MEMBERS OF GROUP

Christy Imelda Margaretha M Ketut Suwadiaya Vania Petrina Febrina Ernawati Ketut Wida Komalasari Supri Suryadi

INFANTICIDE

Act of a mother who kill her baby at the time of birth or as soon as after birth because the mother fear that the other people will discover that the mother has given birth.

CRITERIA OF INFANTICIDE
The perpetrator must be biological mother The victim must be own baby The killing must be done at the time of birth or shortly thereafter The motive is frightened of the other people discovered she has given birth and do not want to be ashamed

THE BASIC LAW OF INFANTICIDE IN INDONESIA

Pasal 341. Seorang ibu yang karena takut akan ketahuan melahirkan anak pada saat anak dilahirkan atau tidak lama kemudian, dengan sengaja merampas nyawa anaknya, diancam karena membunuh anak sendiri dengan pidana penjara paling lama tujuh tahun.

Pasal 342. Seorang ibu yang untuk melaksanakan niat yang ditentukan karena takut akan ketahuan bahwa ia akan melahirkan anak, pada saat anak dilahirkan atau tidak lama kemudian merampas nyawa anak sendiri dengan rencana, dengan pidana penjara paling lama sembilan tahun.

Pasal 343. Bagi orang lain yang turut serta melakukan kejahatan yang diterangkan dalam pasal 342 KUHP diartikan sebagai pembunuhan atau pembunuhan berencana.

Viable or not Cause of death the infant livebirth or stillbirth

How long the baby has been lived

Forensic examination signs of nursing

Sign of injuries

Aterm or not

1.Livebirth or Stillbirth

Livebirth: is a complete release of conception products, which after separation, baby breathe or show any other signs of life regardless of gestational age or condition of the placenta.

Stillbirth: is death of conceptus before exiting or incurred by the mother, regardless of gestational age (either before or after the age of 28 weeks gestation in the womb). Characterized by not breathing infants or theres no signs of life, such as heart rate, umbilical cord pulse or skeletal muscle movements

SIGNS OF LIFE
a.

Breathing Diaphragma position:

breathing infants: diaphragma location at costae 5 or 6. not breathing infants : diaphragma location at costa 3 or 4.

Lungs macroscopic
- Breathing infants: pink color, not homogenous(mottled), sponge-like consistency, - Not breathing infants: red purples color, homogenous, rubbery consistency

Lungs Floating test no touch technique Principle Specific gravity of an unrespired lung is 1040 to 1056. it is heavier than a respired lung whose specific gravity is 940. The foetal lungs therefore sink in water and those that have breathed, float. A negative result does not mean definitely stillbirth so that sometimes need a histopatologic examination to ensure stillbirth or livebirth Pulmonary floating test less reliable if it was obviously decomposed, so the test is not recommended

1. Remove the tounge through lower jaw 2. pull towards ventrocaudal until palatum mole appear then separated from the palatum durum

3. Releas Faring, laring, esophagus and trakea from fascia that attached on vertebrae 4.Tied Esofagus and trakea under cricoid cartilage

5. Organ expulsion of the tongue to the lung by using forceps or pincers and scalpel surgery 6. Tied esophagus above diaphragma then cut above the band 9. If small pieces of lung are float, apply pressure on small pieces of lung with cardboard and then put them again in water

7. Put it in the water and whether float or sink

8. Sequentialy separated and put in water: left and right lungs,each lobes, Five small pieces of periphery of each lobes

Lungs microscopic Lungs preparat fixation with formalin 10%, and histopatologic stain with Hematoxilin eosin Glands-like structure is sign that infants lung have not yet reached 26 weeks gestation Specific sign for unrespired lungs of infant is projection of cushion-like form that increase with thin base that looks club-like. Check for presence of meconeum and amnion fluid

NO. 1

Unrespired lungs Small volume, collapse, attach to the vertebra, dense consistency, no crackles

Respired lungs Volume 4-6x larger, partially covering the heart, such as the consistency of rubber foam (crackles positive) Blunt edge Pink color

2 3

Sharp edge Homogeneous color, purplish red If the lungs are squeezed under water there isnt gas bubbles came out or when there was a decay the bubble is large and different No alveoli which expands on the surface If it is squeezed less blood come out and forthy (except when there is decay) Lung weight less than 1/70 BW

Bubble gas soft and same size

5
6

Visible alveoli, sometimes separated each other When it is squeezed a lot of frothy blood came out although decaying not yet shown (the blood volume is twice much than before breath) Lung weight approximately 1/35 BW

