Histopathology Department, Sheffield Children's Hospital NHS FT, Sheffield, UK.
Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
Forensic Sci Med Pathol. 2020 Jun;16(2):226-233. doi: 10.1007/s12024-019-00212-4. Epub 2020 Feb 6.
It is known that concealed and denied pregnancy are both associated with increased health risks to the mother and infant. Whilst there is literature surrounding management and safeguarding in these instances, we are not aware of a case review of post-mortem findings in infants with a history of concealed or denied pregnancy. We performed a retrospective review of all coronial post-mortems performed between 2003 and 2018 on infants and fetuses with a history of concealment or denial of pregnancy. Maternal demographics, delivery information, post-mortem findings and results of ancillary investigations were analyzed. Twenty cases (1.8% of total coronial workload in the period of the study) were included. Four women admitted to concealing their pregnancy, eleven denied their pregnancy and in the remaining five cases the bodies of the infants had been abandoned and the mother was not traceable. The bodies of these infants were found in waste disposal sites, wooded areas and in a drainpipe. Only six infants in total were judged to have survived delivery, all others were stillborn or unascertained. Perinatal hypoxia, large subdural hemorrhage and congenital pneumonia were the reported causes of death in those infants that were liveborn. In one case there was suspicion of neonaticide. Concealment and denial of pregnancy occur in a wider demographic than perhaps anticipated and is not limited to teenage primigravids. Mothers with concealed and denied pregnancy hid the body of their deceased infant out of fear of prosecution. In many circumstances, viability at birth cannot be ascertained.
已知隐瞒和否认怀孕都会增加母婴的健康风险。虽然有关于这些情况下的管理和保护的文献，但我们不知道有对有隐瞒或否认怀孕史的婴儿的死后发现进行案例回顾。我们对 2003 年至 2018 年间所有有隐瞒或否认怀孕史的婴儿和胎儿进行的尸检进行了回顾性分析。分析了产妇人口统计学、分娩信息、尸检结果和辅助检查结果。纳入 20 例（研究期间尸检工作量的 1.8%）。四名妇女承认隐瞒怀孕，十一名否认怀孕，其余五名婴儿尸体被遗弃，母亲无法追踪。这些婴儿的尸体被发现在废物处理场、树林地区和排水管中。总共只有 6 名婴儿被认为是活产，其余的都是死产或无法确定。那些活产婴儿的死因报告为围产期缺氧、大硬脑膜下血肿和先天性肺炎。在一例中，怀疑有新生儿杀婴行为。隐瞒和否认怀孕的情况比预期的更广泛，不仅限于青少年初产妇。隐瞒和否认怀孕的母亲出于害怕起诉而隐藏了她们死去的婴儿的尸体。在许多情况下，无法确定出生时的存活率。
