HOW USEFUL IS POSTMORTEM EXAMINATION IN SUDDEN-INFANT-DEATH-SYNDROME

There exists great variability in the literature as to the percentage of cases of sudden and unexpected infant death in which definable caus es can be identified. Review was undertaken of the clinical and family histories, death scene features including parental interviews, and pa thological and microbiological features of 361 consecutive cases prese nting as sudden and unexpected infant death with minimal preceding sym ptoms and signs to the Adelaide Children's Hospital over a 10 year per iod from 1983 to 1992. Three hundred and twenty-nine cases of SIDS wer e identified. Nine cases (2.5 %) were attributed to accidental asphyxi a based partly on death scene examination. This left only 23 cases (6. 4 %), which were due to a variety of other diverse entities including sepsis, volvulus with sepsis, congenital cardiac disease, probable met abolic disorders, heat stroke, and unclassifiable disorders. This rela tively low figure lends support to definitions of SIDS that emphasize the importance of death scene investigation and clinical history revie w prior to postmortem examination.