All parts of the lungs sank in Parts of the lungs that inflate floating

SIGNS OF LIFE
b. Crying Cries that sounded not mean the baby is born alive because crying sound can occur either in uterus or vagina c. Muscle movement This situation must be witnessed by witnesses, because in post mortem could not be proven. d. blood circulation, heart beat and haemoglobin change Includes functional evidence that is umbilical cord pulse and heart rate (there must be a witnesses) and anatomical evidence that is changes in Hb and changes in the ductus arteriosus, foramen ovale and the ductus venosus

e. gaster and intestine content When there is foreign body found in gastric baby which can only be entered due to swallowing reflex, then this is evidence of life (livebirth) f. placenta condition - presence or absence of umbilical cord pulse after birth(there must be a witnesses) - drying of umbilical cord, position and type of knot, how umbilical cord was cut g. skin condition Maceration can occur when a baby has died a few day in the uterus(8-10 days)

Evidence of intra uterine fetal death: a. Ante partum rigor mortis which often cause difficulties during childbirth b. Maceration, is softener of infant in amniotic fluid marked by:

Brownish-red color (green color on decaying) White cuticule, often made bulae with reddish fluid. Limber bones and detached from soft tissue

Maceration occur when the infant was dead 8-10 days in uterus

NOT SIGNS OF NURSING

The body is still covered by blood The placenta is still attached to the umbilical cord and still connected with umbilicus. If the placenta does not exist, then the end of the cord seems irregular, it can be known by putting the end of the cord to the surface of the water. There are vernix caseosa on the forehead and in the area there are crease skin, such as crease armpits, groin and the back of the buttocks.

VIABILITY
Ages of gestation 28 weeks. Body Length 35 cm. Body Weight 2500 gram. Fronto-occipital circumference 32 cm. No severe birth defects. Example: anensefalus, esophageal stenosis

Aterm baby

Eksternal Characteristics

Center of Bone Reinforcement

Interpretation of age gestation

EKSTERNAL CHARACTERISTIC

Ears

Cartilage auricle was formed perfectly and when folded quickly returned to its original form.

Breast

Well defined nipple, areola protruding above the surface of the skin and areolas diameter > 7 mm.

Fingernails

Finger nails was passed over fingertips, and relatively hard so that the palm examiner firmly felt the scratch.

Foot Soles line

There are lines on the entire sole of the foot, from the front to the heel. We assessed lines that wide and deep.

Genitals eksterna Male : testicles was move perfectly to scrotum, and scrotal skin rugae was perfectly form. Female: labia minora was well covered by labia majora

Hair hair is relatively rough, each strand separated from each other and looked shiny. Hairline on forehead was obvious.

Skin opacity In mature infants, the fat tissue under the skin is thick enough so that a rather large blood vessels in the abdominal wall does not look or seem vague.

Processus xiphoideus In mature infants processus xiphoideus bent to dorsal.

Eyebrows In mature infants, eyebrows was complete..

OSSIFICATION CENTER

Distal femur, proximal tibia, and cuneiform cuboideum ossification appears at 36 weeks gestation. Talus and calcaneus ossification appears at 28 weeks gestation.

INTERPRETATION OF BONE AGE

First 5 months of head-heel length in centimeters is equal to the square of the number of months.

De Haas Formula

Last 5 months, the length of the body is the same as the number of months multiplied by the number 5.

Arey Formula

Age (months) = length of the head - heels (cm) x 0.2 Age (months) = length of the head - buttocks (cm) x 0.3

Finnstrom Formula

Using length oksipito-frontal head circumference . Gestational age = 11.03 + 7.75 (head circumference lenght)

Bleeding

Eritroblas tosis foetalis

Solusio Plasenta

Cause of natu ral death

Larynx eous spasm Immaturity, congenital disease Malforma tion

Mother death

Traumatic

Accidental death

Stranggulation of umbilical cord

Long duration of delivery

STRANGULATION

POISONED

BLUNT TRAUMA TO THE HEAD

Homicide

SHARP TRAUMA

DROWNING

SMOTHERING

EXAMINATION OF THE MOTHER

POST PARTUM SIGNS

HOW LONG THE BABY HAS BEEN DELIVERED a. size of the uterus return to its original size in 2-3 weeks b. lochia: 1-3 days post partum coloured red, 4-9 days post partum coloured white, 10-14 days post partum there is no sap childbirth c. genital laceration heals in 8-10 day

a. New rips on the genitals b. Ostium uteri can be passed by fingertips c. Bleeding from the uterus d. Uterine size e. Breasts secrete milk f. Hyperpigmentation of aerola mamma g. Striae gravidarum

Sign of Partus Precipitatus

a. rips on the genitals

b. invertio uterine c. rips of umbilical cord d. injuries to the baby's head that may cause bleeding under the scalp or within the skull

Histopathology examination

HOW TO PROVE SUSPECT IS THE MOTHER OF THE BABY?

