Pathology
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Atlas of Neonatal Pathology
Marta Ježová, Josef Feit
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+ Introduction
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+ Neonatal pathology
Gross appearance of premature infant
Macroscopic appearance
  • Skin  —  very thin, red, wrinkled and translucent with easily visible veins. There is little subcutaneous fat.
  • Lanugo  —  none or abundant
  • Plantar creases  —  smooth feet with few creases
  • Breast buds  —  flat areola, little or no breast bud
  • Ear  —  little cartilage, stays folded
  • Genitalia male  —  smooth scrotum, undescended testes
  • Genitalia female  —  prominent clitoris, labia minora not covered by labia majora
  • Posture  —  hypotonic with extension of extremities
Pictures

Premature 24-week gestation newborn child with birth weight of 690 g. The baby survived only for a few minutes. Premature rupture of membranes was complicated by prolapse of upper right extremity. Immaturity, 24-week, Macro, autopsy (73857) Immaturity, 24-week, Macro, autopsy (73858)

Premature infant born at 31 week's gestation. The baby died of necrotising enterocolitis which is a frequent complication of immaturity. Immaturity, 31-week, Macro, autopsy (73859)

Premature twin infant born at 33 week's gestation. Birth weight was 1200 g. This twin had serious congenital heart defect. Immaturity, 33-week, Macro, autopsy (73860)

Hypotrophia, immaturity (25-week): Immaturity, hypotrophy (25th week), Macro, autopsy (74411)

Clinical signs

Early complications in virtually all body systems occur as a result of difficulties in maintaining homeostasis

A preterm infant has difficulties with fetal to neonatal transition and maintaining homeostasis i.e. temperature control, euglycemia, fluid and electrolyte balance. Preterm infants usually exhibit significant jaundice and profound anemia. Full enteral nutrition is a problem even in healthy a near-term infant.

Internal organs immaturity

  • Lung
    • hyaline membrane disease (HMD)
  • Intestine
    • necrotizing enterocolitis (NEC)
  • Brain
    • intraventricular hemorrhage (IVH)
    • periventricular leukomalacia (PVL)
  • Cardiovascular
    • patent ductus arteriosus (PDA)
  • Iatrogenic damage
    • barotrauma
    • pneumothorax (PNO)
    • intersticial lung emphysema
    • bronchopulmonary dysplasia (BPD)
    • retinopatia of prematurity (ROP)