Pathology of death in infancy Flashcards
What problems with the umbilical cord can result in stillbirth
Prolapse
Constricting loop or knot
Velamentous insertion
What problems with the placenta can result in stillbirth
Praevia
Abruptio
Insufficiency
What problems with the amniotic fluid can lead to still birth
Chorioamniotitis
Oligohydramnios
Polyhydramnios
What problems with the uterus can lead to still birth
Uterine abnormalities
Rupture
What problems with mother can lead to still birth (6)
Diabetes Thyroid disease HT (essential or pregnancy) Lupus Cholestasis Drug misuse
What 2 things can happen intrapartum leading to still birth
Asphyxia
Birth trauma
4 histological changes that can be seen in intrapartum asphyxia
Capillary reduplication and calcification
Gliosis
Neuronal apoptosis
Macrophages
What distinguishes between acute mode of death and chronic mode of death
Acute= occurs in a few hours Chronic= days to several weeks
What are the main causes of acute mode of death
Placental abruption
Cord accidents
How does baby appear if death was acute
Well grown, no maceration, traces of meconium, liquid blood
How does baby appear if death was chronis
Moderate-advanced maceration
IUGR
How does placenta appear if death was acute
Normal feto: placental ratio
How does placenta appear if death was chronic
Small
Normal or higher feto: placental ratio
What age is included in infant mortality
<1 year
What is SUDI
Sudden unexpected death infancy
What is SUDI SIDS?
If an autopsy fails to demonstrate cause/ abnormality
What are the types of sudden unexpected deaths
- Baby found dead in cot/ bed
- Baby dies in parents/ carers arms–> instantaneous death
- Rapid death due to recognised illness
What reasons can there be if a baby is found dead in a cot
- Congenital heart disease
- Resp infections
- CNS infections
- Septicaemia
- Intoxication
- Seizures
- SIDS
- NAI
What is the definition of SIDS
Sudden unexpected death of an infant under 1 year of age, remains unexplained after thorough case investigation including a complete autopsy, examination of death scene and review of clinical history
When is SIDS most common
Winter
4-20 weeks
What are the risks for SIDS
Co-sleeping Male Maternal smoking LBW Social class City
What period is known as the critical development period
2-4 months
What is one hypothesis for the cause of SIDS relating to problems in the critical development period
Delayed development of arousal, CR control or CV control and thermal regulation
Laryngeal spasm
Failure to autoresusicitate
Abnormalities in what network are a suspected cause of SIDS
Serotoniergic
