DIAGNOSTICS OF SUDDEN INFANT DEATH SYNDROME

Abstract

Background. Sudden infant death syndrome is a diagnosis of excluding which is made according to forensic medical examination (autopsy) data, after excluding the fact of poisoning, metabolic disorders, etc. But in most cases, the cause cannot be revealed.

Material and methods. 87 relevant cases have been analyzed after the autopsy performed in the forensic medical examination departments of Donetsk region. Babies were divided into three groups based on clinical and morphological signs and the mechanism of sudden death, and the nature of morphological changes in deceased babies was analyzed.

Results. According to the degree of prominence of the morphological changes in the deceased babies were divided into three groups. For people around the dead children their death came unexpectedly while sleeping peacefully in favorable conditions. Most of them had the signs of rapid death: moderate segmental pulmonary oedema, areas of emphysema and atelectasis in the lungs, cerebral oedema. The babies of the second group (81,6 %) had a history of minimally pronounced clinical signs of respiratory infections (50,0 %), which had not been treated. Death occurred while sleeping, mostly at night. The death of babies of the third group (10,3 %) occurred suddenly on the background of non-infectious disease (acute myeloblastic leukemia, malignant brain tumor, etc.) and serious infectious diseases that were not diagnosed during life (meningococcal infection, acute purulent meningo-encephalitis, etc.). The autopsy revealed distinct morphological changes which are typical for these diseases.

Conclusions. To solve the problem of the probability of sudden infant death syndrome it is recommendable to use the classification of pathomorphological changes by Emen J. L. (1992), which were revealed during the autopsy of an infant without signs of violent death. It allows to define the probability of death owing to sudden infant death syndrome according to the amount of diagnostic points.