Useless and limits of Postmortem CT (PMCT) in a complex case of preterm infant murder

The present case-report empathizes the usefulness of post-mortem computed tomography (PMCT) in the detection of live birth signs in a baby found dead, comparing the results with standard autoptic, histologic and immunohistochemical examinations. The report describes the case of a new-born who was thrown out on the footpath from a window of the fifth floor according to the investigative police, whilst the mother has hidden herself immediately after childbirth. PMCT showed diffusely aerated lung parenchyma with signs of severe lung distress, air in the airways with no fluid inside, and air in the upper gastro-intestinal tract, in absence any resuscitation manoeuvres performed on the baby at delivery. PMCT underlined multiple fractures of the skull with degeneration of cerebral parenchyma. All these findings were confirmed by conventional autopsy and histological and immunohistochemical examinations, clinching the usefulness of PMCT in differentiating live births from stillbirths. •PMCT is useful to identify signs of vitality after birth - aerated lung parenchyma and air in the gastrointestinal tract.•Major limitations of PMCT is the absence of clinical details at delivery consequently, conventional autopsy and specimens remains crucial.•PMCT should not replace conventional autopsy, but provide important information for the conduction and interpretation of it.