Citation

Byard RW, Zuccollo JM. Am. J. Forensic Med. Pathol. 2010; 31(3): 258-260.

Affiliation

Discipline of Pathology, The University of Adelaide, Adelaide, South Australia, Australia; and daggerDepartment of Obstetrics and Gynaecology, School of Medicine and Health Sciences, University of Otago Medical School, Wellington, New Zealand.

Copyright

(Copyright © 2010, Lippincott Williams and Wilkins)

DOI

10.1097/PAF.0b013e3181e12eb8

PMID

20436337

Abstract

Birth under water has become a widely disseminated technique that is promoted to improve the quality of labor. The case of a 42-week gestation male infant is reported who died of respiratory and multiorgan failure secondary to florid pneumonia and sepsis due Pseudomonas aeruginosa following a water birth. Other infants who have been delivered underwater have drowned or have had near-drowning episodes with significant hyponatremia and water intoxication. Local and disseminated sepsis has been reported, with respiratory distress, fevers, hypoxic brain damage, and seizures. There have also been episodes of cord rupture with hemorrhage. The postmortem investigation of such cases requires a complete autopsy of the infant, with examination of the placenta. Full details of the pregnancy and delivery and inspection of the birthing unit are also needed. A septic workup of the infant and placenta should be undertaken along with sampling of water from the birthing unit and microbiological swabbing of the equipment. Vitreous sodium levels may reveal electrolyte disturbances. While fatal cases appear rare, this may change if water births gain in popularity.

Language: en