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Infant Death Following Home Birth: A Case Report of Fatal Neonatal Hypoglycemia
Author(s) -
Schuppener Leah M.,
Corliss Robert F.
Publication year - 2020
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.14247
Subject(s) - hypoglycemia , medicine , autopsy , neonatal hypoglycemia , gestational diabetes , diabetes mellitus , pediatrics , birth trauma , cause of death , fetus , obstetrics , pregnancy , birth injury , infant mortality , gestation , endocrinology , population , environmental health , biology , disease , genetics
Infants born to diabetic mothers are at increased risk for symptomatic hypoglycemia and death after birth. A 36‐year‐old G4P3 mother with a history of gestational diabetes and newly diagnosed type II insulin‐dependent diabetes gave birth at home, in the care of a midwife, to a macrosomic infant girl (10 lbs.). Several hours after birth, the infant became lethargic and was found to be hypoglycemic (blood sugar: 28 mg/dL). Glucose and sugar water were administered by the midwife; however, the infant continued to decompensate. Emergency medical services were called, and the infant was transported to the hospital where, despite resuscitative efforts, she died. An autopsy and review of the literature was performed. At autopsy, characteristic features of maternal–fetal glucose dysregulation were identified, including fetal macrosomia, cardiomegaly, hepatomegaly, and severe pancreatic islet cell hypertrophy/hyperplasia. Developmental abnormalities and other potential causes of death were not identified. Although deaths due to hypoglycemia cannot be reliably diagnosed postmortem using vitreous glucose levels, a clinical history of maternal glucose dysregulation in combination with certain gross and histologic findings should prompt a pathologist to consider maternal–fetal glucose dysregulation as a diagnosis of exclusion and cause of death.