1* Professor, Department Of Pathology, Sri Lalithambigai Medical College And Hospital, Dr M.G.R. Educational And Research Institute, Chennai. Orcid Id: 0009-0000-4588-7168, Email: dr.karthikapadmavathy88@gmail.com
2 Associate Professor, Department Of Forensic Medicine And Toxicology, Esic Medical College, Sanathnagar, 500038, Hyderabad, India. Orcid Id: 0009-0008-3859-9385, Email: ravikumarchary13@gmail.com
3 Pursuing Phd, Department Of Forensic Science, Specialization In Dna And Serology, Galgotias University, Plot No. 2, Yamuna Expy, Opposite Buddha International Circuit, Sector 17A, Greater Noida, Uttar Pradesh 203201. Orcid Id: 0009-0002-1298-2593, Email: navneetavi3@gmail.com
Background: The problem of unexplained cardiovascular deaths in the perinatal period is a significant diagnostic and medico-legal issue, especially since there is overlapping of maternal, fetal, and neonatal risk factors. Cardiovascular events can be silent clinically and the person may collapse suddenly leading to the absence of such events when a post-mortem examination is performed to identify the cause of death properly.
Methods: A retrospective medico-legal review was conducted on maternal, fetal, and neonatal deaths occurring from 22 weeks' gestation to seven days postpartum. Standardized autopsy protocols were applied, including gross examination, detailed cardiovascular assessment, histopathology, toxicology, and forensic scene analysis. Risk factor profiling and clinical history correlation were performed. Statistical analyses included descriptive and inferential methods to identify patterns and group-specific variations.
Results: Distinct cardiovascular patterns emerged across perinatal categories. Maternal deaths most frequently involved sudden collapse, ischemic changes, and arrhythmogenic mechanisms. Fetal deaths demonstrated a predominance of structural cardiac anomalies and placental vascular lesions. Neonatal outcomes reflected mixed etiologies, including myocardial fibrosis, ischemic injury, and congenital defects. Comparison of antemortem diagnoses with autopsy findings revealed substantial clinical-pathological discrepancies, particularly in fetal and neonatal cases, highlighting under-recognition of congenital and placental pathology.
Conclusion: The findings underscore the importance of comprehensive medico-surgical and forensic evaluations in perinatal cardiovascular deaths. Integrating autopsy data with clinical history significantly enhances diagnostic accuracy, informs maternal–fetal care improvements, and strengthens medico-legal accountability. Systematic cardiovascular assessment and placental examination should be prioritized in perinatal death investigations.
Keywords: Perinatal Mortality, Cardiovascular Pathology, Forensic Autopsy, Medico-Surgical Evaluation, Maternal-Fetal Health.
How To Cite This Article: Padmavathy K, Ravi Kumar B, Kumar N. Medico-Surgical Evaluation Of Unexplained Cardiovascular Deaths In The Perinatal Period: A Forensic Pathology Perspective. Int J Drug Deliv Technol. 2026;16(4):326. Doi: 10.25258/ijddt.16.4.34