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
+ Hardware
+ Software
+ How to use the atlas
+ Navigating through the text pages
+ Controlling the pictures
+ Logos and labels
+ What will you need to use the atlas
+ Bugs, problems
+ Netscape
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+ Some other Internet resources concerning dermatopathology and pathology
+ Support
+ Support
+ 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
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)