Fetal Death Due to an Unusual Coexistence of Two Umbilical Cord Anomalies: Analysis in a Forensic Perspective
<b>Background and Clinical Significance:</b> In stillbirth, bereaved parents must be promptly taken in by healthcare staff, and their requests to understand what happened must be fully explained and discussed. Empathic and open communication with the parents is fundamental in avoiding ti...
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2025-06-01
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| author | Alice Ferretti Maria Paola Bonasoni Benedetta Petrachi Giuseppina Comitini Immacolata Blasi Arianna Giorgetti Paolo Fais Susi Pelotti Lorenzo Aguzzoli |
| author_facet | Alice Ferretti Maria Paola Bonasoni Benedetta Petrachi Giuseppina Comitini Immacolata Blasi Arianna Giorgetti Paolo Fais Susi Pelotti Lorenzo Aguzzoli |
| author_sort | Alice Ferretti |
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| description | <b>Background and Clinical Significance:</b> In stillbirth, bereaved parents must be promptly taken in by healthcare staff, and their requests to understand what happened must be fully explained and discussed. Empathic and open communication with the parents is fundamental in avoiding time-consuming lawsuits for investigating medical liability. Herein, we describe a case of stillbirth in which many elements exemplify potential concerns, either from a parental or judicial context. All these hypothetical questions will be addressed and discussed. <b>Case presentation:</b> A female stillbirth was vaginally delivered at 41 weeks of gestation after induction of labor. The baby was normally grown for gestational age, and the umbilical cord examination disclosed a length of 90 cm (75 cm attached to the placenta and 15 cm to the fetus), two tight knots, and a furcate insertion into the chorionic plate. Histologically, non-occlusive luminal thrombosis was found in the umbilical vein, extended to the cord insertion, and was in a few chorionic vessels. The knots showed myonecrosis in the vascular wall, widespread in the first one and more focal in the second, indicating prolonged contraction. <b>Conclusions:</b> The case we described, though fully diagnostically explained, raised many hypothetical questions that might have been brought up either in a judicial context or during communication with the parents of the autopsy results. Frequent questions may include what the cause of death was, when the baby died, if the death might have been avoidable, and, in the latter, potential medical liability. |
| format | Article |
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| institution | OA Journals |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-06-01 |
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| series | Diagnostics |
| spelling | doaj-art-2b2d1c8f6fb343e7bbb0956074b2c6982025-08-20T02:23:44ZengMDPI AGDiagnostics2075-44182025-06-011511142310.3390/diagnostics15111423Fetal Death Due to an Unusual Coexistence of Two Umbilical Cord Anomalies: Analysis in a Forensic PerspectiveAlice Ferretti0Maria Paola Bonasoni1Benedetta Petrachi2Giuseppina Comitini3Immacolata Blasi4Arianna Giorgetti5Paolo Fais6Susi Pelotti7Lorenzo Aguzzoli8Unit of Obstetrics and Gynecologic Oncology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, ItalyPathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, ItalyUnit of Obstetrics and Gynecologic Oncology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, ItalyUnit of Obstetrics and Gynecologic Oncology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, ItalyUnit of Obstetrics and Gynecologic Oncology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, ItalyDepartment of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, 40126 Bologna, ItalyDepartment of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, 40126 Bologna, ItalyDepartment of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, 40126 Bologna, ItalyUnit of Obstetrics and Gynecologic Oncology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy<b>Background and Clinical Significance:</b> In stillbirth, bereaved parents must be promptly taken in by healthcare staff, and their requests to understand what happened must be fully explained and discussed. Empathic and open communication with the parents is fundamental in avoiding time-consuming lawsuits for investigating medical liability. Herein, we describe a case of stillbirth in which many elements exemplify potential concerns, either from a parental or judicial context. All these hypothetical questions will be addressed and discussed. <b>Case presentation:</b> A female stillbirth was vaginally delivered at 41 weeks of gestation after induction of labor. The baby was normally grown for gestational age, and the umbilical cord examination disclosed a length of 90 cm (75 cm attached to the placenta and 15 cm to the fetus), two tight knots, and a furcate insertion into the chorionic plate. Histologically, non-occlusive luminal thrombosis was found in the umbilical vein, extended to the cord insertion, and was in a few chorionic vessels. The knots showed myonecrosis in the vascular wall, widespread in the first one and more focal in the second, indicating prolonged contraction. <b>Conclusions:</b> The case we described, though fully diagnostically explained, raised many hypothetical questions that might have been brought up either in a judicial context or during communication with the parents of the autopsy results. Frequent questions may include what the cause of death was, when the baby died, if the death might have been avoidable, and, in the latter, potential medical liability.https://www.mdpi.com/2075-4418/15/11/1423umbilical cord true tight knotfurcate umbilical cord insertionlong umbilical cordmyonecrosisstillbirthpost-mortem interval |
| spellingShingle | Alice Ferretti Maria Paola Bonasoni Benedetta Petrachi Giuseppina Comitini Immacolata Blasi Arianna Giorgetti Paolo Fais Susi Pelotti Lorenzo Aguzzoli Fetal Death Due to an Unusual Coexistence of Two Umbilical Cord Anomalies: Analysis in a Forensic Perspective Diagnostics umbilical cord true tight knot furcate umbilical cord insertion long umbilical cord myonecrosis stillbirth post-mortem interval |
| title | Fetal Death Due to an Unusual Coexistence of Two Umbilical Cord Anomalies: Analysis in a Forensic Perspective |
| title_full | Fetal Death Due to an Unusual Coexistence of Two Umbilical Cord Anomalies: Analysis in a Forensic Perspective |
| title_fullStr | Fetal Death Due to an Unusual Coexistence of Two Umbilical Cord Anomalies: Analysis in a Forensic Perspective |
| title_full_unstemmed | Fetal Death Due to an Unusual Coexistence of Two Umbilical Cord Anomalies: Analysis in a Forensic Perspective |
| title_short | Fetal Death Due to an Unusual Coexistence of Two Umbilical Cord Anomalies: Analysis in a Forensic Perspective |
| title_sort | fetal death due to an unusual coexistence of two umbilical cord anomalies analysis in a forensic perspective |
| topic | umbilical cord true tight knot furcate umbilical cord insertion long umbilical cord myonecrosis stillbirth post-mortem interval |
| url | https://www.mdpi.com/2075-4418/15/11/1423 |
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