Pathology
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Atlas of Neonatal Pathology
Marta Ježová, Josef Feit
Index
Contents
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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
+ Microsoft Internet Explorer
+ 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
Cranial trauma
Clinical signs
  • Caput succedaneum
    • hemorrhagic oedema involving the skin and subcutaneous tissues over the presenting part
    • has no clinical significance
    • with vaccum extraction a more circumscribed oedema with significant bleeding and damage to the skin may occur
  • Cephalhematoma
    • bleeding betwwen the periosteum and the bone, limited by bounderies of the individual bone
    • parietal bones usually involved
    • in up to 25% of cephalhematomas there is an underlying skull fracture
    • the extent of hemorrhage is rarely significant
    • commonly seen in uncomplicated vertex delivery
  • Subdural hemorrhage and tears of the dural folds
    • commonly found together because both result from the same type of injury  —  excessive frontooccipital compression or oblique distortion of head
    • tears of the dural folds in tentorium at the junction with falx or in the falx itself
    • hemorrhage results form rupture of the bridging veins or rarely from extension of the dural tears into the sinuses
    • relatively small hematomas in the posterior fossa can cause brain stem compression and death.
    • on the other hand small hematomas over the hemispheres are usually asymptomatic, but major can present with obvious signs of acute blood loss or anemia
  • Skull fractures
    • linear fractures of the parietal bones
    • depressed fractures of the parietal bones
    • multiradiate fractures of skull bones (usually parietal bones bilaterally)  —  associated with significant intracranial hemorrahage
  • Occipital osteodiastasis
    • separation of the squamous and lateral parts of the occipital bone (these parts do not fuse until the second year of life)
    • lower edge of the squamous occipital bone is displaced and rotated inward thus narrowing the foramen magnum
    • in fatal cases the displacement causes compression of the posterior fossa without massive hemorrhage, or the dura and sinuses are torn resulting in gross subdural hemorrhage in the posterior fossa
    • laceration of the cerebellum with cereberall emboli within pulmonary and other vessels have been reported
  • Spinal cord injury
    • excessive longitudinal stretching of the neck in breech delivery or excessive rotation in verex delivery (minority of cases)
    • grossly laceration or even total transection of the cervical cord is observed
    • the fetus is stillborn or dies in the early neonatal period with respiratory failure
    • serious spinal cord injuries occur etramely rare nowadays with increasing use of cesarean section in breech presentations