June 'Katie' Jones had at least 21 knife wounds in her neck and the left side of her chest that were in tight clusters, Wolverhampton Crown Court was told.
Home Officer pathologist Dr Alexander Kolar, who carried out the post mortem examination, said while giving evidence to the trial of her partner Michael Folan who admits her manslaughter but denies murder: "Close clustering of the injuries suggests a lack of mobility and a possible lack of consciousness."
Evidence of bruising and pressure to the neck indicated Ms Jones had been asphyxiated while alive.
The thyroid cartilage which forms part of the protective structure of the larynx had been fractured on both sides, explained Dr Kolar.
He was asked by Mr Anthony Berry QC, defending Folan, if this could have brought about unconsciousness before she was stabbed in the bath at her first floor flat in Wyndmill Crescent, West Bromwich.
The pathologist replied: "I think that is the most likely explanation."
A knife similar to those in the kitchen was found lying on top of her body, near her head, revealed Mr Mark Heywood QC prosecuting.
The prosecution believe that Ms Jones lost her life on December 10 last year but the body was not discovered until New Years Eve - the day Folan was driven to Liverpool by his 34-year-old friend Keith O'Dwyer, who lived in Beaconview Road at a block of flats opposite Wyndmill Crescent.
He claimed to know nothing about the killing and said he was told Foran was leaving because he had nothing to keep him in the area after Ms Jones had supposedly left him, the court heard.
The defendant was driven to King Harry's Bar and Hostel on Blessington Road in the Anfield district of Liverpool where he booked in for two nights under the name of Michael.
After his stay had ended the hostel's manager Martyn Matthis saw the photograph of Foran in a local paper on January 3 and realised he was Michael.
The defendant was arrested two days later after being spotted sitting on the pavement with a dog begging outside a city centre shop. He had Ms Jones' debit card, the court was told.
O'Dwyer had been arrested two days earlier.
He denies assisting an offender while Foran admits manslaughter but pleads not guilty to murder.
The case continues.