Atlas of Neonatal Pathology
Marta Ježová, Josef Feit
+ Introduction
+ Using this atlas
+ Conditions of using this atlas
+ Technical notes
+ Hardware
+ Software
+ How to use the atlas
+ Navigating through the text pages
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+ 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
Meconium aspiration syndrome (MAS)

Meconium is the first intestinal discharge of newborn, viscous and dark green composed of intestinal epithelial cells, lanugo, mucus, intestinal secretions and swallowed amniotic fluid elements. Meconiumstained amniotic fluid may be than aspirated before or during birth causing neonatal respiratory distress syndrome. The causes of premature meconium passage in utero are not clear, hypoxic stress may play a role. Meconium aspiration syndrome is seen in term and postterm infants, it is rare before 34 weeks.

  • Risk factors (not always found)
    • placental insufficiency
    • maternal hypertension and preeclampsia
    • oligohydramnion, maternal drug abuse
  • Aspiration of meconium induces hypoxia via
    • airway obstruction
    • surfactant dysfunction
    • chemical pneumonitis
    • pulmonary hypertension due to hypoxic vasoconstriction of pulmonary arteries
    • the presence of meconium in the airways also predispose the infant to bacterial pneumonia
Clinical signs
  • severe respiratory distress
  • pneumothorax is frequent
Macroscopic appearance
  • the lungs are greenish brown in massive meconium inhalation but this is rare.
  • mostly the lungs are congested and airless with petechial hemorrhages.
  • meconium staning of skin and fingernails may be seen concurrently
  • meconium in the lungs is present as eosinophilic granular material with small yellowish meconium bodies and mucus
  • acute inflammation appears in survivors after several hours