Byard Roger W, Zuccollo Jane M
Discipline of Pathology, The University of Adelaide, Frome Road, Adelaide, SA 5005, Australia.
Am J Forensic Med Pathol. 2010 Sep;31(3):258-60. doi: 10.1097/PAF.0b013e3181e12eb8.
Birth under water has become a widely disseminated technique that is promoted to improve the quality of labor. The case of a 42-week gestation male infant is reported who died of respiratory and multiorgan failure secondary to florid pneumonia and sepsis due Pseudomonas aeruginosa following a water birth. Other infants who have been delivered underwater have drowned or have had near-drowning episodes with significant hyponatremia and water intoxication. Local and disseminated sepsis has been reported, with respiratory distress, fevers, hypoxic brain damage, and seizures. There have also been episodes of cord rupture with hemorrhage. The postmortem investigation of such cases requires a complete autopsy of the infant, with examination of the placenta. Full details of the pregnancy and delivery and inspection of the birthing unit are also needed. A septic workup of the infant and placenta should be undertaken along with sampling of water from the birthing unit and microbiological swabbing of the equipment. Vitreous sodium levels may reveal electrolyte disturbances. While fatal cases appear rare, this may change if water births gain in popularity.
水下分娩已成为一种广泛传播的技术，该技术被宣传可提高分娩质量。本文报告了一例孕42周的男婴，其在水下分娩后因铜绿假单胞菌引起的严重肺炎和败血症继发呼吸和多器官衰竭而死亡。其他在水下分娩的婴儿则出现溺水或近乎溺水的情况，并伴有严重低钠血症和水中毒。有报告称出现局部和播散性败血症，伴有呼吸窘迫、发热、缺氧性脑损伤和癫痫发作。也有脐带破裂出血的情况。对此类病例的尸检调查需要对婴儿进行完整的尸体解剖，并检查胎盘。还需要了解妊娠和分娩的详细情况以及对分娩单位进行检查。应对婴儿和胎盘进行败血症检查，同时从分娩单位采集水样并对设备进行微生物擦拭取样。玻璃体液钠水平可能显示电解质紊乱。虽然致命病例似乎很少见，但如果水下分娩越来越流行，这种情况可能会改变。
