter of up to 1 cm. You can also determine by the weight of the placenta and the length of the umbilical cord, if they stayed with the baby.

54.6. Signs of maturity

Maturity is the degree of physical development of the baby, which ensures the readiness of organs and systems for extrauterine life. Signs of maturity include: sufficient development of the subcutaneous fat layer, the length of the hair on the head is at least 2 cm, the cartilage of the ears and nose is dense, the nail plates on the fingers extend beyond the ends of the fingers, on the feet they reach the ends of the fingers, the condition of the external genitalia and other signs. A full-term baby is usually mature.

54.7. Signs of vitality

Viability is the baby’s ability to continue living outside the mother’s body. The viability of an infant is determined by a certain degree of physical development and the absence of deformities incompatible with life.

In forensic medicine, a baby of 8 lunar months, length 40 cm, weight 1500 g is considered viable and there should be no deformities that disrupt the most important functions of the body - breathing, blood circulation, central nervous system, digestion.

54.8. Determination of live birth of an infant

The determination that an infant is alive is determined by the presence of signs indicating that the infant was breathing.

Vital (hydrostatic) tests are performed - the Galen-Schreyer pulmonary test and the Breslau gastrointestinal test.

The pulmonary test is based on the fact that non-breathing lungs have a specific gravity greater than one and sink when immersed in water, while breathing lungs have a specific gravity less than one and float on the surface of the water.

In appearance, the lungs of a stillborn baby (non-breathing lungs) do not fill the pleural cavities, dense to the touch, dark red in color; The lungs of a live-born baby (breathing lungs) have pleural cavities that feel airy and pinkish-red in color.

Pulmonary test technique. Before opening the chest cavity, the trachea is ligated below the cartilage of the larynx, a second ligature is placed on the esophagus located above the diaphragm, after which the chest is opened. The esophagus is cut above the diaphragm and the complex (tongue, neck organs, thymus gland, heart, lungs) is lowered into a vessel with cold water. They note whether the complex floats or not. Having taken the complex out of the water, each lung is separated, noting the volume and weight, and each lung is lowered into the water. Then the lobes of the lungs and individual pieces of the lungs from different sections are lowered, determining their swimming ability. The test is considered positive when the chest complex, lungs, individual lobes and pieces of the lungs float, therefore the baby lived and breathed.

Technique for performing a gastrointestinal test. The test is based on the fact that immediately after birth the child swallows air, which penetrates the stomach and then the intestines. The air-filled stomach and intestines float in water. Before removing the stomach and intestines, ligatures are placed on the stomach at the entrance and exit, on the swollen parts of the intestine and on the rectum. The intestines are isolated along with the stomach, immersed in water, noting which areas float. Then the stomach and intestines are pierced under water.

Evaluation of hydrostatic samples. Hydrostatic swimming tests can be positive not only if the baby was born alive, but also with the development of putrefactive changes (putrefactive gases are formed when a corpse rots); when performing artificial respiration; when examining the corpse of a frozen baby, when frozen, unthawed lungs float in water.

In addition to the listed tests, Dillon's X-ray test can be used, which allows you to determine air in small quantities in the lungs and stomach before examining the corpse.

Histological examination of the lungs. A microscopic examination of the lungs of a live-born baby reveals a gap in the lumen of the bronchi, bronchioles, the alveoli are straightened, and the epithelium lining the alveoli is flat. Lungs of a stillborn baby - the lumens of the alveoli and bronchi are collapsed, the alveolar epithelium is cubic, the interalveolar septa are thickened.

Histochemical methods determine the activity of enzymes in the lungs of a live-born and stillborn baby; the highest activity of redox enzymes is noted in a live-born baby.

When examining the blood serum of infants using electrophoresis, the content of protein fractions of the blood determines whether the baby was born alive or dead.

Emission spectral analysis method. The microelementary composition of the lungs, liver, and kidneys of live and stillborn infants is different and makes it possible to resolve the issue of a baby’s live birth rate based on microelement ratios. The advantage of this method over others is that it can be used in case of significant putrefactive changes when other methods are not effective.

54.9. Determination of the duration of extrauterine life

54.10. Presence or absence of signs of baby care

The lack of clothing on the baby's body, the torn umbilical cord, traces of blood, meconium, and cheese-like lubricant indicate that there were no signs of caring for the baby.

54.11. What is the cause of death of the baby?

The death of a newborn baby can be violent or non-violent.

Non-violent death of an infant can occur before birth and is caused by diseases of the mother (syphilis, heart defects, diabetes mellitus, kidney disease, etc.) or diseases of the fetus. During childbirth, the death of an infant can occur from birth trauma, intrauterine asphyxia, or as a result of the umbilical cord entangling the baby's neck. After birth, the death of an infant can be caused by intrauterine infection, the presence of deformities incompatible with life, or other reasons.

The violent death of a newborn baby can be the result of passive (abandonment without care, and more often the baby dies from being cold) or active infanticide - various types of violent death.

The most common cause of active infanticide is mechanical asphyxia as a result of closing the openings of the nose and mouth with hands and soft objects; closing the respiratory tract with foreign objects (a piece of cotton wool, paper, etc.) and other types of mechanical asphyxia - strangulation with a noose, strangulation with hands, drowning in water and other liquids.

Mechanical damage as a method of murder is less common.