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Introduction: Every neonatal death causes much distress to parents making the ward-staff vulnerable to accusations
of medical mismanagement. JMO was confronted with two main issues: the possibility of malicious exchange and
whether the life would have been saved with early intervention Case Report:: A 17 year old primi with a 36 week POA was admitted with dribbling on the same day. She was!
managed conservatively for three days. On the third day she developed a mild fever and a lower abdominal pain and '
went into spontaneous labour to deliver a severely asphyxiated baby girl of 2.5 kg. who died 7 hrs 30 nits after
delivery. The parents were preoccupied with the gender of their unborn child preparing blue clothing anticipating a
baby boy. The labour-room staff has clad the child with pink clothing for genuine reasohs creating"a grave suspicion
in the bereaved mother of malicious exchange of her healthy boy for a sick girl. The medico-legal* investigation
concluded the cause of death as birth asphyxia (peripartum hypoxia) with intra-cerebral haemorrhages. ,
Discussion: Simple measures of effective communication such as showing the gender of the newborn to the mother
at the time of delivery would certainly have prevented issues regarding wrongful identity. Birth asphyxia has 1
numerous causes most of which cannot be established at a routine autopsy, Whether there was an element of ehorio- j
amnionitis is a clinical decision beyond the purview of JMO. Serious consideration should be given to the fact 1
whether the outcome could have been better if the baby had been delivered early through Caesarian section in the
context of marginal prematurity, teenage pregnancy and possibility of uterine infection.
