Pathology
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Atlas of Neonatal Pathology
Marta Ježová, Josef Feit
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+ Introduction
+ Using this atlas
+ Conditions of using this atlas
+ Technical notes
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+ How to use the atlas
+ Navigating through the text pages
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+ Support
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+ Neonatal pathology
+ Basic terms and classification of newborn infants
+ The Apgar score
+ Classification of newborn infants by weight and gestation
+ Pathology of gestation length
+ Prematurity
+ Postmaturity (Clifford syndrome)
+ Growth and developement
+ Intrauterine growth retardation (IUGR), small for gestational age infant (SGA)
+ Large for gestational age infant (LGA)
+ Physical maturity
+ Pathology of prematurity
+ Gross appearance of premature infant
+ Difficulties in maintaining homeostasis
+ Thermoregulation
+ Hypoglycemia
+ Hyperbilirubinemia
+ Fluids and electrolytes
+ Apnea of prematurity
+ Anemia of prematurity
+ Hyaline membrane disease (HMD)
+ Necrotizing enterocolitis (NEC)
+ Intraventricular hemorrhage (IVH)
+ Periventricular leukomalacia (PVL)
+ Patent ductus arteriosus (PDA)
+ Iatrogenic diseases and damage
+ Respiratory system
+ Injuries caused by endotracheal intubation
+ Pulmonary air leak
+ Bronchopulmonary dysplasia (BPD)
+ Retinopathy of prematurity (ROP)
+ Cardiovascular system
+ Total parenteral nutrition associated hepatic damage
+ Infections
+ Viability, survivability and long term sequelae of prematurity
+ Viability
+ Survivability in prematurity
+ Severe long term sequelae in babies born prematurely
+ Birth asphyxia
+ Hypoxic-ischemic encephalopathy (HIE)
+ Meconium aspiration syndrome (MAS)
+ Persistent pulmonary hypertension of the newborn (persistent fetal circulation)
+ Birth trauma
+ Extracranial lesions
+ Soft tissus injuries
+ Intraabdominal injuries
+ Peripheral and cranial nerve injuries
+ Bone injuries
+ Cranial trauma
+ Perinatal infection
+ Intrauterine infections (TORCH group)
+ Sepsis neonatorum
+ Blenorrhea neonatorum
+ HIV infection
+ Stillbirth and perinatal mortality
+ Stillbirth
+ Perinatal mortality
+ Neonatal pathology nonrelated to prematurity, birth asphyxia or infection
+ Congenital anomalies in liveborn infants
+ Kernicterus
+ Hemorrhagic disease of the newborn
+ Spontenous gastric perforation in a neonate
Classification of newborn infants by weight and gestation
Classification

Newborn classification based on gestational age

  • Preterm (premature)  —  born at 37 weeks' gestation or less
  • Term  —  born between the beginning of week 38 and the end of week 41 of gestation
  • Post-term (postmature)  —  born at 42 weeks' gestation or more

Newborn classification based on birth weight

Low birth weight (LBW)  —  less than 2500 g Very low birth weight (VLBW)  —  less than 1500 g Extremely low birth weight (ELBW)  —  less than 1000 g

Newborn classification based on birth weight and gestation is valuable in predicting the outcome. At any gestation the poorest outcome is seen in infants with marked intrauterine growth retardation.

  • Appropriate for gestational age (AGA) —  weight is appropriate for the gestational age
  • Small for gestational age (SGA) —  smaller than expected, the weight falls bellow the 5th percentile for the gestational age
  • Large for gestational age (LGA) —  heavier than expected, the birth weight is above the 95th percentile for the gestational age
Clinical signs

Evaluation of newborns enables to predict complications which may occur during fetal to neonatal transition period. Premature infants are at main risk of organ system immaturity espacially respiratory. Hyperbilirubinemia and hypothermia is a frequent problem, there is an increased risk of infection and sepsis. SGA infants are at high risk of birth asphyxia, there is often transient hypoglycemia and hypothermia even in term hypotrophic infants and increased incidence of cogenital anomalies and intrauterine infections as the underlying condition of growth failure.

Pathology of gestation length
Growth and developement