Placental Pathology Examination, A Key Element of Fetal Autopsy: Case Report of a Home Abortion in a Vulnerable Patient.

Abstract

Introduction: Anatomopathological examination of the placenta is essential in forensic medicine and obstetrics to determine the underlying causes of miscarriages and fetal deaths.

Objectives: This study focuses on the importance of this examination in determining the causes of miscarriage, particularly in cases where the cause remains unexplained after the initial fetal autopsy.

Methods: We report the case of a 23-year-old patient with intellectual disability who was admitted to the emergency room for massive vaginal bleeding. Clinical examination and ultrasound revealed placental retention, requiring emergency surgery. A forensic investigation was opened due to the context: home abortion and the patient's mental vulnerability.  

Results: Histopathological analysis of the placenta revealed intervillous thrombosis, suggestive of placental malperfusion, a lesion frequently associated with late spontaneous abortions. This observation made it possible to confirm the spontaneous origin of the abortion and rule out suspicious circumstances.

Conclusions: This case illustrates that histopathological analysis of the placenta can reveal abnormalities that are sometimes undetectable at autopsy, and that collaboration between pathologists and forensic scientists is crucial in clarifying the circumstances of the abortion and guiding the judicial investigation.