[The forensic medical aspects of the perinatal losses from intrauterine infections].

The objective of the present study was to evaluate the contribution of intrauterine infections to the loss of fetuses and newborn babies and to elucidate the cause-and-effect relationships between the unfavourable outcomes of pregnancies and the actions of the attending medical personnel. The main group of the patients included in the study was comprised of 28 women whose pregnancy ended in stillbirths (13 cases) and infant death during the neonatal period (15 cases) in the association with intrauterine infections (IUI). The control group consisted of 11 practically healthy women with the physiological course of pregnancy and parturition matched to those of the main group in terms of age, parity, and social status. Special attention was given to the possibilities of prevention of neonatal deaths and the severity of harm to the health of mother and child. Examination of the patients of the main group revealed multiple infectious foci in the body affecting various organs and their systems including the urogenital tract. The premature birth occurred in 46.4% of the women presenting with fetal-placental insufficiency. They gave birth to the babies with a low weight for gestational age in the state of asphyxia that required the application of the resuscitation procedures and intensive therapy. The present study has shown that the immediate cause of fetal and neonatal deaths was multiple organ dysfunction associated with intrauterine infections. No direct relationship between the unfavourable outcomes of pregnancy and the actions of the medical personnel was documented in the majority of the cases (89.3%). It is concluded that the main factors responsible for tanatogenesis were the character and severity of the difficult to diagnose pathological process.