Mazuchowski Edward L, Franco Dori M, Berran Philip J, Harcke H Theodore
From the Armed Forces Medical Examiner System, Dover AFB, DE.
Am J Forensic Med Pathol. 2017 Mar;38(1):24-28. doi: 10.1097/PAF.0000000000000287.
The hydrostatic test is used to help determine if there has been a live birth. Computed tomography (CT), with its ability to detect and localize air/gas in the body, offers a rapid, noninvasive tool for assessment.Four baby deaths (20 to 25 weeks' gestation) in which the hydrostatic test, radiographs, and CT were performed before autopsy are presented. In 2 cases, considered stillbirths, the lungs and liver sank, and there was no air seen in the lungs or gas in the liver on CT. Histology of the lungs showed collapsed alveoli. In 1 case, concluded to be a live birth, the lungs floated, the liver sank, and air was seen in the trachea, bronchi, and both lungs on CT. Histology of the lungs showed multiple areas of expanded alveoli. In 1 case, where both the lungs and liver floated, the CT showed gas widely distributed in the soft tissues. This reflected decomposition, and no conclusion could be made regarding birth status.Assessment of live birth is a critical and difficult decision. Postmortem CT offers another technique to consider in this determination, and it has significant advantages over radiography. Continued study and correlation with existing methods seem warranted.
水压试验用于辅助确定是否为活产。计算机断层扫描（CT）能够检测并定位体内的空气/气体，为评估提供了一种快速、无创的工具。本文介绍了4例（妊娠20至25周）在尸检前进行了水压试验、X光片检查和CT检查的婴儿死亡案例。在2例被判定为死产的案例中，肺和肝脏下沉，CT检查未发现肺部有空气或肝脏有气体。肺部组织学检查显示肺泡塌陷。在1例判定为活产的案例中，肺漂浮，肝脏下沉，CT检查显示气管、支气管和双肺均有空气。肺部组织学检查显示多个区域的肺泡扩张。在1例肺和肝脏均漂浮的案例中，CT显示气体广泛分布于软组织中。这反映了尸体分解情况，无法就出生状态得出结论。评估活产是一个关键且困难的决定。尸检CT为这一判定提供了另一种可考虑的技术，且相较于X光片检查具有显著优势。似乎有必要继续进行研究并与现有方法进行对比。
