Perinatal pathology Flashcards
What is the definiton of miscarriage? [1]
What is the definiton of stillbirth? [1]
What is early and late neonatal death? [2]
What is infant death? [1]
Miscarriage: pregnancy loss <24 weeks
Stillbirth: baby born >24 weeks with no signs of life
Neonatal death: baby born live but dies in first 28 days of life
- Early neonatal: 0-7 days death
- Late neonatal: 7-28 days death
Infant death: anytime in first year
When do most of the 3500 deaths in children in the UK occur? [1]
< 4 weeks (but mainly the first day)
WHO recommends at least [] antenatal visits to reduce 8 in every 1000 births
WHO recommends at least 8 antenatal visits
What are biggest global causes of neonate death? [3]
What are biggest global causes of stillbirths? [3]
Neonates:
* Preterm
* Infections
* Birth complications (e.g. birth ashpyxia /
Still births:
* Malaria
* syphilis
* Diabetes & obesity
Name 8 causes of neonatal and infant death
Complications of prematurity
Complications of delivery: e.g. birth asphyxia
Congenital malformations, chromosomal abnormalities” known (antenatal diagnosis), unknown (SUDI)
Infection (SUDI, SUDC)
Accidents: e.g. drowning, suffocation, foreign body aspiration
Trauma: Road Traffic Accidents (SUDI, SUDC)
Non-accidental injury (NAI): inflicted injury
Unexplained deaths : SIDS
What are steps for a perinatal post mortem exam? [6]
- Clinical history and circumstance of death
- Radiology (XR)
- Check identification
- Body weight and measurements (IUGR)
- External signs of injury (skin lacerations / bruises / torn frenula / perineum and anus)
- External signs of disease (Dysmorphism and deformities rashes / oedema / jaundice)
Most common cause of deaths in newborns is []
Infections: Pneumonia 1st, RSV 2nd
Which ancillary investigations would you conduct in a post-mortem exam? [4]
Bacteriology
Virology
Toxicology
Metabolic and genetic studies
Ancillary investigations: which metabolic and genetic studies would you conduct if perinatal death has occured [4]
Vitreous humor (slow turn over – so stores problems)
Guthrie card: blood and bile spots
Skin for fibroblast culture
Frozen tissue: muscle, heart, liver, kidney for oil-red-O, to assess for abnormal fat accumulation
What internal examinations would you conduct in post-moretm?
Sampling: blood, fluids, tissue samples,
- Organ examination (weigh & exam); tissues samples from all organs
- Open skull: remove and weigh the brain (fix in formalin for 1-2 weeks prior to dissection & sampling)
What is SUDI? [1]
SUDI = sudden unexplained death in infancy
How does respiratory syncytial virus cause infant death? [1]
How does this appear histologically? [2]
RSV accounts for many cases of pneumonia in children under 2
Histologically:
* giant cells / macrophages with intracytoplasmic inclusion
* massive infiltrate of lymphoid cells in walls of bronchi causing obstruction
Mother delivers which immunoglobulin across the placenta? [1]
IgG
Which viruses is hand, foot and mouth disease commonly caused by? [3]
Describe pathology
Enterovirus 71 Virus
Coxsackie virus
Kawasaki virus
Causes neurological or cardiac complications including death
Kawasaki disease causes medium vessel vasculitis of children that can cause coronary artery aneursym
Explain pathophysiology of Marfans syndrome causing sudden death (include gene mutation) [2]
Lack of Fibrillin covering elastin due to mutation in FBN1 gene.
Can cause aortic aneurysm which burst
Which causative agent most likely caused this pneumonia? [1]
Cytomegalovirus
Parainfluenza virus
Respiratory syncytial virus
Adenovirus
Which causative agent most likely caused this pneumonia? [1]
Cytomegalovirus
Parainfluenza virus
Respiratory syncytial virus - Multinucleated giant cells can be seen within the bronchial epithelium and neighboring alveoli.
Adenovirus
What type of virus caused this lung infection? [1]
RSV
. Multinucleated giant cell (MNGC) of respiratory syncytial virus infection
demonstrating a large intracytoplasmic inclusion (arrow); (H&E, 1000 ). MNGCs
are more commonly seen within alveoli than within bronchioles.
