3. By Falls.—It is beyond doubt possible for a child to be born so precipitately as to fall on the floor and be severely injured, and that even fatally. In cases of alleged precipitate birth, to account for injuries found on the child, the following points should be remembered, and will assist in forming a diagnosis:
1. In Favour of Precipitate Birth
and Accidental Injury
(a) Rupture of the umbilical cord. In all cases it would be advisable to measure the length of the cord, and then the distance of the vulva from the ground, allowing of course for the woman not being quite erect at the time of delivery owing to a separation of the legs. A disproportion between the two measurements may or may not account for the rupture of the cord. The following measurements may be taken: usual length of cord, eighteen to twenty inches; distance of vulva from the ground, twenty-six inches, but allowing for stooping, two-thirds of the above. To the length of the cord must be added about nine inches, the distance from the navel to the top of the head of the child. Thus, a fall of about thirty inches will put no strain on the cord. A case is on record of a rupture of the cord taking place while the woman was in a recumbent position, but in that case the labour was precipitate, and the cord very short and small.
(b) Placenta not detached from the child.
(c) Fracture of the parietal bones; the fracture radiating into the frontal and squamous portion of the temporal bone. In experiments on twenty-five children dropped from a height of thirty inches, one parietal bone was found fractured in sixteen of the cases; both parietals, in six cases. The fractures in most cases occurred about the parietal protuberances. It must be remembered that the children were dead, and that it is easier to fracture the skull of a live infant than that of a dead one.
(d) Imperfect ossification of the bones of the skull.
(e) Absence of other injuries.
2. In Favour of Criminal Violence
(a) The fact of the umbilical cord being divided by some sharp instrument and not torn. A caution must be here inserted, for Taylor mentions a case where rupture of the cord occurred in such a manner that it could not be decided whether it had been intentionally cut or torn.
(b) Extensive fracture of one or more of the bones of the cranium.