Difference between revisions of "Fetal autopsy"
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# [[Pituitary]]. | # [[Pituitary]]. | ||
== | ==Microscopic== | ||
===Adrenal gland=== | ===Adrenal gland=== | ||
*Centre regresses. | *Centre regresses. | ||
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*Can be access with ''oil red O'' staining. | *Can be access with ''oil red O'' staining. | ||
The pattern of adrenal fat is informative about intrauterine demise:<ref>{{cite journal |author=Becker MJ, Becker AE |title=Fat distribution in the adrenal cortex as an indication of the mode of intrauterine death |journal=Hum. Pathol. |volume=7 |issue=5 |pages=495–504 |year=1976 |month=September |pmid=964978 |doi= |url=}}</ref> | The pattern of adrenal fat is informative about duration of stress prior to (intrauterine) demise:<ref>{{cite journal |author=Becker MJ, Becker AE |title=Fat distribution in the adrenal cortex as an indication of the mode of intrauterine death |journal=Hum. Pathol. |volume=7 |issue=5 |pages=495–504 |year=1976 |month=September |pmid=964978 |doi= |url=}}</ref> | ||
*Pattern I: scant fat/fat only close to medullary zone; acute | *Pattern I: scant fat/fat only close to medullary zone; acute death/no stress reaction. | ||
*Pattern II: widespread fat; | *Pattern II: widespread fat; subacute death/moderate stress reaction. | ||
*Pattern III: massive fat - fetal zone and cortex; | *Pattern III: massive fat - fetal zone and cortex; chronic death/marked stress reaction. | ||
===Kidney=== | ===Kidney=== | ||
Revision as of 16:13, 25 March 2011
The fetal autopsy is done to determine the cause of death in a fetus. An introduction to the autopsy is in the autopsy article.
External exam
Post-mortem changes
Sequences of changes with intrauterine death:[1]
- Normal ~0-12 hours.
- Skin blistering - usu. prominent on head ~12-48 hours.
- Moderate skin separation (sloughing) - usu. hands & feet ~48-72 hours
- Massive skin separation and loosing of symphysis menti (midline mandible), symphysis pubis ~72+ hours.
Common measures[2]
- Body mass (weight).
- Crown-to-heel length.
- Crown-to-rump length.
- Occipito-frontal circumference.
- Chest circumference - at nipples.
- Abdominal circumference - at umbilicus.
Routinue sections
- Rib.
- Thymus, skin, diaphragm, psoas muscle.
- Rectum, duodenum, ileocecal region, mesentery.
- Adrenal gland.
- Kidney.
- Bladder.
- Internal genitalia.
- Spleen.
- Stomach, GE junction, GD junction, pancreas.
- Liver.
- Right lung.
- Left lung.
- Heart.
- Upper airway with thyroid.
- Pituitary.
Microscopic
Adrenal gland
- Centre regresses.
Fat pattern
- Can be access with oil red O staining.
The pattern of adrenal fat is informative about duration of stress prior to (intrauterine) demise:[3]
- Pattern I: scant fat/fat only close to medullary zone; acute death/no stress reaction.
- Pattern II: widespread fat; subacute death/moderate stress reaction.
- Pattern III: massive fat - fetal zone and cortex; chronic death/marked stress reaction.
Kidney
- Cortex regresses.
Lung
- PMNs may be seen in chorioamnionitis.
- Meconium-laden macrophages may be seen.
Thymus
- Hassall's corpuscles (thymic corpuscle).
Image:
Amnion rupture sequence
A term that encompasses:[4]
- Amniotic band syndrome.
- Amniotic adhesion sequence.
- Limb-body wall complex
Etiology
- Congenital.
- Karyotypes is normal.
Gross
- Autoamputation of appendages and body wall defects +/- anomalies of internal organs.
Developmental stuff
- Chiari malformations (from least severe to most severe):
- Chiari type I.
- Chiari type II.
- Chiari type III.
- Dandy-Walker syndrome.[5]
- Complete or partial agenesis of the vermis.
- Cystic dilatation of the fourth ventricle.
- Large posterior fossa.
Growth parameters
Main article: Growth charts
See also
References
- ↑ Burton, Julian L.; Rutty, Guy N. (2010). The Hospital Autopsy A Manual of Fundamental Autopsy Practice (3rd ed.). Oxford University Press. pp. 191. ISBN 978-0340965146.
- ↑ Burton, Julian L.; Rutty, Guy N. (2010). The Hospital Autopsy A Manual of Fundamental Autopsy Practice (3rd ed.). Oxford University Press. pp. 196, 198. ISBN 978-0340965146.
- ↑ Becker MJ, Becker AE (September 1976). "Fat distribution in the adrenal cortex as an indication of the mode of intrauterine death". Hum. Pathol. 7 (5): 495–504. PMID 964978.
- ↑ URL: http://moon.ouhsc.edu/kfung/jty1/neurotest/Q11-Ans.htm. Accessed on: 26 October 2010.
- ↑ URL: http://moon.ouhsc.edu/kfung/jty1/neurotest/Q12-Ans.htm. Accessed on: 26 October 2010.