Pathology of death in infancy

Question 1

What problems with the umbilical cord can result in stillbirth

Answer 1

Prolapse
Constricting loop or knot
Velamentous insertion

Question 2

What problems with the placenta can result in stillbirth

Answer 2

Praevia
Abruptio
Insufficiency

Question 3

What problems with the amniotic fluid can lead to still birth

Answer 3

Chorioamniotitis
Oligohydramnios
Polyhydramnios

Question 4

What problems with the uterus can lead to still birth

Answer 4

Uterine abnormalities

Rupture

Question 5

What problems with mother can lead to still birth (6)

Answer 5

Diabetes
Thyroid disease
HT (essential or pregnancy)
Lupus
Cholestasis
Drug misuse

Question 6

What 2 things can happen intrapartum leading to still birth

Answer 6

Asphyxia

Birth trauma

Question 7

4 histological changes that can be seen in intrapartum asphyxia

Answer 7

Capillary reduplication and calcification
Gliosis
Neuronal apoptosis
Macrophages

Question 8

What distinguishes between acute mode of death and chronic mode of death

Answer 8

Acute= occurs in a few hours
Chronic= days to several weeks

Question 9

What are the main causes of acute mode of death

Answer 9

Placental abruption

Cord accidents

Question 10

How does baby appear if death was acute

Answer 10

Well grown, no maceration, traces of meconium, liquid blood

Question 11

How does baby appear if death was chronis

Answer 11

Moderate-advanced maceration

IUGR

Question 12

How does placenta appear if death was acute

Answer 12

Normal feto: placental ratio

Question 13

How does placenta appear if death was chronic

Answer 13

Small

Normal or higher feto: placental ratio

Question 14

What age is included in infant mortality

Answer 14

<1 year

Question 15

What is SUDI

Answer 15

Sudden unexpected death infancy

Question 16

What is SUDI SIDS?

Answer 16

If an autopsy fails to demonstrate cause/ abnormality

Question 17

What are the types of sudden unexpected deaths

Answer 17

• Baby found dead in cot/ bed
• Baby dies in parents/ carers arms–> instantaneous death
• Rapid death due to recognised illness

Question 18

What reasons can there be if a baby is found dead in a cot

Answer 18

• Congenital heart disease
• Resp infections
• CNS infections
• Septicaemia
• Intoxication
• Seizures
• SIDS
• NAI

Question 19

What is the definition of SIDS

Answer 19

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

Question 20

When is SIDS most common

Answer 20

Winter

4-20 weeks

Question 21

What are the risks for SIDS

Answer 21

Co-sleeping
Male
Maternal smoking
LBW
Social class
City

Question 22

What period is known as the critical development period

Answer 22

2-4 months

Question 23

What is one hypothesis for the cause of SIDS relating to problems in the critical development period

Answer 23

Delayed development of arousal, CR control or CV control and thermal regulation
Laryngeal spasm
Failure to autoresusicitate

Question 24

Abnormalities in what network are a suspected cause of SIDS

Answer 24

Serotoniergic

Question 25

What external stressors are suggested to cause SIDS

Answer 25

Minor URTI
Prone position
Bed sharing
Overheating

Question 26

What are the typical external findings of SIDS

Answer 26

Frothy fluid around nose

Cyanosis of lips and nail beds

Question 27

What are the typical internal findings of SIDS

Answer 27

Large thymus
Petechiae
Full lung expansion
Liquid heart blood
Empty bladder
Prominent peyers patches