Forensic Pathological Study Of Neonatal Death With Medical Disputes

BackgroundAs the citizen gradually enhanced the consciousness of rights safeguarding,and family members don’t completely understand the particularity of medicine itself,causing both doctors and patient often failed to reach a mutual agreement and so the neonatal death caused by medical disputes yearly increased and become the focus of public opinions.The neonatal get into the independent living environment with its organ function not mature,weakened immune systems and poor adaptation,so any improper nursing feeding,factors such as labor injury and medical negligence are easy to lead to illness and even death.In addition,the occurrence of neonatal diseases,change and the outcome is fast and hard to predict,this peculiarity make of a high incidence of medical disputes in the neonatology department.Moreover,in forensic practice,neonatal asphyxia is still the important causes of its death,and with the limitations of clinical diagnosis,all makes the newborn asphyxia death medical dispute become difficult in forensic identification.ObjectiveRetrospective 51 cases of neonatal death in medical disputes in Judicial Center of Xinxiang Medicial University from January 2004 to December 2015,analyzes the reasons of neonatal death in the different periods,and the change of mortality and the reasons for dispute.And explore the objective basis of diagnosis of neonatal asphyxia death.Provide new ideas and indicators for forensic medicine appraisal of neonatal asphyxia death cases.Methods1.A retrospective analysis of the result was by SPSS 13.0 software,using chi-square test.2.Using forensic autopsy and pathology inspection methods.Results1.The number of medical disputes of neonatal death from 2010 to 2015 is significantly increased compared with 2004 to2009,and early neonatal mortality was 64.7%,The main causes of neonatal death are aspiration pneumonia,asphyxia,HMD,neonatal sepsis,neonatal scleroderma,etc.In the last 6 years,the main causes of neonatal death are disease of respiratory system,congenital aplasia and cerebral diseases etc.Asphyxia is still the main causes of neonatal death.County hospitals have a higher incidence of neonatal deaths medical disputes,private hospitals and private clinics have a higher rate of misdiagnosis.2.This group of the experimental results show that abnormal umbilical cord,foreign bodies suction and multiple organ dysfunction caused by intrauterine asphyxia newborn are common positive pathological changes of neonatal asphyxia death in forensic autopsy examination.Obstetric factors during pregnancy and the production such as amniotic fluid,placenta,umbilical cord,and position of membrane,lasting birth process,and the exception of pregnancy time,pregnancy complications,premature birth can also provide the basis for forensic medicine in the diagnosis of neonatal asphyxia death.Conclusion1.The early neonatal was a period of high incidence of neonatal death,premature infants and asphyxia is still present in the most common neonatal death.County hospitals have a higher incidence of neonatal deaths medical disputes,private hospitals and private clinics have a higher rate of misdiagnosis.2.Forensic autopsy of neonatal asphyxia death test should focus on whether there is an abnormal umbilical cord,whether the organs and tissues have general signs of suffocation,forensic pathological examination should focus on whether the alveolar has foreign body,whether the umbilical cord tissue and organs have pathological changes of ischemia and hypoxia,.Obstetric factors during pregnancy and the production also provide the basis for forensic medicine in the diagnosis of neonatal asphyxia death.