Forensic medical evaluation of the role of the formation of ascending amniotic infection in the event of intrauterine fetal death

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Abstract

The analysis of expert practice and scientific research conducted during the last decade show that the greatest number of claims to the correctness of the provision of medical care are made by doctors of surgical specialties, including obstetrician-gynecologists, and, at the same time, inspections for “medical cases”, including profile “obstetrics and gynecology” are complex and time-consuming. The article considers the problem of the unfavorable outcome of medical care in obstetric practice. The questions of etiology, pathogenesis, diagnosis of intrauterine infection (VUI), which largely determines the frequency of perinatal morbidity and mortality, are also analyzed and analyzed questions of the prescription of the pathological process in the amniotic membranes, its role in the formation of fetal death. On a concrete example, expert practice shows how the forensic medical commission, taking into account the data of medical documents, as well as the results of macroscopic and microscopic studies, solves the problem of the immediate cause of antenatal death and establishes the role of intrauterine infection in the death of the fetus, the timing and causes of its formation. The information that is relevant to the practice of forensic medical examinations is presented, which allows us to formulate objective and scientifically substantiated conclusions about the existence of cause-effect relationships between the defects in the provision of medical care and the onset of an unfavorable outcome of medical care in similar cases.

About the authors

Zlata V. Davydova

St. Petersburg State Pediatric Medical University

Author for correspondence.
Email: zlata.davydova@rambler.ru

MD, PhD, Associate Professor, Department of Pathological Anatomy at the Rate of Forensic Medicine

Russian Federation, Saint Petersburg

Olga V. Sokolova

St. Petersburg State Pediatric Medical University

Email: last_hope@inbox.ru

MD, PhD, Associate Professor, Department of Pathological Anatomy at the Rate of Forensic Medicine

Russian Federation, Saint Petersburg

References

  1. Башмакова М.А., Савичева А.М. Врожденные и перинатальные инфекции: проблемы и решения // Журнал акушерства и женских болезней. - 2010. - T. 59. - № 5. - С. 17-22. [Bashmakova MA, Savicheva AM. Intrauterine and perinatal infections: problems and decisions. Journal of Obstetrics and Women’s Diseases. 2010;59(5):17-22. (In Russ.)]
  2. Глуховец Б.И., Глуховец Н.Г. Восходящее инфицирование фето-плацентарной системы. - М.: МЕДпресс-информ, 2006. [Glukhovets BI, Glukhovets NG. Voskhodyashchee infitsirovanie feto-platsentarnoy sistemy. Moscow: MEDpress-inform; 2006. (In Russ.)]
  3. Ерофеев С.В., Эделев Н.С., Малахов Н.В., Семенов А.С. Проблема экспертной оценки неблагоприятного исхода медицинской помощи: мониторинг, развитие, современное состояние // Судебная медицина. - 2017. - Т. 3. - № 1. - С. 4-9. [Erofeev SV, Edelev NS, Malakhov NV, Semenov AS. The problem of peer review of adverse outcome of health care: monitoring, the development and modern state. Russian Journal of Forensic Medicine. 2017;3(1):4-9. (In Russ.)]. doi: 10.19048/2411-8729-2017-3-1-4-10.
  4. Клевно В.А., Веселкина О.В., Сидорович Ю.В, Зазулин В.А. Мониторинг дефектов оказания медицинской помощи по материалам Бюро судебно-медицинской экспертизы Московской области в 2015 году: ежегодный доклад. - М.: Ассоциация СМЭ, 2016. [Klevno VA, Veselkina OV, Sidorovich YV, Zazulin VA. Monitoring defektov okazaniya meditsinskoy pomoshchi po materialam Byuro sudebno-meditsinskoy ekspertizy Moskovskoy oblasti v 2015 godu: ezhegodnyy doklad. Moscow: Assotsiatsiya SME; 2016. (In Russ.)]
  5. Копылов А.В., Рыжков В.В. Судебно-медицинские аспекты перинатальных потерь от внутриутробных инфекций // Судебно-медицинская экспертиза. - 2016. - Т. 59. - № 6. - С. 18-21. [Kopylov AV, Ryzhkov VV. The forensic medical aspects of the perinatal losses from intrauterine infections. Sud Med Ekspert. 2016;59(6):18-21. (In Russ.)]. doi: 10.17116/sudmed201659618-21.
  6. Радзинский В.Е. Акушерская агрессия. - М.: StatusРraesens, 2011. [Radzinskiy VE. Akusherskaya agressiya. Moscow: StatusRraesens; 2011. (In Russ.)]
  7. Сидорова И.С., Макаров И.О., Матвиенко Н.А. Внутриутробная инфекция: ведение беременности, родов и послеродового периода: учеб. пособие. - М.: МЕДпресс-информ, 2011. [Sidorova IS, Makarov IO, Matvienko NA. Vnutriutrobnaya infektsiya: vedenie beremennosti, rodov i poslerodovogo perioda: ucheb. posobie. Moscow: MEDpress-inform; 2011. (In Russ.)]
  8. Тимофеев И.В. О понятии ятрогения. Патология лечения. - СПб., 1999. [Timofeev IV. O ponyatii yatrogeniya. Patologiya lecheniya. Saint Petersburg; 1999. (In Russ.)]
  9. Хамадьянов У.Р., Русакова Л.А., Хамадьянова А.У., и др. Внутриутробное инфицирование плода: современный взгляд на проблему // Российский вестник акушера-гинеколога. - 2013. - Т. 13. - № 5. - С. 16-20. [Khamad’yanov UR, Rusakova LA, Khamad’yanova AU, et al. Intrauterine fetal infection: the present view of the problem. Rossiiskii vestnik akushera-ginekologa. 2013;13(5):16-20. (In Russ.)]
  10. Цинзерлинг В.А., Мельникова В.Ф. Перинатальные инфекции (вопросы патогенеза, морфологической диагностики и клинико-морфологических сопоставлений): Практическое руководство. - СПб.: Элби-СПб, 2002. [Tsinzerling VA, Mel’nikova VF. Perinatal’nye infektsii (voprosy patogeneza, morfologicheskoy diagnostiki i kliniko-morfologicheskikh sopostavleniy): Prakticheskoe rukovodstvo. Saint Petersburg: Elbi-SPb; 2002. (In Russ.)]
  11. Чайка В.К. Инфекции в акушерстве и гинекологии: Практическое руководство. - Донецк: ООО «Альматео», 2006. [Chayka VK. Infektsii v akusherstve i ginekologii: Prakticheskoe rukovodstvo. Donetsk: OOO “Al’mateo”; 2006. (In Russ.)]

Copyright (c) 2018 Davydova Z.V., Sokolova O.V.

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