The establishment of live birth

Along with questions about neonatal, goosenest and maturity of the child is of paramount importance to the issue of a live birth or dead birth. To solve the issue of live birth means to find evidence of extrauterine life of the baby. The main features of extrauterine life is an external respiration. Therefore, you need to install: breathed whether a baby. This involves the so-called life (hydrostatic) tests: pulmonary sample Galen and gastrointestinal sample Breslau.
Pulmonary test is based on the difference in the proportion of breathing and nadyshavshis lungs. Medisave light dense and airless, uniform dark red colour, the surface is smooth and homogeneous, in the pleural cavities they take back the departments. Specific density nadyshavshis lung greater than one - 1,05-1,06, so they sink in water.
With the first breath of a child when the user switches from amnesticheskim (in utero) to pnevmiticheskoe external respiration, the alveoli are beginning to fill up with air, light straightened, their volume increases and they almost completely fill the pleural cavity. The surface of the lungs becomes like a "marble" look, they become lighter. Specific density breathing of the lungs less units, so they swim on the surface of the water.
The technique of pulmonary samples. Before opening the chest cavity tsaparevetsa larynx and trachea, below the larynx is imposed ligature on the trachea and the esophagus. Opened the chest cavity, superimposed ligature to the esophagus from the diaphragm. Retrieved in a single organoleplice language, the organs of the neck, the thymus gland, heart, lungs and fall to the vessel with clear cold water. After that investigated the heart, pulmonary artery, arterial canal. Then separated the thymus gland, okoloserdecna shirt, heart, large vessels and lungs and throat with trachea fall into the water. Then opened the larynx, trachea and bronchi, if need be - taken-strokes, light cut off at the root and fall into the water. Consistently fall into the water every slight separately, the proportion of light, some parts of shares. These observations about how to swim or drown light, their share and separate areas of shares, recorded in the report of the examination of the corpse.
Evaluation of the results of pulmonary samples. A positive result (light or their shares, parts float) indicates that the baby after birth breathed, therefore, lived. However, this is only true if the corpse is not decayed (decayed light will float because of the presence in them of putrefactive gases)that the corpse is not frozen (frozen and not completely thawed light will also swim in the water), and that the baby after birth was not made artificial respiration.
In rare cases, there may be so-called secondary atelectasis - losing already breathing of the lungs, they will sink in water. The proper solution of the issue will help histological examination of the lungs: the second atelectasis medium-sized bronchi are well pronounced gaps, small bronchi in a narrow slit, alveolar moves wide. In the lumen of the alveolar moves discovered the so-called hyaline membrane - education increased eosin in bright pink. The not-breathing baby's lungs are in primary atelectasis, small bronchi, bronchioles and alveoli savchina, irregular shapes and sizes, do not contain air alveolar epithelium cubic, in the bronchi and the alveoli can find elements of amniotic fluid.
The technique of gastrointestinal samples. Immediately after the start of the independent external respiration occurs penetration of air into the stomach and then in the intestines. Air-filled stomach and intestine get the opportunity to swim in the water. Based on this gastrointestinal sample. For its implementation, before the extraction of the stomach and intestines, superimposed ligatures on the stomach of inputs output, the ulcer in those places, where you can visually determine the presence of air, and rectum (Fig. 3). After that bowels released from the mesentery and together with the stomach immersed in a vessel with clean cold water. Note which parts swim, some sink. To make sure that the stomach or intestines contain air (gas), they are lowered into the water and gently pierce, this will stand out air bubbles.

Fig. 3. Location ligatures under hydrostatic tests.

Evaluation of the results of the gastro-intestinal samples. If the corpse has no signs of decomposition and if it is established that the newborn was not made artificial respiration, and if pulmonary test is positive, it can be considered that the child born alive.
If the corpse has signs of putrefaction, the positive result of the gastro-intestinal samples is misleading, since in the lumen of the stomach and intestines can accumulate putrid gases. The accumulation of gases will be uneven: some parts may be vzduchu gases, others spasimira. The air in the stomach and intestines can get and then, when it was made of artificial lung ventilation. In these cases, a positive samples can be considered a proof of live birth.
To evaluate the results of pulmonary and gastrointestinal samples should in the complex. As a rule, the results of these samples are the same. However, if the newborn lived a very short time, pulmonary test may be positive, but in the stomach and intestines air may not be.
Unlike lung, which at the first breath can kill and be filled with air, the air in the stomach and the intestine, penetrates gradually, first filling the stomach and the initial intestine. Therefore, the degree of filling air gastrointestinal tract is possible to judge about the longevity of the baby.
So, if the air is found only in the stomach, the life expectancy was a few minutes; if the air is filled with the stomach and small intestine, life expectancy was within 4-6 hours; if the entire gastrointestinal tract air-filled life expectancy was not less than 12 hours
In addition to lung and gastrointestinal swimming samples to establish the live birth is applied the so-called x-ray test - radiography of all of the corpse of the newborn (showdown). The x ray determined by the presence of air (gas) in the lungs, stomach, intestines, and gases, resulting from rotting in the blood vessels and internal organs.
Using x-ray can detect kernel ossification in various bones, and they set the gestational age of the fetus, bone injuries.
The issue of life expectancy, infant is solved on the basis of availability and changes of characteristics neonatal, the results of the life of the samples.
To conduct the necessary care of the newborn testify cleansing of the mouth of the child from mucus and blood; Department of umbilical cord and tubal; the liberation of the fruit of fetal membranes measures; intensive care; protection of the child's body from cooling.