CHECK THE TIME OF HAVING GIVEN BIRTH CHECK BLOOD TYPE DNA EXAMINATION

CHILD MURDER
Murder of the child when his age more than 1 day in life by father, mother and step parents as perpetrator. In Indonesia Infanticide vs Non infanticide

Motive Perpetator Time of death Victim

THE FACT
In 2007 there are 470 cases child abuse in Indonesia, 67 were killed while 23 was a rape cases with family were the perpetator. In 2004 there are 27 children were killed by their parents in Canada with father, mother and step parents as perpetator.

Altruism

Acute Psychosis

Unwanted children

RESNIK CLASSIFICATION

Accident al

Spousal revenge

ALTRUISM
Is a murder commited out of love to reliave the real or imagined suffering of the children <3 <3 <3<3<3 <3<3<3 <3<3<3<3<3 <3<3<3<3<3 <3<3<3<3<3<3<3<3 <3<3<3<3<3<3 <3<3<3<3 <3<3 <3

Jordan was a divorce mother kill her own son because of her financial problem. She think after her death,her son will have sexual abuse by her exhusband

Major Depresive

Acute Psychosis
Schizophren ia

ACCIDENTAL

Unintentional death due to child abuse

Generally following with BATTERED CHILD SYNDROME

Injuries sustained by a child as a result of physical abuse

SPOUSAL

BOUGET AND GAGNE CLASIFFICATION

CHILD MURDER BY MOTHER

It happen usually with depression and have a lack of mental and material support. Many factor can lead mother to do child murder.

Being primary caregiver

Financial problem

Factor

Abusive adult relationship

Limited social support

Conflict with family member

POSTPARTUM DEPRESSION

New mother

Giving a birth

JOYFUL L DEPRESS ED

POSTPARTUM DEPRESSION

Baby blue

Postpartu m depressio n

Postpartu m psychosis

1. Sleep disorder 2. Mood swing 3. Feeling of vulnerability

1. 2. 3. 4.

Anxiety Irritabality Fatigue Felling Guillty

1. Extreme confussion 2. Agitation 3. Feeling hopeless 4. Hallucinations occur

CHILD MURDER BY FATHER

Bourget and Gagne found there is 77 case of child murder by his father in Quebec while in different research they found there is 24 case of child murder by his mother in Quebec.

FAC TOR

1. Financial Problem 2. Insecure Married 3. Afraid of Separation

THE FACT

There is lack of reseach of child murder by father

There is no spesific basic law about child murder (non infanticide) in Indonesia, then basic law of child murder refer to KUHP pasal 338, 339, 340, 344, and children law.

Pasal 338 Barang siapa dengan sengaja merampas nyawa orang la in, diancam karena pembunuhan dengan pidana penjara p aling lama lima belas tahun.

Pasal 339 Pembunuhan yang diikuti, disertai atau didahului oleh sua tu perbuatan pidana, yang dilakukan dengan maksud untu k mempersiapkan atau mempermudah pelaksanaannya, a tau untuk melepaskan diri sendiri maupun peserta lainnya dari pidana dalam hal tertangkap tangan, ataupun untuk m emastikan penguasaan barang yang diperolehnya secara melawan hukum, diancam dengan pidana penjara seumur hidup atau selama waktu tertentu, paling lama dua puluh t ahun.

Pasal 340 Barang siapa dengan sengaja dan dengan rencana te rle bih dahulu merampas nyawa orang lain, diancam karena pembunuhan dengan rencana, dengan pidana rnati atau pidana penjara seumur hidup atau selama waktu tertentu, paling lama dua puluh tahun.

Pasal 344 Barang siapa merampas nyawa orang lain atas perm intaan orang itu sendiri yang jelas dinyatakan dengan kesungguhan hati, diancam dengan pidana penjara p aling lama dua belas tahun.

UNDANG-UNDANG PERLINDUNGAN ANAK

Pasal 13 (1) Setiap anak selama dalam pengasuhan orang tua, wali, atau pihak lain mana pun yang bertanggung jawab atas pengasuhan, berhak mendapat perlindungan dari perlakuan: a. diskriminasi; b. eksploitasi, baik ekonomi maupun seksual; c. penelantaran; d. kekejaman, kekerasan, dan penganiayaan; e. ketidakadilan; dan f. perlakuan salah lainnya. 2) Dalam hal orang tua, wali atau pengasuh anak melakukan segala bentuk perlakuan sebagaimana dimaksud dalam ayat (1), maka pelaku dikenakan pemberatan hukuman.

CONCLUSION
We can see the differences of infanticide and child murder (non infanticide) from 4 aspects: - Perpetrator, - Victim - Time - Motive - Basic law

Forensic examination must be done to the suspect (biological mother) and the victim (the baby). Purpose of the examination are to identify

Baby is live birth or stillbirth. The baby is viable or not. The baby is aterm or not. There is sign of nursing or not. Cause of death